#daniel bergner

She stayed seven nights, the official limit. It’s all that is feasible given the demand for Afiya’s bedrooms, with residents coming via mental-health agencies and word of mouth. Fleeting as a week is, it’s not all that different from a typical stay on a psych ward, to which Afiya sees itself as a better alternative. The W.H.O. estimates that Afiya is one of three dozen comparable places, known as peer-run respite houses, across the country.

In March, Mazel-Carlton, whom I first met in 2019, took me to Afiya and introduced me to its director, Ephraim, who asked that only his first name be used to protect his privacy. That afternoon, over his slender frame, he was wearing a black sweatshirt emblazoned with “Spiritbox,” the name of one of his favorite metal bands. Guests, he explained, are free to come and go at any hour. Then he shared: “I feel like I want to die every day. It’s one of the first things I think about when I wake up. That is normal for me. Many people act like it isn’t normal. Here, we have people express that they want to harm someone. These are all normal thoughts. But people train themselves to believe that they’re not. Giving space to express these things, to have these conversations, that’s the healing thing, that’s the magic here. When we don’t allow that space, things get bigger.”

“For some people,” Ephraim said, “staying here is only a slight beginning. There’s power in feeling able to talk and feeling truly heard, in not feeling alone. But for other people, it’s transformative.”

Okay, team, it’s June and I have so many new things - about half of which are actually new and half of which are just new in the sense that I just discovered them - to share with you that this is going to be a DOUBLE POST. BUCKLE THOSE SEATBELTS.

Fred & Anthony’s Horrible, Hideous Back-to-School Thriller by Esile Arevamirp and Elise Primavera is a children’s book about two best friends who are trying to figure out strange events at their elementary school with the help of the Phantom of the Mop Closet, who appears obviously based on Lon Chaney’s portrayal of the character in the 1925 movie.

The Other Side of Desire: Four Journeys into the Far Realms of Lust and Longing by Daniel Bergner is a collection of short erotic essays focused on fetishes often considered disturbing, with a first story entitled “The Phantom of the Opera” that revolves around foot fetishes. These are technically non-fiction, designed more to talk about real-life subjects in a fictionalized context.

Vigil by Jove Chambers is an erotic romance about a woman trying to have a relationship with a masked vigilante superhero who is also fighting the mysterious Phantom, an evil supervillain. It’s billed as “Fifty Shades meets Batman meets the Phantom”, so that’s just a whole lot.

The Reaping by Shirley Anne Edwards is a fantasy version of the story featuring a small-town girl who falls in love with a local boy only to be kidnapped and spirited away underground by a magical mist that demands she be his bride. The copy describes it as a fusion of the Phantom story, John Fowles’ The Collector, and Lewis Carroll’s Through the Looking Glass.

The Loneliest Alpha by T.A. Grey is a modern-day paranormal romance featuring a scarred cowboy alpha werewolf who kidnaps a woman and demands that she live with him for thirty days before he’ll let her go (if she still wants to, of course). Lots of angst about his hideous face is involved, and also, if you’re excited by werewolves, EVERYONE IS WEREWOLVES.

Imagine the Kiss by Laura Haley-McNeil is a modern-day romance novel with a violinist escaping a failed marriage only to meet a masked, disfigured architect who she only interacts with as a soothing voice in the distance.

Night Child by Ann Majors is another modern-day romance, this time featuring a ballet dancer who falls in love with a strange haunting figure, who knows she was kidnapped as a child and needs to be saved with liberal use of Lloyd Webber lyrics in plot descriptions.

Diabolus in Musica by Brent Monahan is the story of a young tenor whose career suddenly takes off when a world-renowned soprano teaches him to become a hit, only to find that when she disappears and is presumed dead, she begins to possess him from beyond the grave, killing his rivals and taking control of his voice. Modern-day and horror-focused.

Touches by Aline Popescu is a collection of gay erotica featuring the story “A Touch of Glamour”, in which the main character goes to New York to see the Lloyd Webber musical but accidentally meets the Phantom’s actor on Grindr and real-life romance ensues.

The Music Box Girl by K.A. Stewart is a steampunk story with a gender-flipped cast, featuring a young man with an angelic voice being tutored by a mysterious musical mastermind woman, and the globe-trotting heiress who remembers him as her childhood love, all set in the Detroit Opera House where the majority of the performers are automatons.

