The History of the Soteria movement
The beginning
Ronald David Laing (October 7, 1927–August 23, 1989), was a Scottish psychiatrist who wrote extensively on mental illness and particularly the experience of psychosis. He is noted for his views, influenced by existential philosophy, on the causes and treatment of mental illness, which went against the psychiatric orthodoxy of the time by taking the expressions or communications of the individual patient or client as representing valid descriptions of lived experience or reality rather than as symptoms of some separate or underlying disorder. He is often associated with the anti-psychiatry movement although, like many of his contemporaries also critical of psychiatry, he himself rejected this label. He made a significant contribution to the ethics of psychology.
(Source: http://en.wikipedia.org/wiki/R._D._Laing)
R.D. Laing & Kingsley Hall
Following World War II, with the welfare state undertaking much of the work advocated by the Lester sisters, Kingsley Hall continues as a youth hostel and community activity centre on a quieter note.
1965. R.D. Laing and his colleagues ask the Lesters for use of the Hall as a community for themselves and a few people in a state of psychosis. As a result, Kingsley Hall became home to one of the most radical experiments in psychology of the time.
The aim of the experiment, known as the Philadelphia Association, was to create a model for non-restraining, non-drug therapies for seriously affected schizophrenics.
Based on the notion that psychosis, a state of reality akin to living in awaking dream, is not an illness simply to be eliminated through the electric shocks favoured in the Western tradition of the time but, as in other cultures, a state of trance which could even be valued as mystical or Shamanistic, it sought to allow schizophrenic people the space to explore their madness and internal chaos.
One notable resident of this experiment was Mary Barnes. Along with resident psychiatrist Joseph Berke, Mary later went on to write Two Accounts of a Journey Through Madness, describing her stay at Kingsley Hall and use of her mental condition as a vehicle for painting and creative expression. Her account became famous in the 1970's when it was used as the basis for a well-received theatre piece.
(Source: http://www.kingsleyhall.freeuk.com/kingsleyhall.htm)
The first Soteria Project
Loren R. Mosher
Dr. Mosher, former Chief of the Center for Studies of Schizophrenia, National Institute of Mental Health, founder and first editor of Schizophrenia Bulletin, advocated for a kinder, gentler treatment model for psychosis, rejecting the coercive methods used by his profession –usually in concert with government policies of control. He encouraged mental health professionals to reject involuntary treatment policies which always resulted in increased use of powerful, psychotropic drugs – a boon to the drug industry and its beneficiaries – the unholy alliance.
In the 1970s through the early 1980s, Dr. Mosher and his colleagues founded and operated Soteria house, a residential, community-based treatment for individuals undergoing their first psychotic episode. With minimal use of drugs and no restraints, Soteria-treated individuals showed comparable or superior outcomes to a control group of hospital- and drug-treated individuals. Two-year follow-up outcomes were also superior for the Soteria group. Although Dr. Moshers findings are discussed in over 30 publications, his approach received little publicity in the United States
(Source: http://www.ahrp.org/infomail/04/07/13.php)
In an article he writes the following about his Soteria project:
To interests in the meaningfulness of madness, understanding families, and the conduct of research, I added one from my institutional experience; if places called hospitals were not good for disturbed and disturbing behavior, what kinds of social environments were? In 1966-1967, this interest was nourished by R.D. Laing and his colleagues in the Philadelphia Association's Kingsley Hall in London. The deconstruction of madness and the madhouse that took place there generated ideas about how a community-based, supportive, protective, normalizing environment might facilitate reintegration of psychologically disintegrated persons without artificial institutional disruptions of the process. This, combined with my existential/phenomenologic- psychotherapy and anti-neuroleptic drug biases resulted, in 1969-1971, in the design and implementation of the Soteria Research Project. Soteria is a Greek word meaning salvation or deliverance. In addition to my interests, the project included ideas from the era of moral treatment in American psychiatry (Bockhoven, 1963), Sullivan's (1962) interpersonal theory and his specially designed milieu for persons with schizophrenia at Sheppard and Enoch Pratt Hospital in the 1920s, labeling theory (Scheff, 1966), intensive individual therapy based on Jungian theory (Perry, 1974) and Freudian psychoanalysis (Fromm-Reichman, 1948; Searles, 1965), the notion of growth from psychosis (Laing, 1967; Menninger, 1959), and examples of community-based treatment such as the Fairweather Lodges (Fairweather et al., 1969).
