Soteria [Hardcover]

Loren R. Mosher Voyce Hendrix wi Fort (Author)

Book Description

Publication Date: December 21, 2004

This is the story of a special time, space, and place where young people diagnosed as

Editorial Reviews

About the Author

After studying at Stanford University, Loren R. Mosher received his MD from Harvard Medical School in 1961. His psychiatric training took place at Harvard and at the National Institute of Mental Health's Intramural Program in Bethesda, MD. After working with Anna Freud, John Bowlby, R. D. Laing, and others in London, Dr. Mosher served as Chief of the Center for the Studies of Schizophrenia at the NIMH from 1968 to 1980 during which time he designed and implemented the Soteria Project. He also established and was first editor-in-chief of the Schizophrenia Bulletin. In 1980, he studied Italy’s radical new mental health law. From 1981 to 1988, he was professor of psychiatry at the Uniformed University of the Health Sciences (Maryland). From 1988 to 1998 he was medical director of two county-wide public mental health systems in Maryland and California. His last posts were as clinical professor of psychiatry at the University of California at San Diego and director of! Soteria Associates in San Diego. Soteria was complete and at the publisher when Dr. Mosher died in 2004.

After earning his undergraduate degree in American Studies with a minor in sociology from California State University—Fresno, Voyce Hendrix, LCSW, took an MS in social work at the University of Wisconsin—Madison. Before completing his formal studies, he worked in the field of mental heath in state institutions, private hospitals, and community-support programs. Hendrix took part in research examining alternatives to treatment in psychiatric hospitals in the community (Soteria) and at the Mental Research Institute in Palo Alto. This research was funded by the National Institute of Mental Health. Hendrix also worked as a licenced psychiatric technician and served as an administrator. He is now a licenced clinical social worker practicing in Wisconsin. His 40-year career has offered him comprehensive experience with a wide spectrum of services and models for helping those who suffer and experience alternative states of reality and has taught him that there are no simple answers! for disturbed and disturbing persons in pain.

Washington, D.C.-area freelance writer and editor Deborah C. Fort earned her PhD in comparative literature from the University of Maryland in 1974. After a decade of teaching English and writing at the college level, she turned full-time to writing and editing, specializing in science, education, and women's issues. Of the numerous books on which she has worked, she is proudest of her service as association editor on Gifted Young in Science: Potential Through Performance (National Science Teachers Association, 1989) and A Hand Up: Women Mentoring Women in Science (Association for Women in Science, 1993, 1995). Among other projects, she is currently working on a study of the influence of Paul F. Brandwein on science education in America.

Product Details

• Hardcover: 360 pages
• Publisher: Xlibris Corporation (December 21, 2004)
• Language: English
• ISBN-10: 1413465242
• ISBN-13: 978-1413465242
• Product Dimensions: 8.6 x 5.8 x 1.3 inches
• Shipping Weight: 1.3 pounds (View shipping rates and policies)
• Average Customer Review: 4.2 out of 5 stars  See all reviews (6 customer reviews)
• Amazon Best Sellers Rank: #2,783,482 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

29 of 30 people found the following review helpful:

5.0 out of 5 stars Soteria's Message for today, March 27, 2005

By 

Jim Gottstein (Anchorage, Alaska) - See all my reviews
(REAL NAME)   

This review is from: Soteria (Hardcover)

In "Soteria: Through Madness to Deliverance," Loren Mosher and Voyce Hendrix, with Deborah Fort, paint a vivid picture of the day to day life at Soteria-House, the Northern California alternative to psychiatric hospitalization that proved it is possible to help people through madness with kindness, empathy and validating people's experiences, and most importantly, by "being with" people, rather than "doing to" them. Due to his prolific writings, Dr. Mosher has presented many scientific papers on Soteria, but in this book, the program comes to life. The failures as well as the successes are described.