What Do Women Want?

Daniel Bergner

“As human beings,” Mazel-Carlton said later, “we are drawn to meaning; it gives us a sense of power. But to get there, you can’t feel only that the voice is scary. And to do this work, you have to get past your own fears.”

This confidence stemmed from psychiatry’s first pharmaceutical breakthrough a decade earlier, the discovery of chlorpromazine (marketed in the United States as Thorazine), the original antipsychotic. The drug brought on debilitating side effects — a shuffling gait, facial rigidity, persistent tics, stupor — but it becalmed difficult behavior and seemed to curtail aberrant beliefs. The Times hailed the drug’s “humanitarian and social significance,” and Time magazine compared Thorazine to the “germ-killing sulfas,” groundbreaking drugs developed in the 1930s and 1940s to fight off bacterial infections. But patients didn’t seem persuaded that the benefits outweighed the harm; they frequently abandoned their medication.

Thorazine was followed by Haldol, a more potent antipsychotic whose side effects were no kinder. Yet each drug contributed to a sweeping release of residents from psychiatric asylums, and by the 1970s, crude concepts emerged about how these medications work. Overactive systems of dopamine, a neurotransmitter, were thought to be the culprit in psychosis, and antipsychotics inhibited these systems. The problem was that they impaired dopamine networks all over the brain, including in ways that led to movement disorders and torpor.

By the 1980s, though, biological psychiatrists believed that they would solve this flaw by creating more finely tuned antipsychotics. Joseph Coyle, then a professor of psychiatry and neuroscience at the Johns Hopkins School of Medicine, was quoted in a 1984 Pulitzer Prize-winning Baltimore Sun series that heralded new brain research and deftly targeted antipsychotics and other psychotropics on the horizon: “We’ve gone from ignorance to almost a surfeit of knowledge in only 10 years.” A protégé of Coyle’s, Donald Goff, now a psychiatry professor at New York University’s Grossman School of Medicine and for decades one of the country’s pre-eminent researchers into psychosis, told me, about the end of the 1980s, “Those were heady years.” Every day, as he neared a Boston clinic he directed, he saw the marks of Haldol in some of the people he passed on the sidewalk: “As you approached, there were the patients from the clinic with their strange movements, their bent-over bodies, their tremors. Not only was the illness debilitating; the medications were leaving them physically so miserable.” Yet he sensed, he said, “the possibility of limitless progress.”

What were christened the “second-generation antipsychotics” — among them Risperdal, Seroquel and Zyprexa — came on the market mostly in the 1990s. In addition to their assault on dopamine, they seemed to act, in lesser ways, on other neurotransmitters, and they appeared to have fewer side effects. “There was so much optimism,” Goff remembered. “We were sure we were improving people’s lives.” But quickly worries arose, and eventually Eli Lilly and Johnson & Johnson, makers of Zyprexa and Risperdal, would pay out several billions of dollars — a fraction of the drugs’ profits — in lawsuits over illegal marketing and the drugs’ effects on users’ metabolisms. Zyprexa caused a greatly heightened risk of diabetes and severe weight gain (Eli Lilly concealed internal data showing that 16 percent of patients gained over 66 pounds on Zyprexa). Some boys and young men who took Risperdal were affected by gynecomastia; they grew pendulous breasts. In 2005, the N.I.M.H. published a study with 1,460 subjects looking at whether the new antipsychotics were in fact better, in efficacy or safety, than one of the first-generation drugs. The answer was no. “It was a resounding disappointment,” Goff said, though he advocates long-term and probably lifelong medication as, on balance, the best way to guard against psychiatric devastation.

“If you look at the treatments we have right now,” Coyle, Goff’s mentor, told me, “in terms of their fundamental mechanisms” — the drugs’ disruption of dopamine pathways — “they’re no different than they were almost 70 years ago with the discovery of chlorpromazine. That’s pretty scary.”

