The Most Misunderstood Mental Illness

Where does schizophrenia come from? From mother-blaming to microbiology, inside the perilous search

“Schizophrenia is a disease of theories,” the psychiatric historian Edward Shorter once told me — and the twentieth century produced easily hundreds of them. To some, insanity is little more than a quirk of brain chemistry, a dial to be fiddled with pharmaceutically; to others, it’s a metaphor for something else — something bigger, more profound, about the way we all comprehend the world. But the nature of madness and how to grapple with it has stumped absolutely everyone, despite the endless procession of people who are convinced that they — they alone! — have cracked the case.

For a writer, the subject of mental illness can be both intimidating and irresistible. Next week, Anchor Books is publishing the paperback edition of Hidden Valley Road, my nonfiction medical mystery and family saga of the Galvins, a large mid-century Colorado family with twelve children, six of whom were diagnosed with schizophrenia, and who, together, presented researchers with a once-in-a-lifetime chance to understand what could be the world’s most misunderstood disease.

Since Hidden Valley Road was published, I’ve heard from countless families touched by severe mental illness, all applauding this family’s decision to come forward despite the stigma schizophrenia still carries today. While this has been intensely gratifying to hear, it’s only made the questions surrounding the family’s experiences seem more urgent. This family suffered greatly even as they became research subjects for scientists. And while their story offers a shadow history of mental illness research in the twentieth century, including all the conflicting theories and compromised ideologies and wrongheaded remedies, it’s also true that the Galvins had been trying to make sense of their experiences long before they decided to be interviewed. The book presented a chance — a hail Mary, maybe, but still, a chance — to find meaning where there seemed to be nothing but chaos. In the book itself, you can see how that search was, at least in part, answered by science, and how the Galvins played a crucial role in breakthroughs that others will no doubt benefit from in the future.