Only with this book has it been possible to get a sense of what it was like to be at Soteria. Through the truly dedicated and caring staff, such as the incredible Voyce Hendrix (and even the residents), people were allowed their madness and, through being allowed their madness, able to get through it and on with their lives. This book is a must read for anyone interested in alternatives to the prevailing pessimistic paradigm of psychiatric treatment. It is truly a story of hope. A story of a better path -- a path not currently taken.

Dr. Mosher, loved "being with" people who were psychotic. He called them "my most interesting customers." Dr. Mosher, passed away in July of 2004, at the age of 70, five months before the book was published. He must have written this book knowing that his personal efforts on behalf of providing a humane form of care was going to cease. Thus, "Soteria: Through Madness to Deliverance" must be seen as his final act of love to people experiencing disturbing psychosis by leaving a trail to follow for those who have the vision to see it.

27 of 32 people found the following review helpful:

5.0 out of 5 stars Damage Vs. Understanding, January 8, 2007

By 

Bill Norwood - See all my reviews
(REAL NAME)   

This review is from: Soteria: Through Madness to Deliverance (Paperback)

Why read the book?
1..Buying it supports vital work.
2..Less than 1% of the book can appear here.
3..Change, action and recovery can replace hand-wringing.
4.."Understanders" are therapeutic for the seriously disturbed.

Soteria (Greek for deliverance) was a community-based, experimental, residential treatment facility in San Jose CA during 1971-1983, offering refuge mostly to young "schizophrenics." Would Soteria be as effective...as a nearby psychiatric ward where antipsychotic drugs were highly valued?

Focus: Given...that people labeled as "schizophrenic" often cannot develop or maintain close interpersonal relationships and supportive (non-family) network systems, Soteria believed these should comprise its focus.

The Moos Social Scales, which were heeded by Soteria, tallied staff's judgments about treatment areas, as they measured involvement, support, spontaneity, autonomy, practical orientation, personal problem orientation, tolerance of anger and aggression, order and organization, program clarity, and staff control.

Causation of Psychosis: More than half of adult admissions...to psychiatric hospital wards have histories of sexual and/or physical abuse. Also there may be parents' inability to focus and be clear, and parents' hostility toward their children... When someone goes "crazy," it's often in response to numerous problems, usually triggered by a particularly distressing event like a romantic rejection, the death of a parent, or excessive involvement with recreational drugs - - or inability to form social networks apart from families of origin.

Violence was much less than in hospital settings, but residents sometimes struck out at staff members who reminded them of their parents; and they also sometimes hit, kicked or bit or verbally abused others, because they felt defrauded, cheated, robbed, neglected, or otherwise treated unfairly.

Realizations and Incentives:
1..Elaborate institutions can impinge negatively on psychotically disorganized people. They often must be inflexible, must rely on authority, must institutionalize roles, and must rest decision-making power and responsibility in a hierarchy outside the client's control - staff and patients often feel powerless, irresponsible and dependent.
2..Jerome Frank's massive review of studies of therapy found, ...that therapist experience, duration of treatment, type of problem, patient characteristics, theory of intervention, etc., generally had no relation to patient outcome.
3..The World Health Org. has found that "schizophrenia" outcomes in poor countries like India, Nigeria and Columbia, where only a small percentage of patients are maintained on antipsychotic medications, are much, much better than in rich countries like the United States.
4..A massive 1979 World Health Org. study of "schizophrenic" outcomes correlated recovery with low reliance on neuroleptic medication...
5..The first case reports of tardive dyskinesia appeared in 1956. ...1:4 patients started on neuroleptics, will develop TD, a cosmetically disfiguring and untreatable condition...within five years...stigmatization is nearly inevitable.
6..The Germans who invented neuropathology, looked at the brains of thousands of "schizophrenics" before there were any neuroleptics and were unable to find any specific cellular pathology.

