Photo by Craig Carlson

“Whenever I didn’t know what to do, I called a group, and we as a group came up with a solution."

I know this: if ever I go crazy — stark raving psychotic, you know, hearing voices, fending off hallucinations — I would rather be at Hanbledeya than anywhere else. If I ever become so alienated from reality that I lose the ability to handle even simple tasks like getting dressed, I would like to live in the big, rambling house on Mt. Vernon Street in Lemon Grove. I have seen enough of it to believe that the people there have affection and concern for each other in greater abundance than do many natural families. But... can life there really teach one how to recover from the gravest forms of mental illness? Can one walk in, chronically deranged, and leave, a few years later, indisputably sane? Modern psychiatry may scoff, but that’s Hanbleieya’s promise.

“They loved me out of it. They gave me unconditional, undying love.”

Photo by Craig Carlson

If I were crazy. I’d like to have that hope, but I also know this: that I probably never would be able to afford the tab at the maverick Lemon Grove establishment. Life at the main house for the most dysfunctional individuals costs $3500 per month — a bill that neither the government nor any private insurance company will pay. So Hanbleieya today is a refuge for rich crazy people. That’s rather ironic, given the organization’s humble beginnings.

Moira Fitzpatrick. Her therapist gave her a choice: enter a psychiatric hospital or gamble on a “therapeutic community” in Oakland called the Cathexis Institute.

Photo by Craig Carlson

It was in July of 1979 that four and a half psychotic women came together to form this iconoclastic community. The “half’ was Hanbleteya’s founder, its high priestess and ultimate mother Figure, Moira Fitzpatrick. Slight and raven-haired, the thirty-five-year-old Fitzpatrick speaks softly and is intensely reserved. There’s not a scintilla of flashiness about this woman. But beneath the surface stillness, one senses a bedrock authority. It’s hard to believe she was ever even slightly insane.

Ida: “Got some great oats, you guys. Raisins and nuts and seeds.”

Photo by Craig Carlson

And yet the Connecticut native says that at the age of sixteen she began to lose contact with herself. By her early twenties, after earning an undergraduate degree from the University of California at Davis, she had developed some of the classic schizophrenic symptoms: taunting voices, hideous visual hallucinations. She saw hands coming after her, violent scenes, enraged eyes, and distorted mouths. She turned to psychotherapy but continued to be gripped ever tighter by a paralysis of her personality. Her therapist prescribed antipsychotic drugs, but Fitzpatrick says they didn’t stop the hallucinations — and the drugs’ soporific effect further deadened her. Finally, her therapist gave her a choice: enter a psychiatric hospital or gamble on a “therapeutic community” in Oakland called the Cathexis Institute.

"We do such things as holding people."

Photo by Craig Carlson

Fitzpatrick chose the latter, and today she says that within its authoritarian structure she began to recognize and express her feelings and needs. That one-year interlude confronted her with the greatest terror she has ever experienced, she says, as she struggled to wrest her soul from madness. Significantly improved, she finally left the institute and came to San Diego to enroll as a graduate student in the California School of Professional Psychology. But she says her personal psychological struggles were hardly over. First she was astonished to discover that her psychosis had robbed her of the ability to concentrate for more than about a minute at a time. Tenaciously, she forced herself to concentrate on study materials for one minute, then five, fifteen, thirty minutes, an hour. “One day, focusing arose spontaneously within me,” Fitzpatrick has written of that experience. “The ability to focus my attention bloomed and the burden disappeared. I now had learning and school available to me.”

Another roadblock sprang up before her. Under the pressure of her fast-changing life, she began hallucinating again. This time, however, Fitzpatrick was adamant that she herself could solve this “problem ” as overwhelming as it might seem. Though stymied at times, she began to feel there were powerful links between stressful situations, strong emotional reactions that she sought to ignore or deny, and physical reactions in which she froze and tightened up her body. She says she painstakingly taught herself to relax, to concentrate on the world around her, and to deal directly with her feelings.

As part of her academic training, Fitzpatrick began working as a counseling intern at the Crisis House counseling center in El Cajon. Although she didn't initially reveal her own psychological history, she says psychotic clients seemed drawn to her, for which she credits her intuitive comprehension of their private hell. “I had been there,” she says. “I could help them based a lot on my own experience.”

Despite her preoccupation with graduate school, the counseling work, and her own continuing psychological development, Fitzpatrick says she began to miss having some deeper purpose in her life. Not that she lacked spiritual direction — she had by then become deeply involved with studies of native American religion and culture. But in search of a mission, she decided to follow the Indian custom of vision quest — called hanbleceya (“hahn-bleh-chee-ya”) in the Sioux language. She prepared herself through fasting and “various purification rituals” and then left for the mountains of Colorado. “I had forgotten how peaceful it could be amongst the trees, the gurgling streams, the colorful wildflowers, and the songs of the birds. I felt tremendously happy and forgot about my purpose.... I felt like a child playing in the mountains and watching life unfold with wonderment and freshness. As I was nearing the top of one peak before descending to a lake, I sat back against a rock to soak up the rays of the sun and marvel at the mountains, majestically towering over me. My mind was at peace and I felt very much alive. All of a sudden, I saw a vision of a large home. There were many people in and about the house, embracing one another, working and playing together. I blinked to see if the vision would go way. It did not. I smiled to myself and surrendered into the experience. I... knew that my purpose was to create community, create the space for people to heal themselves and to discover their vision.”

