Bipolar 2 From Inside and Out

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Schizophrenia: Nature and Nurture

Think about the devastation that a case of schizophrenia can cause a family. Then multiply that times six.

If you want a book that explores such a situation, look no further than Hidden Valley Road: Inside the Mind of an American Family by Robert Kolker. It’s the true story of a middle-class family with 12 children, six of whom became schizophrenic. The children included ten boys and two girls; neither of the girls developed schizophrenia, so that’s a full 60% of the boys who did.

The story begins in the 1950s, when at least there were hospital beds as well as halfway houses for psychiatric patients. The matriarch, Mimi Glavin, however, preferred to care for her boys at home as much as she could. This was, of course, disruptive to the rest of the family. And the patterns were perhaps obscured by the fact that four of the boys and the two girls never developed the disorder. One of the girls was sent to live with a rich friend, and the other managed to be admitted to a boarding school. These were irregular family arrangements, intended to get the girls out of harm’s way, though they certainly harbored resentment at what they saw as abandonment.

The 50s and 60s were the era of what the mental health community called the “schizophrenigenic” mother. Back then, schizophrenia was thought to be caused by the mother, who was either too cold and distant or too controlling. Take your pick. It was the mother’s fault. It was also the era when Thorazine was the best (or only) treatment that could be given for the disorder.

The boys, many of whom were talented athletically or musically, presented with schizophrenia, as you would expect, during their late teen or early adult years. Chief among the delusions affecting Donald, the oldest son, were religious ones. The younger ones also heard voices. One committed a murder-suicide, and another sexually abused his younger sisters. Violence among the brothers was common. Overlooked in all this was that Don Galvin, the father, had suffered a mysterious hospitalization while on duty in the service, which was classified as depression.

Psychiatrists and other researchers were at that time conducting twin studies to examine whether twins were equally likely to develop schizophrenia or not. The Galvin family was a treasure trove.

Still, the family couldn’t resolve the nature-nurture debate. Were the six boys affected by defective genes? Or was their illness because they had all been raised in the same household? DNA study was in its infancy. Most of the family agreed to interviews and blood studies, though they proved not to be much help.

Of course, the children, when they began to have children themselves, were afraid that the family affliction would be passed down to them. One of the young women put her child in therapy at a young age, hoping to spot incipient signs of psychosis. This choice did possibly more harm than good, as the young boy never developed any symptoms and resented the unnecessary therapy.

The heroines of this story were, of course, Mimi – who cared for all her children as best she could, and her husband after he had a stroke in later life – and Lindsay, the youngest child. The care for her schizophrenic brothers was her purview – monitoring their health, their medications, their hospitalizations, and their money, as well as caring for her mother, who became incapacitated in old age. The mentally healthy brothers and the older sister largely detached from the family and went about living their own lives.

Why read this book? It delves into how schizophrenia can affect not just a person, but a whole (and large) family. It illuminates the struggles the family had to deal with in caring for the brothers who had mental illness. It records how treatments for and research about schizophrenia over the years worked and didn’t. And it’s a well-written book on top of that. I could easily have read it in a couple of days, but I stretched it out over weeks to savor and contemplate.

The book rings with authenticity, as interviews with all of the family and records of their therapy and hospitalizations were made available to the writer. It resonates with pain, frustration, pity, courage, illness, relapses, and desperation. It is truly the best chronicle of schizophrenia I have read. I can’t recommend it highly enough.

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