(Source: LOREN R MOSHER, M.D.: Soteria and Other Alternatives to Acute Psychiatric Hospitalization A Personal and Professional Review THE JOURNAL OF NERVOUS AND MENTAL DISEASE 187:142-149, 1999)
Soteria in Europe
Soteria has been successfully replicated in several European countries. Indeed, Soteria Berne in Switzerland celebrated its 20th year of operation in 2004. Today, non-coercive, minimal-drugging family approaches to schizophrenia treatment are flourishing in several Scandinavian countries, in contrast to the United States, where coercive approaches resting on indiscriminate multiple-drug cocktails are the norm - even though such cocktails have never been tested to demonstrate either their safety or efficacy. A succinct description of the saga of Soteria and its institutional neglect is included in Robert Whitaker's book, Mad in America.
(Source: http://www.ahrp.org/infomail/04/07/13.php)
Dr. Luc Ciompi, professor of social psychiatry in Bern, Switzerland, is primarily responsible for Soterias renaissance. Operating since 1984, Soteria Bern has replicated the original Soteria study findings. That is, roughly two-thirds of newly diagnosed persons with schizophrenia recover with little or no drug treatment in 2 to 12 weeks (Ciompi, 1994, 1997a, 1997b; Ciompi et al., 1992). As original Soteria Project papers diffused to Europe and Ciompi began to publish his results, a number of similar projects were developed. At an October 1997 meeting held in Bern, a Soteria Association was formed, headed by Professor Weiland Machleidt of the Hannover University Medical Faculty. Soteria lives, and thrives, admittedly as variations on the original theme, in Europe.
(Source: http://www.moshersoteria.com/soteri.htm)
It was during this wave of interest that in 1995, Dr. Andrew Feldmar and Dr. Éva Csom established our Hungarian Soteria Foundation in Budapest. Our original aim was to establish a "crisis house" in Hungary similar to the original Soteria House in San Francisco. However, because of the lack of community-based mental health services in Hungary, Soteria steered itself to provide such services and furthermore, address Hungarian mental health reform. In 2001, our Foundation launched Hungary's very first drop-in mental health center, the "Kilátó Clubhouse," in the third district of Budapest. More recently, in early 2006, we opened our "Materia Clubhouse," in Budapest's thirteenth district.
Our clubhouses run services that enable users to live in an environment of choice, avoiding the risk of being labelled or excluded from the local community. In other words, users may avoid living their lives in large, closed, secluded institutions and transition safely to mainstream life. In addition to the clubhouses, virtually every service introduced by Soteria - which include family counseling, legal advocacy efforts, or employment training - has been pioneering within the largely institutionally based Hungarian mental health system. As of now, Hungary's social welfare system still does not provide mental health users with crisis intervention facilities or other alternative solutions to hospitalization. While maintaining our dedication to current outreach activities, the Soteria Foundation still hopes to raise enough revenue to achieve its initial goal of opening a Soteria House here in Hungary. Please click here for more information on how you may support Soteria's mission.
Recent Soteria projects in Europe available on the internet:
Soteria Bern (Switzerland) www.soteria.ch
Soteria Zwiefalten (Germany) http://www.zfp-web.de/K3/html/artikel.php3?path=0:3:32:138&a_id=83
Toll-haus project (Germany) http://www.toll-haus.de/index.html
Soteria Frankfurt an der Oder (Germany) http://www.lunaticpride.de/SOTERIA.HTM
Soteria Budapest (Hungary) www.soteria.hu
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