Eleven months would pass before Fitzpatrick and her first residents moved into the Lemon Grove house where her vision would unfold, but that interval was eventful. At Fitzpatrick’s request. Crisis House agreed to serve as the administrative umbrella for the community-to-be. Searching for a building to house it, Fitzpatrick talked to realtors and pored over classified ad sections, and tensions within her little group of patients began to build; Fitzpatrick increasingly began to hear comments about how the screaming, loud voices, and body work were scaring the other clients at Crisis House.

She continued doggedly searching for a house while experimenting with the small group of psychotic young people who looked forward to forming the new community with her. For example, Fitzpatrick worked on “regressing” these group members. She says many psychotic individuals can readily return to a younger mental state even without the aid of hypnosis. “Psychotics have the ability, because they’ve got so much energy in a very young part of themselves, that with permission they’ll just go right into it.” Fitzpatrick says she had been directing these regressions, under very controlled circumstances, for maybe an hour at a time, and prior to each session she had always made an arrangement with each patient that when she told them to return to their adult selves, they would do so. One day, however, when Fitzpatrick was working at Crisis House, she received a panicked call informing her that one person in the group, Linda, on her own had regressed to infancy. The group had no idea what to do with her.

Filled with trepidation, Fitzpatrick finished up her work and headed for the apartment. There she found the group gathered around a young woman in her late twenties who was lying on the floor, crying with the voice of a tiny baby and displaying eerily infantile reflexes. “I tried to get her back into her adult, but everything I tried didn’t work,” Fitzpatrick says. “So then I asked the group what they wanted to do.” With surprising calm, the group decided to take on the daunting task of caring for Linda, rather than sending her to a hospital. “So we became an instantaneous family,” Fitzpatrick says today with a wry grin. The group members fed Linda, diapered her, held her, played with her, loved her, and after a week or so of this bizarre routine, Linda finally advanced to about the age of three. “That was much easier,” Fitzpatrick recalls, and two or three days later, Linda returned to her adult self. But Fitzpatrick had learned a lesson. “I wanted to make it real clear that I didn’t want everybody doing it” she says. She proposed that no one be allowed to regress without first explicitly arranging with the community to do so, and the group agreed.

Not long thereafter, Fitzpatrick and a male co-therapist decided that the community needed to live closer to one another, even if they still lacked a house. So they rented a couple of apartments in El Cajon. Fitzpatrick and her partner moved into one, while four women patients settled in as their next-door neighbors. They all would gather first thing in the morning, in Fitzpatrick’s living room, then meet again at Crisis House in the afternoons. Again Fitzpatrick sought to lay down the law: no one was to engage in bizarre or destructive behavior in the apartments. They would have other outlets for dealing with their feelings. “I knew from the inside that you could stop acting crazy if you started to get your needs met, started releasing some of that old pent-up rage and terror," Fitzpatrick says. Sometimes the group members complied beautifully; other times things went less well. One evening, for example, one of the patients unexpectedly set a fire on the patio; fortunately, it caused no serious damage.

Finally, an ad for the house on Mt. Vernon Street surfaced in the newspaper. Fitzpatrick says she was captivated by the place the first time she laid eyes on it. It’s located on a block that has no sidewalks but is shaded by luxuriant trees. Though it's large, there's nothing intimidating about this roomy, five-bedroom dwelling. It “had a healing feeling about it,” according to Fitzpatrick, and even better, its two owners actually liked the idea of renting it to the health-seeking community. (Eventually, they sold the house to the parents of three Hanbleieya residents, who in turn now rent the house to the community.) Fitzpatrick obtained the relevant state community care license, and the fledgling community moved in.

I can stand in the Hanbleceya living room today and easily imagine what it looked like then. The heavily carved wooden doors haven’t changed, nor has the rough-hewn stonework of the fireplace facade. Light from many windows streams into the first-floor quarters, then as now.