While visiting Lichtenberg’s houses in 2019, I sat with three residents and two melavim, who talked in an internal courtyard. One resident said that Descartes was the source of his trouble, that while at a job one night, passing the hours playing video games, he had wandered onto a website that included Descartes’s dictum “I think, therefore I am.” “It is stuck in my head like glue,” the young man said, eyes in anguish below his bangs. Before that night, he had had issues with obsessional thoughts. Since, everything outside him was unreal. The melavim, the other residents, the courtyard’s walls and benches, none of it existed. He knew his mind was awry but couldn’t set it right. The melavim asked him about his experience, listening openly, no more, no less.

As I spent time with Lichtenberg, I asked about one of the pressing fears with psychosis — eruptions of violence. What he recounted was akin to what I heard at Afiya, where I was told there was just one incident in 10 years, when a staff member suffered two black eyes and was threatened with a pair of scissors. Lichtenberg said that chairs have been broken and plates smashed but that threats against other residents, melavim or staff members are rare. With the exception of one broken nose, the situations have ended with hardly more than a scratch, though one melaveh was put in a headlock before being released without injury. “If someone becomes intimidating,” Lichtenberg said, “I’ll sometimes put my hands behind my back, look him in the eyes and tell him, ‘If you want to attack me, it’s going to be so easy for you.’”

Occasionally the Israeli Soterias will insist on medication if a resident becomes too belligerent, but the drug is almost as often an anti-anxiety pill as an antipsychotic, and the dose may then be tapered down, sometimes to nothing. The houses refuse to take a small fraction of applicants because of a recent history of violence, but they have also knowingly accepted residents who, a few months or only weeks before their arrival, put a parent in the hospital, for example, or assaulted a government security officer.

Avraham Friedlander, a former director of Lichtenberg’s first house, told me about a resident who, on the man’s first day, interrupted a group meeting in the living room. He splintered a darbuka, a Middle Eastern drum, and began to dance aggressively. In response, Friedlander joined him in the middle of the group, dancing wildly. “Everybody made a drumbeat with their feet, stomping, and we fought in a choreographed way, a dance-fight,” Friedlander said. “He grabbed me; he put me on the floor; but I wasn’t hurt; and later we talked. He was asking what was happening to his mind. He was crying. I slept near him that night, and when he woke with nightmares, I sang him songs and gave him tea.”

Soteria’s methods may seem romantic and naïve, but Lichtenberg has won the support of Israel’s Health Ministry, and two of Israel’s four public insurance carriers as well as the Defense Ministry’s insurance system will pay for a stay in Soteria as an alternative to hospitalization. Since Lichtenberg got started in 2016, 17 houses with practices similar to Soteria’s have opened throughout Israel. This year, at the invitation of one of Jerusalem’s major psychiatric institutions, Kfar Shaul Psychiatric Hospital, Lichtenberg has taken over its locked ward and begun to turn it into a Soteria facility.

Beth, who asked that I use only her first name and who has led H.V.N. groups in Western Massachusetts, pointed out that though the Hearing Voices movement wrestles against conventional psychiatry, it isn’t anti-psychiatry. A former music teacher and cellist, Beth used to take medications that left her with terrible tremors and a torturous physical restlessness called akathisia, deepening the agony of a teaching career lost to her struggles. But after an odyssey of working with inflexible psychiatrists, she found one willing to chart a path of mutual understanding and compromise. She continues to have unsettling visions, but a religious practice along with a calibrated mix of drugs helps somewhat to make her life more manageable while inflicting only mild tremors, and she is playing her cello for the first time in 20 years.

“It’s like an ecosystem of dreams,” Dmitriy Gutkovich said, describing his voices to me over Zoom from Foster City, Calif. Some threaten his family; others speak philosophically on entropy. He takes an almost negligible dose of an antipsychotic, an amount bordering on a placebo. More relevant, he explained, is that H.V.N. groups helped him to realize that coexistence with voices is possible. It is, he said, “about understanding them and their intentions, so that we can live in harmony; it’s about relationship management.” A decade ago, in his early 20s, he was “not in a period of perfect functioning,” he said wryly. “The professional assessment was doom and gloom.” He is now married and a new father. On the screen, he smiled beatifically about this. He is a marketing director at a magazine and oversees an eight-person team.

2018 Book #15: Sing for Your Life: A Story of Race, Music, and Family by Daniel Bergner

I really enjoyed this read.  I’d say it’s more about music than it is about race or family.  The opera seemed to be the main focus to me and Green’s race and family situation was just the scenery.