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Graham Gaskin, Graham was a key influence on getting greater access to our files, through the European court case of 1989

William Glasser, psychiatrist

Jeffrey Moussaieff Masson, former psychoanalyst

Alice Miller, psychologist and author

Bruce Perry, clinician and researcher in children’s mental health and the neurosciences

David Smail, psychotherapist and writer

Graham Gaskin

The Life of Graham Gaskin

This story is about one of the early pioneers of files access, Graham Gaskin. Graham was a key influence on getting greater access to our files, through his famous European court case of 1989. That case resulted in a judgement that has had far-reaching implications in opening data on our lives for care leavers. Here, Graham’s friend and author of a biography on him, James MacVeigh, talks about Graham’s life and his journey in accessing his files.

The Life of Graham Gaskin, by James MacVeigh

I first met Graham Gaskin in 1980. My girlfriend had left me and I was alone in my Bristol house when I turned the radio on one morning and the voice of a Liverpudlian teenager came into the room to haunt me. Graham had just been released from a Detention Centre, where he had been sent for trashing the house of a care worker who had sexually abused him. He gave clear, verbal snapshots of the horrors of his life up until then: put into eleven foster homes by the time he was eight, running away, sleeping in cardboard boxes behind Tesco's, and, at nine years old, being incarcerated in an adult mental hospital where he was given forcible injections of largactil. A strictly regimented Boys' Home followed and, when he escaped, his life's pattern was set at ten years old: abuse, escape, sleeping rough, capture and return to even worse forms of repression. At fourteen, Social Services had given Graham into the 'care' of a wealthy man who turned out to be a predatory paedophile.

He clearly had no idea what he would do next and this made me remember my own youth, when a move to a different environment could have saved me from serious trouble. I wrote to Graham via the programme and days later opened my door to a tall, handsome nineteen-year-old who was bursting with intelligence. In a normal life, his good looks and charm would have been assets, but as I got to know him it became clear to me that they had merely made him the target for the unwanted attentions of a succession of paedophiles. His bitterness about this, though seldom mentioned, coloured all aspects of his life. It was Graham's idea that I should write his biography and that first book, GASKIN, was made into a BBC film starring Paul McGann.

The ravages of a lifetime of abuse on Graham’s personality soon began to show themselves in appalling acts of violence, usually drunken and often unprovoked. I was better able than most people to handle this, but the constant conflict between us still wore me down. He moved in with an older woman, but the police were in the habit of raiding my house in search of him, and this went on until he waved goodbye to the UK and departed for Europe, leaving a legacy of cheque card fraud, broken bones and damaged lives behind him.

I saw little of him then for several years, though there were occasional flying visits which left the same carnage in their wake: fights in my local pub, a massive phone bill after Graham had spent hours making international calls and the arrival of the police in a dawn raid after he had left. I once said jokingly to him, 'Graham, you're an emotional gypsy. You arrive in a place where all is order and peace, and leave devastation behind you.' He laughed understandingly. As far as self-knowledge was concerned, he was always top of the class.

We met up again in Strasbourg in 1989, when the Court of Human Rights ordered that his Social Services file be opened, a milestone victory for all people growing up in care. He was living in Germany by that time, and he showed me the special pockets he had sewn into his overcoat for shoplifting. Disturbingly, in view of what was to happen later in Manila, in the Philippines, he was carrying a dismantled handgun in one of them.

The visits stopped as he moved further and further abroad, but I still got occasional letters, and phone calls, from Manila. In two drunken conversations, he told me he had thrown someone to his death from a rooftop, but both versions were different: in one the victim was a Filipino policeman, in the other an Australian federal agent. Graham was not a fantasist, in the sense of making things up, but he moulded events in the telling so that they showed him in what he considered to be the best light. Later, I received a desperate letter from a prison in Germany, where it transpired that Graham was awaiting extradition to the UK for the murder of a sex club owner in Manila. He asked me to get in touch with various influential people “in case they disappear me” and I did so, learning in the process that because his victim was British he could be put on trial in England. In the event, the jury were unable to agree on a verdict. At his retrial Graham defended himself, but he was found guilty and given Life.