It’s almost impossible, on the other hand, to conjure up a ready image of what Fitzpatrick was like eight years ago. Today she dresses in tailored business outfits, and she wears her shoulder-length hair carefully coiffed; friends says she’s taken to coloring the premature gray that used to streak it. She seems so quietly concerned with the present and the future that she offers only the briefest, most dispassionate glimpses of her tumultuous past. When Hanbleieya opened, “I was like an ex-patient,” she says, “in that I had just gotten out of a therapeutic community myself. I would run around in T-shirts and jeans and a head-band.” She blazed with a passionate commitment to keep her people off all medication and out of mental hospitals. In hospitals, she had come to believe, “They learn how to get attention by acting out. They learn how to be manipulative.” Without these means of restraining the residents, almost every day brought some kind of “escalation” (psychological jargon for bizarre, destructive, and attention-getting behavior). In the first months, residents swallowed spoons, flew into rages. They escaped into the street. The runaways posed some of the scariest moments, Fitzpatrick says. “We’d all get together and we would comb the streets of Lemon Grove. And we’d generally find them.” Even more terrifying was the time when one of the residents drenched her legs with lighter fluid and then put a match to them, suffering excruciating burns.

“I didn’t have all the answers,” Fitzpatrick says today. But she explains, “Whenever I didn’t know what to do, I called a group, and we as a group came up with a solution. One of the basic principles of the community is that all problems are solvable, through the interaction of all the group members.” A meeting could be called at any time — by any staff member or resident — and that rule still prevails; it’s not unheard of for residents to be rousted out of their beds at two in the morning to deal with some sudden crisis. That’s how families work, Hanbleceya staff members point out, and Hanbleceya aims at being a type of family.

But though Fitzpatrick shared authority in the community, she still, unquestionably, was the messianic parent. “I was willing to go above and beyond what typical therapists were willing to do,” she says — quite an understatement. She gave all her attention and energy, round the clock, to her little schizophrenic family; some nights she would even crawl into bed with this or that tormented person and sleep with her arms around them — not a sexual gesture, but a fiercely tangible act of mothering them through the crisis. “I thought she was a witch. Because she comes into your space so firmly,” says Marlene Townsend, a six-year Hanbleieya resident who graduated from the program this past summer. Townsend remembers Fitzpatrick flying across the room, her (then) long, dark hair streaming out behind her. According to Townsend, Fitzpatrick would scream at her, “You are not the center of the universe!” Townsend says just recently she noted with awe how petite Fitzpatrick is. “I always thought she was bigger than me!”

The forty-two-year-old Townsend says her own mental troubles began to surface in her early teens, when her grades and her relationship with her family started to decline. She ran away, began using drugs and alcohol. She first was admitted to San Diego’s County Mental Health facility at eighteen, and by 1981 she’d been hospitalized more than a hundred times. Some doctors diagnosed her as schizophrenic, but Townsend also was called sociopathic and manic-depressive. “There wasn’t one that they didn’t lay on me.” She explains her state of mind in blunter language. “Most of the time, I was either an alcoholic or on drugs. I drank to anaesthetize myself.... I had no concept of reality; no concept of cause and effect. Things just kind of happened to me. I had nothing to do with them.” She says when people touched her, she felt physical pain. “It burned. I would feel their heat.” Also oversensitive to odors, she couldn’t stand the way other people smelled. She was combative. Filled with an unremitting rage. “There was no logic to the world. Everything was a potential threat; it was not safe to be here.”

Often her own terror exploded into violence. She recalls one particular day when Fitzpatrick was confronting her over something, “And I moved into rage. I shoved her, and somehow she went flying over a dresser.” Townsend says a few horrible seconds passed, and Fitzpatrick finally popped up and spat out the words, “You be careful!" Another time, Townsend pulled a knife on Fitzpatrick at the comer of Fifth and Robinson avenues in Hillcrest. “She backed off. She knew I was out of control. She knew I was terrified,” the former mental patient says. She says Fitzpatrick calmly stated that she wouldn't allow Townsend to hurt her, then laid out several alternative choices (she could put the knife down and get into Fitzpatrick’s van; Fitzpatrick could call the police, and so forth). Townsend says every time she came up with some outrageous statement, the psychologist would calmly reject it and come up with alternatives. “I would say, for instance, ’I want to kill you,’ and she'd say, (fiercely) ‘Think again. That’s no good.’ Little by little, she would take the power.

“They loved me out of it. They gave me unconditional, undying love,” Townsend continues, looking back on the years of gradual progress. “It’s a step-by-step process, and you don’t know you’ve finished one step until you’ve already started to take the next one.” Townsend made the biggest advance this August when she ended her formal participation in the Hanbleceya program. She has returned to living with her husband of seventeen years, and this fall she began taking classes that will prepare her to work as a psychiatric technician. It’s been a stressful time, she admits frankly. “All my life, the thing I did was to be a mental patient. I was good at it.” She still lacks confidence in herself and says on occasion she’s even slipped into psychotic thought patterns — but she describes catching herself and firmly backing away from the unhealthy reveries. “The cycles are still there. There patterns are still there. They just become more and more refined,” Townsend says. “It’s a constant recovery.”

