In The Madness Pill, author Justin Garson draws on detailed firsthand research and interviews to tell the engaging true story of one scientific community’s journey to treat schizophrenia and psychosis after experiencing the effects of psychedelics such as LSD. The ethically and methodically dubious tests, drug-induced obsession, and interpersonal trials that transpired over the course of nearly three decades finally culminated in the creation of a successful treatment by Dr. Solomon Snyder in the mid-1970s, paving the way to more advanced medications and treatments that are still prescribed today.
Having a personal connection to schizophrenia, and hearing that Justin Garson does as well via his own father’s diagnosis, I reached out to Justin to hear more about his personal feelings about the history of “the madness pill,” his thoughts on the future of schizophrenia treatment, and what he hopes listeners will take away from his compelling book.
Rachael Xerri: When I first heard about your book, The Madness Pill, I instantly knew that I wanted the chance to connect with you. My grandfather was diagnosed with schizophrenia while he was in his 20s, and he was terrified of doctors and medical attention for much of his life after enduring traumatizing shock therapy. What first interested you in this topic, and why did you want to share this story now?
Justin Garson: I also have a family history. When I was a baby, in the early 1970s, my dad was diagnosed with paranoid schizophrenia. He was working under Richard Nixon at the time, which is interesting because I think Nixon drove a lot of his staff crazy. Unlike your grandfather, though, in the 1970s, many doctors thought schizophrenia could be healed by talk therapy. At least sometimes that was true—my dad found a therapist who agreed not to give him drugs and that seemed to resolve it, at least for a while.
In the mid-1980s, when he started having serious mental health problems again, everything was about pills. He was often hospitalized against his will and put on medications. I know drugs help a lot of people, but the side effects were very disabling for my dad.
"There’s something darkly comical to me about a group of doctors giving each other mind-altering drugs, and giving those drugs to volunteers, to see if they could go mad."
I wrote the book because I wanted to better understand this shift away from talk therapy toward drugs. I discovered that a lot of that shift came down to one doctor, Solomon Snyder, who was fascinated by the power of drugs like LSD and speed to create psychosis.
What do you hope listeners will take away from The Madness Pill?
First and foremost, I want it to be an entertaining read. It’s a serious topic, but at the same time, there’s something darkly comical to me about a group of doctors giving each other mind-altering drugs, and giving those drugs to volunteers, to see if they could go mad. My main goal in writing it is that it would read like a novel instead of a history book.
But I had a broader goal. I want people to understand that our current ideas about mental illnesses—that these are brain disorders to be treated with drugs—didn’t emerge in a vacuum. Knowing this history helps us to think well about what direction psychiatry should take, and what mental health might look like.
You are a philosophy professor, an author, and also a narrator—that’s quite the résumé! What was the recording process like for you? Was there anything in particular that stood out to you about the story you were telling while you were performing?
Narrating the audiobook was an extraordinary experience for me. It let me encounter the book in a fundamentally new way and see it with new eyes. For example, when I was reading it aloud, I understood just how deeply Solomon Snyder fell in love with one of his professors in medical school. I also realized how hard it was for him, years later, to have a very public falling out with a former graduate student named Candace Pert, over their shared discovery of the brain’s opiate receptor. I was able to sympathize with him more as a person.
"Narrating the audiobook was an extraordinary experience for me."
While psychiatry has thankfully taken strides toward offering patients with mental illness better care, patients still face many challenges. What do you think is the next frontier in psychiatric care for patients with schizophrenia?
That's a huge question.
Increasingly, I would love to see more humanistic forms of treatment replace the over-reliance on diagnoses and drugs. For example, there's an incredible group called the Hearing Voices Movement. They've done great work helping patients with schizophrenia navigate the experience of hearing voices. Thanks to them, some patients stopped taking medications entirely and befriended their voices and are living well. The problem is, groups like that often struggle for legitimacy and funding because they are overshadowed by the dominant medical paradigm.
Is there anything else you would like to share with listeners today?
The main thing is I want people to enjoy the ride. I had a lot of fun learning about the story and writing it. As I was doing research, I kept thinking, “How did any of this actually happen?” For example, I was able to interview a doctor named Burton Angrist, who recently died, about a time in the 1960s when he was giving speed to volunteers to make them crazy. Later I dug up the original notes from that experiment and learned a lot more about who these volunteers were and why they did it. It was an incredible pleasure getting to talk with the people I’m writing about and I hope readers experience some of that pleasure.
