Hidden Valley Road - Inside the Mind of an American Family - Robert Kolker Page 0,36

he was there, they did not have the slightest idea what to do with him.

Donald needed help. But what help was available to him? Assuming he’d be willing to go, a private facility like Chestnut Lodge in Maryland or the Menninger Clinic in Topeka—or, closer to home in Colorado Springs, a hospital called Cedar Springs—was too expensive an option for the Galvins. The public hospitals, meanwhile, were a terrifying prospect, places where the peace was kept using neuroleptic drugs and restraints—the stuff of Samuel Fuller’s nightmarish film Shock Corridor, released in 1963. In 1967, the state of Massachusetts made headlines by litigating to stop the distribution of documentarian Frederick Wiseman’s film Titicut Follies, an exposé of the inhuman conditions at that state’s Bridgewater State Hospital, filled with images of inmates stripped naked, force-fed, and bullied by the people who were supposed to be keeping them safe. In Colorado, the very large state mental hospital in Pueblo, about an hour’s drive from Hidden Valley Road, was best known for treating schizophrenia with insulin shock therapy and a powerful drug called Thorazine. Don and Mimi would have to exhaust virtually every other option on the table before agreeing to send Donald to a place like that. A state hospital like Pueblo was for hopeless cases, not healthy young men like their son.

There was an alternative to the brutal public institutions, but that alternative also was hardly attractive to Mimi. The psychoanalytic approach advocated by Frieda Fromm-Reichmann and others held sway at the Colorado Psychiatric Hospital in Denver, part of the university system. This hospital was steeped in the teaching of schizophrenia as a psychosocial disorder, focusing on the “psychodynamic” origins of mental illness—the schizophrenogenic mother. Mimi and Don may not have known the particulars of this approach—how a psychoanalyst would want to know exactly how Donald was raised, and if there was something they could have done differently—but they understood the threshold they would be crossing by sending their son to a mental hospital of any kind.

Again, they thought, were things really so far gone? After all, it seemed clear that diagnosing schizophrenia was—and in many ways remains—more of an art than a science. None of the symptoms, taken by themselves, were specifically characteristic of the illness, and so doctors could only diagnose it by excluding other possibilities. The American Psychiatric Association had published the first edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM, fourteen years earlier. The definition of schizophrenia was about three pages long, and included the subtypes originally proposed by Eugen Bleuler—hebephrenic, catatonic, paranoid, and simple schizophrenia—and added five more: schizoaffective, childhood, residual, chronic undifferentiated, and acute undifferentiated. The definition was roundly panned: In 1956, one prominent psychiatrist, Ivan Bennett, called the DSM’s definition of schizophrenia “a wastebasket diagnostic classification,” preferring instead to focus on what drugs might be helpful in treating the symptoms. Since then, the DSM has changed its description of schizophrenia with each successive edition, often tailoring it to the prevailing style of treatment. The second edition of the DSM, published in 1968, added “acute schizophrenia,” characterized by hallucinations and delusions and nothing else. But there would continue to be no consensus on what schizophrenia actually was. A single illness, or a syndrome? Inherited, or acquired through trauma? Don and Mimi understood that for people in their son’s shoes, whether you even had schizophrenia or not often depended on the priorities of the institution where you were being examined.

There was no talk of prevention. There was very little discussion of a cure. But one thing seemed true: If they admitted Donald to anything resembling a mental hospital, the only certainties were shame and disgrace, and the end of Donald’s college education, and the tainting of Don’s career, and a stain on the family’s position in the community, and finally the end of the chance for their other eleven children to have respectable, normal lives.

Which was why, for Mimi and Don, the most sensible—or at least the most realistic—decision was to hope, somehow, that things would get better on their own. The more they thought about it, the more they decided to be optimistic. Why couldn’t he move on from Marilee, find his footing again, move out of that fruit cellar and into the dorms, and get better? They needed to believe that he could. And so they searched for