One step she hasn’t yet taken is to stop taking any psychotic medication. Whereas once Townsend was receiving a massive daily dose of a phenothiazin (the main category of the so-called neuroleptic drugs used to control psychosis), she now takes only a minimal amount and expects to be weaned completely in the next few months. Still, Townsend's experience with drugs reflects a major change that occurred at Hanbleceya within its first few years of existence. Fitzpatrick now says of her early total rejection of psychotic medication, “We were too extreme.” With no medication at all, residents every day were in “a constant state of escalation,” she says. Finally, she decided, “It was a lot easier for us and a lot easier on the residents to have that containment.” Fitzpatrick says that Hanbleceya now uses medication “when people are so out of it that they need help in containing themselves, until they get the internal structure that they need to be able to cope with the feelings and stress.” That may sound like a major change of philosophy, but Fitzpatrick insists there’s still a big difference between conventional approaches to use of the antipsychotic drugs and her approach. “We use medications as an adjunct to treatment,” she states, “whereas in most traditional systems, they use treatment as an adjunct to medication.”

Fitzpatrick also has backed away from her early, radical carte blanche rejection of hospitalization; today the Hanbleceya staff doesn’t hesitate to have any resident briefly committed to a mental institution if they feel the person poses an immediate threat to himself or to other people. Hospitalization can sometimes help the person to calm down, Fitzpatrick has come to believe. Still other times it can fail miserably. One day last month, for example, the Hanbleceya staff hospitalized one of its young manic-depressive residents only to get a call from the hospital saying that this man had taken another patient hostage and had threatened to hurt her unless he was released. So the hospital let him go, an act that outraged the Hanbleceya staff.

That resident, a thirty-year-old man named Bobby, was still on a manic high when I visited the Hanbleceya residence two weeks later. Staff members say that when Bobby is having one of his periodic depressive spells, he hardly moves or eats. Even his body temperature drops. But during the manic periods, he’s a powderkeg: intrusive, combative, insulting. He’ll stay up most of the night, calling a telephone pornography service or picking fights with other residents. He’s been known to unearth supplies of cocaine (strictly against Hanbleceya rules), and the drug, of course, exacerbates his wild energies. A big, good-looking man, he has a penetrating stare, which he turned on me when I walked into the Hanbleceya living room, just after seven in the morning.

Hardly skipping a beat, he assailed me with half a dozen questions. What was I doing there? What newspaper did I work for? Did I want to write about him? Did I realize he had been institutionalized 117 times? That he was the son of a East Coast Jewish millionaire? Grew up with the Kennedy kids. And on and on. I tried to answer him but felt discomfited by the demanding barrage, and almost instantly he pounced on this, merciless. Why couldn’t I maintain eye contact with him, he grilled me. Did I realize that Werner Erhardt (the founder of EST) would instantly terminate a conversation with anyone who shifted their gaze during a conversation?

I finally managed to extricate myself from him and moved into the spacious kitchen, where a big, very black skinned woman named Ida stood at the stove stirring a huge pot of oatmeal. Bagels warmed in the oven. One of the “community therapists,” Ida normally works from 3:00 to 11:00 p.m., but this day she was filling in on the early-morning shift for a sick colleague. During the night, the house had been supervised by a young woman therapist; she now bustled around the house, tackling the difficult chore of waking up the scattered residents. Hanbleceya staff members say reveille is one of the most difficult parts of a schizophrenic’s day. “It’s frightening,” Ida says sagely. “It’s just like being born. But we try to go around and talk to each of them — because who likes to be blasted out of bed?”

By 7:20 a few residents had appeared in the living room. Sarah, a thin, disheveled looking woman, had joined Bobby. She looked half asleep, an expression that would persist throughout the morning. “Can I have some orange juice?” she asked Ida dully. “No, orange juice is for breakfast,” Ida shot back.

Expressionless, Sarah wandered off. Two male schizophrenics, Dick and Greg, also materialized, prompting Ida to fetch from a locked kitchen drawer a nylon rope, which was then fastened around each man’s waist, linking them together with maybe two feet of space between them. Later, someone explained to me that six days before, Dick’s father had died. In response to Dick’s devastating grief, the community had organized an hourly schedule for who would be tied to him with the rope — which in Hanbleceya is used both as a symbol of connectedness and a practical tool for forcing the schizophrenic to pay attention to the world around him. “It makes you be focused on the fact that somebody exists outside of you,” one staff member said.

Several residents gathered on a side porch, smoking in silence; the house was coming alive. These days, that’s a much more complex process than it was when Fitzpatrick started with one co-therapist and four patients. Now some thirty individuals receive care from Hanbleceya. and over the years, Fitzpatrick has developed an elaborate four-phase organizational scheme for classifying their development. Patients in phases two through four live outside the Lemon Grove house in various stages of independence. Some hold down jobs; some attend school. All participate in both group and individual therapy sessions, which mostly take place in an office complex in downtown Lemon Grove. (Former headquarters for the Lemon Grove sheriffs station, this center was acquired by Hanbleceya in July of 1986.) Residency in the house is reserved for the most severely disturbed people, and in January of 1986, Fitzpatrick won permission from the Lemon Grove City Council to increase their number from six to twelve (this victory came despite opposition from neighbors who complained about the noise, profanity, and other weird behavior from some residents). These days, the house residents include not only the schizophrenics who have become Fitzpatrick’s specialty, but also a few manic-depressives (or “bi-polars,” as contemporary psychiatrists tend to refer to these people whose moods swing from wild agitation to paralyzed lethargy). The house residents overall range in age from eighteen to forty-two, and Fitzpatrick says more than half come from the East Coast, where she frequently travels and speaks.

