Just Say No

Conventional wisdom says psychiatric drugs save lives, but for some San Franciscans the pills are a prescription for disaster

"We worked with some incredibly damaged people there," Bingham says. "It helped me see that once you separate out the meds from the distress, only then can you really see what's going on with people. It gave me a really positive perspective on healing and a belief that with the right support, people didn't need the medications."

Once he got his license, Bingham split from McCready's clinic. He respected his mentor, but felt McCready and his staff ignored the link between physical and mental health. Long involved with yoga and meditation, Bingham wanted to open his own clinic in San Francisco, promoting the med-free approach while offering services like nutrition counseling and movement awareness alongside traditional psychotherapy and a day program for the severely distressed.

Dipping into his inheritance, he leased a space at the northeastern tip of the city. Bingham put a lot of personal attention and money into the interior design, wanting it to feel like home for clients. He assembled an advisory board of educators, activists, psychologists and psychiatrists, and a small staff. In January 2005 he opened the doors at Full Spectrum — a physical space where his work could finally fully match his ideals.

In Pacifica, therapy intern Matthew Morrissey surfs for his own mental health.
Paolo Vescia
In Pacifica, therapy intern Matthew Morrissey surfs for his own mental health.
UCSF psychiatrist Sophia Vinogradov researches behavioral therapies for schizophrenic patients.
Paolo Vescia
UCSF psychiatrist Sophia Vinogradov researches behavioral therapies for schizophrenic patients.

In the art therapy room, the hint of a frown is discernible on Matthew Morrissey's forehead above his thick-rimmed glasses. Morrissey is a Marriage and Family Therapy intern and director of the adult day program at Full Spectrum. Fresh out of a session, he feels he made a misstep by pushing his client too hard to connect the thoughts she was sharing to some of her past trauma. She got upset, Morrissey says, and she shut down.

Morrissey retrieves a white sheet of paper and a blue marker, and improvises a diagram to explain how he theorizes that his therapeutic approach affects the brain. It's a conception shaped largely by his reading of texts by UCLA psychiatrists Dan Siegel and Allan Schore.

He begins with a circle representing the hippocampus, a region in the lower human brain that plays a key role in memory. Inside the circle, he presses the marker to the sheet several times in a scattered pattern; these dots stand for collections of neurons that house memories. He connects them with various lines to represent a functioning neural system.

Unresolved trauma, Morrissey says, creates a "synaptic enclave" — a group of neurons that is disconnected from the rest of the brain's network, which he draws as a series of potential pathways out of the hippocampus. He draws another, smaller circle off to the side to represent the amygdala, the brain's fear center. With repeated strokes of the marker, he makes a bold line between an isolated dot — representing an enclave — and the amygdala. This direct connection, he says, often occurs when a person with such an enclave experiences something that triggers a traumatic memory. They may become paranoid, delusional, emotionally paralyzed.

By tinkering with the chemicals that create neuronal connections, prescription drugs can help relieve symptoms of mental distress, Morrissey acknowledges. But he believes that by shutting off access to the full intensity of emotional experience, psychiatric drugs prevent a deeper healing. Getting truly better requires revisiting the deepest depths of the wounds that cause the upset. This is the philosophy on which Full Spectrum is based.

Morrissey guides his clients through repeated re-livings of their traumas. By reprocessing those painful experiences in a supportive environment with the help of a trusted therapist, he believes that unencumbered by drugs, the brain can learn to remove trauma from isolation by forming new neuronal connections to more rational centers. The theory is that this helps clients put behavioral coping choices into perspective.

"The problem is that in a lot of cases, the definition of recovery has become limited to, you take your pills and you behave, you get part-time work and maybe live independently. And that's certainly a vast improvement from the state asylums of the past where people were locked away. But our approach is to hold out the possibility that there can be something more profound."

To do this, he says, the therapist-client relationship is key. You can't push someone the way he just did, because it takes time.

"I still am just getting started in this work, and for what we're doing with clients, we're into somewhat uncharted territory," he says. "It's certainly not accepted by the community at large, so there's this sense of not being validated. That really wears on you in a subtle way."

Twelve years ago, while in college in Boston, Morrissey started experiencing "revving" — the rapid-fire, uncontrolled succession of thoughts and insights associated with mania. One winter break, it got so bad that he ended up in a locked hospital ward on a 10-day hold, with a diagnosis of unspecified psychosis and a prescription for Risperdal.

After his release, Morrissey says he feared he could be re-institutionalized if he didn't follow doctors' orders, so for three months he continued taking the anti-psychotic as they directed. During that time, he says, he woke every morning with a puddle of drool on his pillow. He says he felt emotionally and physically dulled — the effort to decide to walk down a hallway, and then to follow through on that decision, was a tremendous chore.

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