Hidden Valley Road - Inside the Mind of an American Family - Robert Kolker Page 0,156

she couldn’t understand? Only later did she arrive at the idea that the natural world Mimi had fallen in love with in Colorado offered her some small measure of solace, a refuge from everything else that was happening.

Once Margaret, in her adult years, finally worked up the bravery to start painting, her subject, more often than not, was the very thing she had spent a lifetime trying to avoid: her family. She painted flowers that her mother loved, with a stirring realism. She made one painting about the Garys, called Gray Ease; another called Sophisticated, about her own journey, learning to be vulnerable; and another called Compartmentalizing the Grief. She veered into abstraction in a striking series of twelve paintings based on the twelve Galvin children. Donald is red and white; Jim is a spectral black and white; John, Brian, Michael, and Richard are variations on greenish yellow; Joseph is yellow with red seeping through; Mark, Matthew, and Peter are all studies in red, with only Peter’s including flashes of blue.

Mary is a cross-hatch of thick streaks of soft pink, inflected here and there with black. And Margaret’s self-portrait is similar to her sister’s, only with less pink and more vivid rust-colored flecks.

When, a few years before Mimi died, Margaret helped relocate Peter to his assisted living facility, that inspired another piece, Moving Peter, that seemed like a step forward for her—complex and layered and full of the feelings she found so hard to process any other way. “It just became this emotional outpouring,” Margaret said.

This was the painting Nancy Gary bought, snapping it up before an old classmate of Margaret’s from the Kent Denver School had the chance to buy it.

CHAPTER 43

Our culture looks at diseases as problems to solve. We imagine every ailment to be like polio: hopelessly incurable, until a miracle drug comes along that can wipe it off the face of the earth. That model, of course, only works some of the time. Too often, scientists get lost in their own silos, convinced their theory works to the exclusion of everyone else’s. Whether it’s the Freudians and the Kraepelinians or the family dynamics specialists and the geneticists, the unwillingness to collaborate leaves everyone vulnerable to confirmation bias—tunnel vision. The schizophrenia researcher Rue L. Cromwell described this dilemma in the 1970s: “Like riding the merry-go-round, one chooses his horse. One can make believe his horse leads the rest. Then when a particular ride is finished, one must step off only to observe that the horse has really gone nowhere. Yet, it has been a thrilling experience. There may even be the yen to go again.”

But there is another model for progress—the opposite of the polio model—one in which solutions are not the same as breakthroughs. Progress comes gradually, often painfully, in fits and starts, and only after many people spend their entire careers failing and quarreling and, finally, reconciling. Sooner or later, some ideas fall away as others take hold. And, perhaps only in hindsight, we can see how far we’ve come, and decide on a path forward.

What would progress look like for schizophrenia? If the Galvin boys had been born a half century later or more—growing up today, let’s say, and not in the 1950s or 1960s—would their treatment be any different now? In some respects, little has changed. The market for new schizophrenia drugs remains sluggish. Antipsychotic drugs require expensive and risky testing, even in the early trials, where rats are no substitute for humans. And the same nature-nurture squabbles over the source of the illness have continued, if at a more granular level. Where the conversation once was about Freud, now it’s about epigenetics—latent genes, activated by environmental triggers. Researchers now argue about what might be playing the part of a trigger—something ingested, like marijuana, or infectious, like bacteria? Researchers have come up with a variety of other suspects—head injuries, autoimmune diseases, brain-inflammation disorders, parasitic microbes—all of which have their adherents and detractors. Everyone still picks their horse on the merry-go-round, and very few are willing to stop taking the ride.

There are, however, more subtle changes—as if the atmosphere around the disease has changed a little, charged with a new sense of tolerance. Anti-psychiatry, in its latest incarnation, has become a movement concerned with legitimizing and normalizing the concept of hallucinations—a Hearing