When Hanbleceya won permission to expand, it added a four-bedroom “sky loft” above the huge garage on the property. Despite all these bedrooms, the residence avoids remarkably well having any institutional air; it instead feels homey and middle class. Three large dogs pad about the premises, and on warm days, flies zoom in through the open doors. Plants and comfortable furniture are scattered throughout. The telephone lends one frenetic note; early on the morning of my visit, it began ringing every few minutes. Bobby strode in from the patio and accosted me with the question, “What’s the difference between a Polish woman and a bowling ball?” He paused just a moment then leered. “In a pinch, you could eat the bowling ball."

More and more residents emerged from their bedrooms, including Robert, a five-year veteran of Hanbleceya who was wandering around in two pairs of shorts. This is the kind of strange behavior to which one could easily grow accustomed here — but the staff's mission, its hourly challenge, according to the philosophy of the place — is instead to stay ever alert to spotting such aberrances and to confront them, force the resident to pay attention and correct the problem. In this case, Ida pointed out his inappropriate attire to Robert, but she told him he could leave on the extra pair of shorts until he showered after breakfast.

Just then, a slight, trimly dressed young man walked through the front door: Kambiz Alaei, program director at the house. Two and a half years ago, while working on his doctorate at USIU, he answered a Hanbleceya ad seeking a “soulful individual.” In his native Iran. Kambiz had worked with severely mentally ill individuals, and in addition he had come from a big extended family, which he says helped prepare him for the demands of the familial therapeutic community. “How has Bobby been?” he asked the night therapist now.

“An asshole, as usual,” she replied, sourly. Bobby had walked into a woman schizophrenic’s room in the middle of the night, sending her into a fit of hysterical screaming, plus he’d also been scrapping witji another male resident. “Has he had his meds?" Kambiz interjected quickly, carefully noting the therapist’s recitation of what Bobby got and when.

By 7:40 a.m., Ida had put out most of the breakfast fare on the big round table in the kitchen, announcing cheerfully, “Got some great oats, you guys. Raisins and nuts and seeds.” At least a half-dozen residents by then had taken seats; they began to eat.

“Where’s Marcia?” someone asked.

“In the shower.”

“She thought we were going to eat at eight.”

“For good reason. That’s when breakfast is supposed to be.”

In through the kitchen door walked a fresh-faced, very normal looking young man. This was Mike, a student at the California School of Professional Psychology, who this year is volunteering twenty hours per week at Hanbleceya as part of an internship. (Such interns provide a valuable source of labor for the therapeutic community.) Mike greeted the residents at the table, while Kambiz scurried about like a mother hen trying to control a maddeningly hyperkinetic brood. He noticed that Lauren, one of the manic-depressive young women, was still missing. Pressing a button on an intercom connected to her bedroom, he urged her to join the group. She responded that she had a problem, but Kambiz quickly suggested that she come downstairs and tell him about it. Then he fled from the machine. Other staff members chuckled at this ploy for getting her to appear. The grins quickly disappeared, however, when the young woman appeared on the staircase and began descending, dressed only in gaudy pajamas that left much overweight flesh exposed.

“Lauren, you go and get dressed,” Kambiz said sternly.

“I’m going to come down like this whether you like it or not,” she challenged him back.

Ida chimed in, “I don’t want to see your butt sticking out,” and she advanced swiftly to the stairs. As other voices urged Lauren to get dressed, Ida climbed one step at a time, backing up the smiling young woman. Moments later the two returned together, with Lauren dressed in jeans and a turquoise shirt. “Now you really look nice, Lauren,” someone praised her warmly.

Throughout the meal, the staff worked like parents supervising balky children. Kambiz, for example, pleaded with Lauren to drink her milk, while other staff members cajoled another young woman to join the table. At one point, a schizophrenic young man named Eric quietly slipped out of the kitchen, settling down instead at the empty staff stable in the dining room.

Almost immediately Mike spotted this and suggested that Eric should rejoin the others.

“It’s more civilized out here," Eric said.

“It’s civilized in there, too.”

Eric argued; Mike persisted. Finally, as Ida whizzed by, Eric asked her plaintively, “Is it okay to sit here?”

“No, it isn’t,” she said curtly. Slowly, Eric picked up his oatmeal and fruit and returned to the communal breakfast table.