Precedents in Theory and Facility:
1..Soteria embraced elements of practice from the era of "moral treatment" (J. Sanbourne Bockoven's description of America's mental health practices in the 1700's.)
2..Sullivan used nonprofessional personnel to achieve a 75% success rate (12 of 16 individuals) in the 1920's. Professionals got 25-30% success rate.
3..The healing potential of human relationships was drawn from psychoanalytical pioneers, Frieda Fromm-Reichmann (1948) and esp. Henry Stack Sullivan (1962); but also therapists who have described growth from psychosis (John W. Perry, 1953, 1962; Karl A. Menninger, 1959); a group of psychiatric heretics (Thomas S. Szasz, 1961; Ronald D. Laing, 1967); and chroniclers of the development of psychiatric disorder in response to life crisis (George W. Brown and James L. T. Birley, 1968.)
4..Soteria's phenomenologic stance...from a long-standing European philosophic tradition...was practiced by Laing (1960, 1967), David Graham Cooper (1967), Medard Boss (1963), others.
5..Soteria was...a response to...critiques of psychiatric institutions, most notably Erving Goffman's Asylums (1961).
6..Soteria tried to...test the validity of the critiques of the "anti-psychiatrists," such as Laing, Cooper, and Franco Basaglia (1987)
7..Psychosis as growth has been referred to by Menninger, Perry, and Laing and others.
8..Some members of Soteria's founding group had worked on the rather similar Silverman-Rappaport study based in San Jose in ~1966-1974
9..A Soteria progenitor was The Philadelphia Association's Kingsley Hall commune in London.

Five characteristics of a functional milieu (setting) defined.
1..Control of stimulation.
2..Provision of respite or asylum...
3..Containment of poorly-controlled behaviors engendered by psychosis.
4..Support for the person's immediate experience.
5..Early-on validation of the person's hallucinations etc as real.

Using the 1972 principles of Jerome Frank:
1..Presence of perceived healing context.
2..Development of a confiding relationship with a helper.
3..Evolution of a plausible causal explanation for the development of the problem.
4..Generation of positive expectations by the therapist's personal qualities
5..Provision of opportunities for success through therapeutic processes.

Some of Soteria's successful ingredients:
1..Understanding that psychosis (and regression) could be positive learning processes.
2..Maintaining flexibility via ill-defined roles and relationships.
3..Learning of coping by imitating and identifying with staff, volunteers and other residents.
4..Non-understanding of a given psychotic experience was deemed a staff shortcoming.
5..BEING WITH residents and protecting from harm comprised staff's dominant responsibilities.
6..Accepting "crazy" behavior if it wasn't dangerous.
7..Avoiding psychiatric jargon.
8..Providing physical contact, especially to severely regressed residents.

What set Soteria and Emanon apart?
1..Avoiding codified rules, regulations and policies.
2..Minimizing basic administration time and maximizing undifferentiated time.
3..Limiting intrusion by outsiders.
4..Working out social order on an emergent, face-to-face basis.
5..Following a non-medical model that did not require symptom suppression.

Due to Soteria's success, replications have already been operating in Switzerland and Germany; and more are developing in Hungary, Germany and New Zealand.

Books I have read which variously support Soteria's theory and practice:
1..Thomas Szasz' The Myth of Mental Illness
2..William Glasser's 1. Reality Therapy, 2. Choice Theory
3..Edward Podvoll's The Seduction of Madness
4..Richard Moskovitz'Lost in the Mirror

Presumably "Soteria's" could never be prevalent in the US, because the needs for professionals and drugs would dramatically decrease. Nevertheless, inspiration and hope remain.

Hopefully the waywardness of mainstream psychiatry as seen in the Soteria contrast will lead the young toward greater integrity in their choosing of careers.

Thanks for reading!

Bill Norwood

14 of 16 people found the following review helpful:

5.0 out of 5 stars An important work, June 22, 2005

By 

Michele C. Moore "Hygeia" (Alstead, NH USA) - See all my reviews
(REAL NAME)   

This review is from: Soteria: Through Madness to Deliverance (Paperback)

Soteria is the exposition of a grand experiment in the holistic treatment of schizophrenia and is recommended reading for anyone who has an interest in mental illness. When one applies outcomes criteria to the Soteria program, it holds up as equally effective to any of today's drug therapies.
I applaud the authors for their very accessible and important work.