The most dramatic instances were among people who were psychotic for the first time. These were people with acute schizophrenia, who were able to go into their psychoses, to go down into their madness, often to regress to earlier stages of their lives, and then to grow up again. That happened in several instances it was very powerful.
DR: To turn the breakdown into a breakthrough.
JG: That?s right. Exactly. With people who had been psychotic for a long time, it was harder. It had become a very fixed pattern in their lives. But even with those people, they were able to express themselves more freely and able to feel more relaxed. One young guy remarked, "Everywhere else I?m crazy, but here I?m sane." He became a member of our community and he was able to function. So it was a very powerful experiment.
When I came to the National Institute of Mental Health after my residency, I was still quite interested in working with very troubled and troubling people. I was working with runaway and homeless kids, and runaway houses that worked with those kids, trying to see, again within the context of a place that respected their experience, if their experience could change.
I began to think about what we could do by changing our attitude toward people and changing the setting in which we treated them, creating a real therapeutic community. But I also started wondering about biology, and whether there was a way to work with biology to promote transformation. I thought medication and electroshock therapy simply suppressed the symptoms, and what I was interested in was seeing if this process of transformation, this kind of breakthrough that you mentioned, could happen on a biological basis. So I was open to the possibility of looking at other kinds of alternative therapies.
DR: Did your experience at Einstein at that special ward turn out to be one unique and wonderful episode, or was it something that grew and developed in other settings?
JG: Later, when we were working with the runaway kids, it was based on the same kind of principle. The counselors who had created these programs initially were very much on the same wavelength as I was. They were not psychiatrists or mental health professionals, some were ministers, some were draft resisters, some were hippies, they were just people who wanted to create an environment that was friendly to these kids. They saw themselves as big brothers and sisters to the kids. It didn?t occur to them to think in diagnostic terms. It didn?t occur to them to see these kids as having a disease. They were very puzzled and troubled by how disturbing some of the kids were, and how upset some of them were. It was my job to help them to understand the inner experience of these kids, and to create a setting where the kids could go through that experience, in which they would be dealt with as people and not as patients.
DR: It sounds like even back then you were playing a bridging role between the alternative culture and the establishment.
JG: That?s right. I feel that has been my role at least since that time.
DR: What forms is that taking now?
JG: I have all these establishment credentials: Harvard College, Harvard Medical School, residency in psychiatry, ten years at the National Institute of Mental Health. What I?m trying to do is use the credentials, and my experience as somebody who has the capacity to take a hard critical look at these therapies, and to say, "Let?s take this look, but let?s do it in an open-minded way. Let?s open ourselves to the experience of some of these approaches, and let?s look at the actual scientific literature that backs them up."