The staff members — Ida, Kambiz, Mike, and the house manager, a woman named Anne — finally sat down to their own separate breakfast table about 8:15. They routinely use this time to discuss the day’s strategy, and on this occasion, Kambiz began by noting that Bobby had left the house and was roaming the streets. Kambiz had already received one call, reporting that Bobby had caused some uproar on the block by asking a neighbor for drugs. Soon the conversation shifted to the residents’ breakfast. It had begun much too early this morning; no one was supposed to start eating until eight. Though it might seem a trivial point, structure is crucial in these people’s lives, the staff believes. Let it erode, the group quickly agreed, and havoc would follow.

Kambiz then directed attention to yet another point, one concerning a resident named Marcia. She’s a slim, quiet young woman who looks controlled and pensive, as though burdened by some private grief. Staff members told me that Marcia routinely denies her own physical hunger; if ignored, she’s quite capable of starving herself to death. In response, the staff has devised a logbook tracking Marcia’s food consumption, to be signed before and after every single meal. But Kambiz pointed out that this practice was too often being overlooked.

Finally, the staff members turned their attention to dividing up the residents for supervision. The time had arrived for residents to bathe and do routine chores, but (Kambiz explained to me) many can’t handle by themselves the simplest tasks of personal hygiene. Some, for instance, are terrified of touching and feeling their own bodies. Unsupervised, they get wet in the shower but avoid washing.

On this particular morning, Kambiz was to supervise Dick, the man whose father had just died. Once upon a time, before schizophrenia claimed him, Dick was a star collegiate basketball player, and staff members say even today he moves around on a basketball court with astonishing speed and agility. In the Hanbleceya living room, however, Dick sat on a couch, head nodding, eyes all but closed, as in a stupor. When Kambiz approached him and stated it was time to shower, Dick’s response came with startling ferocity. “I can’t stand up!” he blurted. “Kambiz, I just can’t! I’m so tired.”

As usual, Kambiz appeared soothing, unflustered. “Well, maybe after you shower you’ll feel better.” A moment later he volunteered to “share the rope” with Dick. Though Dick rejected that also, Kambiz smoothly assumed control, which Dick then seemed to accept, passively. Yet when the pair moved to the laundry room to get a towel and Kambiz at one point thanked the other man, Dick snapped back, "You’re not welcome!” They ascended to an upstairs bedroom, and Dick continued, “Shut up. I don’t want to talk to you. I don’t like you at all.” Kambiz replied calmly, “Well, okay. But I care about you.” With relatively little resistance, Kambiz got Dick to remove his clothes and start showering.

Once in the shower, Dick would scrub his body obsessively, Kambiz told me. A far greater trauma for the former basketball player was the daily ordeal of dressing. But Kambiz never got a chance to help Dick with that. Instead, Anne burst into the room and announced that the Lemon Grove sheriffs station had just called to inform the group that Bobby had shown up there. "They say he’s bothering them, and we have to come and take him back where he belongs!”

Kambiz rushed off to attend to this, but Anne continued shaking her head for several minutes after that. “Can you believe it?” she repeated several times. “Why don’t they just lock him up for a while?” A Hanbleceya staff member for two years. Anne is a cheery, middle-aged woman who took this job after moving here from Cambridge, where she raised six children single-handedly. That experience seems to have left her brimming with gritty, common sense. “We give ’em [the residents] a lot of love,” she says. “But we’re tough with them. We say. ‘C’mon, you can be psychotic and still take a shower!’ ”

Anne zoomed off to find Renee (not her real name), the thirty-seven-year-old daughter of one of San Diego’s most prominent and wealthiest sports entrepreneurs. Anne confided to me that Renee is probably her favorite resident. Once a brilliant student, Renee got a master’s degree in music from UCSD and still plays several instruments; she paints beautifully. She became schizophrenic in her early twenties, however, and though she’s lived at Hanbleceya for about five years, “She’s one of our most dysfunctional residents,” Anne told me.

“If she acts out, don’t get scared,” Anne warned, as she corralled the woman and directed her to get a towel. A pretty, dark-haired woman who looks younger than her age, Renee seemed docile about following Anne’s directions; she disappeared into the bathroom. But just a moment later, as Anne stood talking to me out in the hallway, a tremendous noise shook the corridor. Renee had suddenly slammed the bathroom door with savage force. "See. that’s what I mean,” Anne said. Then she sprang into the bathroom and demanded. “Why did you slam that door?” Renee’s reply was muffled, but 1 could hear Anne answer, "If you’re angry at me, let me know. You talk about things with me, Renee. Work it out! That’s what you’re learning, Renee. That’s how you get better.” Anne continued lecturing and bossing the younger woman for several minutes, telling her how to shower. When she emerged, Anne said, “I learn to interpret them after a while.... It takes a year to get to know them. To really, really feel comfortable here, it takes a good year.” A short time later, Ida’s voice, agitated, filled the residence. “Will everybody who’s in the house please come into the living room?” she implored. “I’m calling a group." When a half-dozen or so residents had assembled, she explained that when she went upstairs to get Robert, she found him smoking in one of the bedrooms, a flagrant violation of house rules. Compounding the outrage, when he saw her, he had dropped the cigarette on the floor, smashed it out with his foot, then put the butt in his mouth and started to chew it up. “I’m very angry at you, Robert,” Ida said vehemently. “You could burn the whole place down"

Robert whined, “I don’t know what you’re talking about," but just a moment later he was protesting that he didn’t mean to do it. Someone chimed in, “You mean you didn’t mean to get caught.”

