Dan Fisher: Harbinger of Hope

Dan Fisher has a story to tell.

Some of it is personal.

He was diagnosed with schizophrenia in 1970, while working in the neurochemistry lab at the National Institute of Mental Health. He was trying to find the chemical that would “save” his sister, who was literally starving herself to death. Dan, who had a Ph.D. in biochemistry, got so immersed in the world of the brain that he thought he was a neurochemical. Then he became catatonic.

Next came psychiatric hospitalization—the worst nightmare possible, in many people’s eyes.

For Dan, being hospitalized led him toward his calling. He went on to earn an M.D. from George Washington University Medical School, complete his residency at Harvard, and become a psychiatrist. He worked as a staff psychiatrist and medical director at various mental health centers in eastern Massachusetts for 30 years. He is presently a faculty member in the department of psychiatry at UMass Medical School in Worcester.

Dan Fisher in downtown Greensboro, April 19, 2013
Dan Fisher in downtown Greensboro, April 19, 2013

Even as he was working within the mental health system, Dan was quietly but firmly challenging it. He didn’t like the traditional medical model that ascribed “mental illness” to a chemical imbalance in the brain. He saw far more influences, including childhood trauma and generational patterns.

He became a change agent, championing the growing recovery movement—a grassroots initiative that gained traction in the late 1980s and 1990s. Led by self-proclaimed consumers, survivors, and ex-patients, the movement stressed that people can and do recover from mental health challenges. Recovery activists began lobbying for mental health services that focused on growth, hope, and social inclusion, not just symptom management.

In 2002, President George W. Bush asked Dan to join the President’s New Freedom Commission on Mental Health. Dan convinced his fellow members to take a recovery-oriented stance, and their resulting report, issued in 2003, reflected that perspective. The man once rendered speechless and motionless by catatonia had helped change national mental health policy.  

Dan, who serves as executive director of the National Empowerment Center, does about 18 speaking engagements and workshops a year. The Mental Health Association in Greensboro invited him to Greensboro to hold a community dialogue on recovery and to speak at the 17th Annual Regional Mental Health Conference. “The belief of the people around you is absolutely critical,” he said during the community dialogue. “Hope, hope, hope. It has to be there. Rob the person of hope, and there won’t be any recovery.” 

People came from all over North Carolina hear Dan's talk, "It Takes a Village," held April 18, 2013, at the Interactive Resorce Center
People came from all over North Carolina to hear Dan’s talk, “It Takes a Village: A Community Dialogue on Mental Health Recovery,” April 18, 2013

Read more  of Dan’s thoughts in the following Q&A.

How do you define recovery?

One characteristic is that it’s individualized—so there is no single definition. Recovery is about contributing and feeling your life has meaning. It doesn’t mean you have to be off medication. And it’s not about symptom reduction. People ask me if I continue to have symptoms. I still experience things, as everyone does, like anxiety and ups and downs. But they don’t keep me from having a meaningful role—therefore I consider myself recovered from schizophrenia. I continue to grow, as I hope everyone does.

Recovery has more to do with social interactions. I’m taken by the Finnish model, which uses an approach called Open Dialogue. It emphasizes meaningful dialogue—feeling you can be heard and influence others. It describes psychosis as a monologue, and recovery as a return to dialogue. Open Dialogue grew out of a system of family therapy, but in this system no one is to blame. Robert Whitaker details this approach in chapter ten of his book, Anatomy of an Epidemic.

Optimism is one of the biggest factors in recovery: if you’re with people who believe in you and have hope for your future, you’re more likely to recover.

What’s your proudest accomplishment?

I’m proudest of my work on the White House Commission on Mental Health. I was the only member with a declared psychiatric condition. At the beginning, the other commissioners were mostly against me in terms of recovery. They came around by the end. I brought in a lot of powerful allies.

What is your favorite quotation?

“Explanation separates us from astonishment, which is the only gateway to the incomprehensible.” ~Eugene Ionesco. This is an astonishing thought, and when I attempt to explain it, it loses its astonishment.

What are some simple things people can do to support the recovery movement?

First, try to overcome what I call the medicalized perspective, which presents the world as a set of programs and goals to be carried out. Try to recognize the importance of connecting to other human beings. Also, influence as widely as possible the policies and politics that are dehumanizing all of us.

What’s the biggest change you’d like to see in mental health policy in the next five years?

I’d like to see mental health policy integrated into public health and wellness, so that a person’s overall health is seen as integral to living. I’d also like to see the demise of direct advertising to consumers by pharmaceutical companies; in its place would be public education about unifying mind, body, and spirit for health.

Why do you think there’s such stigma around mental illness?

First of all, the term “mental illness” itself perpetuates stigma—and the term “stigma” stigmatizes. Conceptualizing these human-life problems as medical illness has been proven to increase discrimination against people who are so labeled. Changing the description of “mental illness” would be very important. I think people have a fear of irrationality— that by being close to people who are thinking differently, they are going to lose their capacity to think in a linear, rational fashion. I believe that contributes greatly to what I prefer to call prejudice and discrimination.

As both a psychiatrist and an advocate with lived experience, where does your allegiance lie?

I put more of my energy, time, and enthusiasm into my role as an advocate. I think change has to happen from outside the system; the system is generally protected against change from within. I tried being in the system for 30 years. Now I spend more of my time trying to galvanize from the outside. I feel a little bit like Robert Oppenheimer [developer of the world’s first nuclear weapons]. I didn’t design bombs, but I worked in the labs, writing the scripts.

Whom do you admire most?

Martin Luther King Jr., Nelson Mandela, Mahatma Gandhi, Abraham Lincoln: They weren’t afraid to go against public opinion for what they believed in. My wife, who works in public health, is a hero of mine. And my two daughters—both of them are pretty fearless about questioning the status quo. 

What’s one thing most people don’t know about you?

By nature I’m shy. It took me a long time to feel comfortable speaking to the public. When I was younger, I literally would get sick at the idea of having to give a talk. Having a meaningful reason to speak changed that for me.

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