Today I have the honor of interviewing Irish author Patrick Tracey, who penned an amazing book, “Stalking Irish Madness Searching for the Roots of My Family’s Schizophrenia,” for which he has won the Ken Book Award from the National Alliance on Mental Illness for “outstanding literary contribution to the understanding of mental illness,” a Slate best book of 2008, and the prestigious PEN New England/L.L. Winship Award for Nonfiction. “Stalking Irish Madness” is a dynamite, compelling read. It’s intriguing, informative, poetic, and captivating.
1) Correct me if I’m wrong. You began this search because you have been so devastated by the emotional toll that schizophrenia has already had in your family, which includes two of your sisters, your uncle, your grandmother, your great-great-great grandmother who came over from Ireland. And also because you are afraid to pass the mental illness on to the next generation. I know you are close with your nephew, that he is like a son to you, but have you made a decision not to have children because of the risk of passing the illness on?
Patrick: Yes, I made a point of not having children. And then I kept meeting women who were mad to have them. Or women who were running out of eggs and desperately wanted children. Given my family history, I was not the man.
Not that I would have made a bad father – I think I could be great one – but because I lived with the burden of believing that our bloodline might produce more madness and I could not bear to see another loss. I was on the horn of the same dilemma my mother had been on. Because she saw her own mother and her brother go stark raving mad, and because they were told there was nothing that could be expected to be done about it, my mother decided against having children.
Instead Mom set her sights on a career in the law, inspired by Shakespeare’s cross-dressing Portia from The Merchant of Venice. She was on her way to a high-powered legal career, sans children, and then her head was turned by my father. Dad was set on having his own big Irish Catholic brood. They saw two doctors–a family doctor in Boston who said it ran in families and cautioned against it–and a second specialist in New York that my father found. I’m sure the fix was in, because Dad did roll that way. He knew how to get his way. He talked Mom into having us, and when not one but two daughters, including her baby, stepped into the empty elevator shaft–the change was that dramatic–it killed my mother. She could not handle it. Of course, few could.
They say that genetics loads the gun and environment pulls the trigger. My own feeling is that my mother loaded the gun with her family’s errant gene bank, and my father pulled the trigger with the atmosphere of alcoholism he brought to the table.
Me, I didn’t fall far from the tree. I was behind the door when God was giving out the schizophrenic genes, but I was front and center for the alkie ones. I became a drunk and when I sobered up, finally, I found that the new ex-drunk me was determined to get answers. I was alcoholically clean but I had to get emotionally clean for my sanity.
My travels through Ireland validated many suspicions I had about the high levels of schizophrenia and alcoholism in the Irish and Irish-Americans. The British-fed famine promoted fetal malnourishment that can more than double rates in children. Also older fathers – because you were often 50 before you inherited the potato patch to become eligible – can also more than double rates. Late age of paternity was a direct consequence of the famine. But for me, personally, I could not take the chance because I am no spring chicken myself these days. The clear risk in children of older man was the final nail in the coffin for me. I must get snipped!
So fetal malnourishment and late age of paternity and alcohol abuse form the three legs of my three-legged stool of Irish madness. They didn’t cause it–the underlying susceptibility is there in all of us–but they inflamed it. I promise you.
2) I love your description of schizophrenia in the beginning of the book: “Schizophrenia is not a case of snapping back and forth between different personalities–a common misconception. Schizophrenia is the hearing of voices, but the hallucinations can be seen, felt, and smelled as well as heard. It’s fright night for life for many, an all-consuming terror that never ends.” Wow. What a description. What do you think the most common misconceptions are about the illness?
Patrick: There’s only one misconception that must be cleared up, and it’s a massive one. There is widespread ignorance about the experience of hearing voices, having verbal or auditory hallucinations, and this is the most common experience of schizophrenia. If we could just start thinking of schizophrenia as hearing voices, then this would clear up a lot of confusion right off the bat. People would begin to understand the experience from the point of view of the person having it.
Unfortunately, our ignorance has been abetted by fear. For so long, the idea of engaging therapeutically with verbal hallucinations has been viewed with boneheaded suspicion. This needs to change. The evidence is in. This one shift in attitude could open the flood gates to healing and recovery.
The correction has been firmly planted in Europe, the first glimmer of hope coming twelve years ago with the beginning of the Hearing Voices Network in Maastricht. Their meetings have since flourished in Europe. For some reason this more opened-minded attitude has taken much longer to reach and root itself in the United States. It will though–it’s absolutely inevitable like all irrepressibly good ideas.
The technique, known as “dialoguing,” was deemed irresponsible, even dangerous, by mainstream psychiatry. Now the ground has shifted beneath psychiatry’s feet and all but the most hidebound are open to the technique of encouraging so-called schizophrenics to dialogue with their voices. This places the key to their recovery within their own hands.
It’s encouraging to see that more and more psychiatrists are open to this kind of treatment. It’s nice to see the big tent attitude replace the tiny teepee. I don’t mind drug therapy and continued research, but to believe that medication is the sole answer requires a desperate poverty of imagination.
At one time, if you came in to see a psychiatrist and complained of hearing voices, he’d say “it’s nothing, take these pills.” I know this to be true from my own family. With my sisters, my uncle and my grandmother – who all have lived in the throes of verbal hallucination – we were told “it’s nothing, take these pills.”
I think we can speak for most families in saying, we don’t mind the pills, if they work, but we do mind the blind indifference to auditory hallucinations. If somebody comes to you with a broken nail, the very last response should be “it’s nothing.”
It’s sad to think that so many lifetimes have been lived on the sharp end of “it’s nothing,” but at least we now live in enlightened times. Even if America has yet to accept the hearing voices movement as warmly as it has been received by our more progressive European cousins, it’s just taking a bit longer. The key thing here is that psychiatry on both sides of the water now see things differently.