"How did you get the cigarette, anyway?” another person asked. Robert admitted that he had picked it up on the ground.

“You picked up a dirty old cigarette?” Anne asked, repulsed.

Ida inserted, “You know what your structure is. What is it?”

“I do my chores and all that."

“What about smoking?”

For a long moment, he avoided answering. As one dodge, he tried to pick a fight with one of the other residents, but Ida barked, “Focus, Robert! What is your smoking structure?”

"I don’t know. I get to smoke every two hours.”

“And where do you smoke?”

“Out on the porch, or where there’s not a fire hazard." Robert spoke with the mild slur of the very young or slightly drunk.

Mike, the intern, piped up. "So I’m angry that you smoked up there and caused a potential fire danger and broke the rules.” “I'm angry at you too,” Anne added. "Scary, too,” another voice interjected. "Robert is smart, people," Ida said. "Let me tell you. Robert, you need some consequences.”

Again Robert protested that he didn’t mean to do any harm. He wanted to go do his chores, he said, but Anne interrupted, saying she’d known him for several years, and he’s much more focused now than he’s ever been. “So you know what you’re doing."

Finally, Marcia, the anorexic, stated. “I think he needs supervision. You need somebody with you, Robert, every time you smoke.”

“What does the group think?” Ida asked. Various members discussed the proposal, and within moments they had come to a consensus. Ida finally said, “So we’re all in agreement that from now on, until Robert learns his lesson. Robert will be on smoking structure.... Okay, thank you, group," she concluded. "Come on, Robert. You have to take a shower. You have chores to do."

Many other little dramas unfolded that morning, and the staff members later told me I had come on an unusually calm day. Life at Hanbleceya certainly isn’t boring. After the morning chores, the house community meets to organize the upcoming day, and afternoons bring more group work: a choice that ranges from “Prenatal Group” to “Sexual Issues” to “Bioenrichment.” Among the “body therapies” found at Hanbleceya are “tragering,” acupressure, massage, yoga, and “bioenergetics.” Even eating is supposed to be therapeutic here; staff members currently are working to make the food served at meals “more macrobiotic.” It’s no wonder that Fitzpatrick claims there’s no other therapeutic community quite like Hanbleceya; who could precisely duplicate this rich holistic stew? But Fitzpatrick says that at least ten other therapeutic communities spread throughout the United States are like Hanbleceya to this extent: all believe that a community setting is the most effective tool for helping psychotic people function. Fitzpatrick doesn’t even like to use the phrase “mental illness.” She instead uses such terms as “individuals in a psychotic process” needing a safe, supportive place for their “healing journeys.”

When pressed, Fitzpatrick says she thinks as many as sixty percent of all diagnosed schizophrenics are capable of successfully completing that healing journey and "recovering” to the extent that they can function in the world and have intimate relationships, without medication. That belief sets her in sharp contrast to the psychiatric establishment. One local authority who articulated the orthodox view for me is Dr. James Morrison, the acting chief of psychiatry at the Veteran’s Hospital in La Jolla. Morrison says hardcore, chronic schizophrenia “almost never can be managed without medication.” Almost never can schizophrenics achieve complete restoration of their pre-disease faculties. Numerous scientific studies have demonstrated that “people treated without medication are miserable, miserable people,” Morrison said.

Though he’s never visited the facility, Morrison had heard of Hanbleceya. In fact. I was startled to learn that one of Morrison’s patients has lived for years in the Lemon Grove house, and Morrison told me that all he’s seen of the Hanbleceya staff has led him to believe that they are “very well motivated, very caring people. For the kind of material they work with — which is to say very, very ill people — they do a very good job” The psychiatrist even went so far as to state that in his heart of hearts, he thought his patient had probably benefited from living at Hanbleceya. But that doesn’t lead Morrison to accept the theoretical foundation underlying the local therapeutic community. The doctor states unequivocally that schizophrenia “is a medical/biological process rooted in one’s genetic inheritance and mediated through cellular biochemistry.” And even the most sincere, most loving intentions in the world won’t enable one to talk that condition away.

Fitzpatrick retorts that talk alone isn’t enough. She says, “It’s real important for psychotics to be in what I call ‘experiential therapy.’ They have to experience releasing the feeling and then experience something new, something supportive, something nurturing. So we do such things as holding people. Or when they’re working on connecting, they’re on a nylon webbing where they’re physically connected with the therapist. It’s real concrete.” Fitzpatrick nonetheless takes a conciliatory tone toward the psychiatric establishment. “I agree with the medical profession that this is a biochemical problem. There is the mind/body split. Certainly the [schizophrenic’s] sympathetic system is overactive. The patient doesn’t know how to relax. It’s amazing when somebody in this community first learns how to relax. How scary it is. Because they feel their body. They feel energy.”

But if biochemical factors predispose some people toward becoming psychotic, Fitzpatrick has come to believe that certain experiences very early in life — either before birth or within the child’s first year or two — also are crucial. “I’ve never met a schizophrenic who wasn’t terrified. They’re terrified to live and they’re terrified to die. And every person that I’ve worked with has dealt with prenatal and birth issues. So that leads me to believe that that’s the core of it.” For some reason, they feel that their life is threatened, and then they continue to react similarly to stressful situations throughout their development — even though other people confronted with the same kind of stress don’t react the same way. Fitzpatrick continues that she’s seen “that people can recover in the sense that they can get back in touch with their bodies and react differently to stress. They can learn that their life is not threatened because someone yells at them. They have to gain a whole new repertoire of experience. And then something does change in the body. I have residents talk to me all the time when we’re doing body work about the experience that something has changed in their brain. We don’t know what that is, but they talk about it.”

Fitzpatrick asserts that “if we [societally] would concentrate our efforts on how to treat someone that’s schizophrenic in a system that’s integrated and stop spending so much money on brain research, biochemical research, we’d be a lot better off. Because regardless of whether the problem is developmental, if it’s genetic, if it’s biochemical, we’ve got one percent of the population out there that we need to do something about. And we can’t put them in state hospitals anymore. All we’ve done is, we now contain them in board-and-care facilities with no program. They escalate. They get in the hospitals, and we’ve got a revolving-door syndrome. What’s the point?”

That may sound as though she’s hinting that the government should fund programs like Hanbleceya, but Fitzpatrick says she learned her lesson about such aid. She says from 1980 through 1982, the federal government funded a Hanbleceya-run program in Encinitas called Morningstar. But when President Reagan started making budget cuts, the financial support was cut. ‘‘We did a cost analysis, and we found that one young man prior to coming to that program had already spent $700,000 on treatment. He was looking at going back into the system. Now, because of who I am, there was no way I was going to let all those people go back onto the street. So I gave them all scholarships to Hanbleceya. But I vowed at that point 1 would never open a facility based on government funding again — unless they would guarantee it.”

If the government took a longer view of psychiatric care, Hanbleceya staff members argue, it would find that the therapeutic community model actually costs less. “If you take a look at somebody who goes in and out of hospitals for twenty years, at $400 to $500 a day, plus psychiatric fees, versus putting somebody in a program like ours for four to six years at $3500 a month, decreasing over time, it’s going to be cheaper in the long run,” Fitzpatrick asserts.

That’s one view, premised, of course, on the notion that after a half-dozen years, the Hanbleceya graduate will forever leave behind the mental health system. I heard another view of the fees charged at the Lemon Grove community from one doctoral candidate who worked as a psychiatric counselor at the program but left it in disgust after a short time. “I think somebody’s making a ton of money there,” this person says. “I felt that overall it was a dumping ground for rich kids..,. I think their program is so much gibberish, really. It's kind of an R.D. Laing view of schizophrenia being a romantic journey.”

No hard-nosed scientific work was being conducted at Hanbledeya, this person concluded.

I found that Fitzpatrick and her staff indeed don’t make much pretense at being rigidly scientific about their results. Fitzpatrick told me she’s had three true graduates from the program — but I found that figure included Marlene Townsend, who still was taking medication. The director said she didn’t know offhand how many patients Hanbleceya had served over the years, though she guessed there have been about forty. If that success rate doesn’t sound too impressive, Fitzpatrick adds that a number of residents from the early years who left but weren’t fully graduated from all the (current) phases of the program also are doing “relatively okay.” And she confidently says further successes will gradually quell questions of the program’s efficacy.

Hanbleceya and places like it are part of a movement, Fitzpatrick believes, and she predicts that the ultimate force that will carry that movement along will be its graduates. “There will be people that graduate from this community, and they’ll want to go out and start other communities.” When they do, “We can teach what works and what doesn’t work. They don’t have to reinvent the wheel.” Fitzpatrick says she’s already taking steps to insure that Hanbleceya itself continues far beyond her own individual leadership. “There’ve been a lot of communities that have sprung up from charismatic leaders and then have failed when the leader has left.” So Fitzpatrick incorporated the organization about a year ago, and though she denies that it’s making big profits, Fitzpatrick says, “We are operating in the black.” She says she’s now got a system for developing strong program leaders. “And I really believe that in a couple of years, this community can run without me.” Still visionary, she says she can foresee that “alternative forms of treatment for psychotics will evolve in a similar way that Alcoholics Anonymous did; that we’ll have recovered schizophrenics in the same way that we have recovered, or recovering, alcoholics.”