I visited him in the top security Long Lartin prison, where the staff painstakingly felt along the seams of my clothes and asked me to open my mouth and lift my tongue. There Graham told me a third and final version of the story about throwing someone off a roof, and the hairs on the back of my scalp rose because I knew I was hearing the truth. He always attracted people, and when a guy from a bar where he had been drinking had tagged along when he went up onto the roof to smoke a joint, Graham had thrown him off simply because he knew he would not be caught. There, in a nutshell, is the effect that the abuse of a child can cause.

We had always had a stormy friendship, with violent ups and downs, but I left the prison that day firm in the belief that it would be our last meeting. A few more letters passed between us, especially when he found he was HIV positive, and I was able to put a mutual friend in touch with him who visited him up to the day he died. He left her his autobiography, A BOY CALLED GRAHAM, a testament, at once passionate and chilling, to the destructive effects of the care system that shaped him.

Anyone wanting to read GASKIN, my book about Graham's childhood, can email me direct at: [email protected]


Mark Vonnegut, MD

Mark Vonnegut Speaks at Convention


May 17, 2003

Mark Vonnegut, M.D.

I’m happy to be here. Thirty years ago I wrote a book about going crazy and have been trying to blend in ever since. It’s about time I came around to see what NAMI was all about. I don’t rush into things.

Thirty-two years ago I was diagnosed with schizophrenia but with newer definitions my disease is more consistent with manic depression or bipolar disease, mostly because I’ve gotten better. These labels can be more trouble than they are worth. There are manic depressives who don’t get well and look more and more like chronic schizophrenics as they go along. With the deck stacked against them, a considerable number of schizophrenics do get better. Until we have some unambiguous diagnostic test, we are all talking through our hats.

Whatever the diagnosis, the care for serious mental illness is in disarray. Meaningful leadership and reform in my opinion is more likely to come from patients and their families. The needs of patients and families dealing with manic depression, schizophrenia, autism, depression, substance abuse are very similar. We need a commitment to improving care and the means to do so…

I’ve been lucky. I received good care early, and have had a small number of episodes. Rather than a suicide or chronically disabled son, brother, friend, I’m what they cal A &W, alive and well. The turn around on the investment for recovery is substantial. I’m happily married, have a wonderful life and three strong handsome very smart sons who would not otherwise be. I could be dragging down a dozen or more people.

If nothing I say sparks any thoughts or identification, it’s possible you’re taking too much medication. If it’s the greatest talk you’ve ever heard, you’re not taking enough.

There will be some tangential thinking and loose associations. Being crazy has had a definite effect on how I think. Not all of my good ideas are good.

Family history. My mother’s mother’s father was an alcoholic who I strongly suspect drank to keep the voices away. My grandmother was a very smart very accomplished woman who was in and out of psychiatric hospitals much of her adult life. She warned my mother not to marry my father because there was instability in his family. My father’s mother who was addicted to barbiturates and wouldn’t come out of her room for weeks at a time and who eventually killed herself on Mother’s day, told him the same thing. I’m the fourth straight generation in my family of people who hear voices, have bizarre delusional thinking and hyper-religiosity. We’ve each saved the planed earth several times. My famous father Kurt is not manic depressive. He’s not particularly well, but he doesn’t hear voices or get all pumped up.

My first episode was in 1971. I believe I would have gone crazy eventually regardless of outside events although they were very crazy times. The assassinations of JFK, MLK, RFK. Kent State, the music, the drugs, the counter culture… My father, was transformed from a not very good car salesman who couldn’t get a job teaching English at Cape Cod C.C. to a guru super star. By the time I started hearing voices so many other unlikely things had happened it didn’t seem out of line. I assumed everyone was hearing voices. To try to find out and so as to not appear unsophisticated, I remember sitting down next to someone and saying, “So what do your voices tell you?”

There are many people who fully recover from major psychotic episodes and go on to live full rich lives. Most of them choose to keep quiet about it. In the middle of my illness when I was far from sure that I would survive, I made a promise to remember and tell the truth about whatever it was that was happening to me. I think it helped. For me, remembering and trying to tell the truth is part of my defense against this disease.

Thorazine, ECT, massive doses of vitamins, were the initial medical intervention tried on me. It should be noted that I’m a very positive person. I’ve responded positively to virtually everything that’s been tried on me. If you sprinkle happy dust on me, I get happy, at least for a little while. What I loved and continue to love about the medical model more than the actual medical means, is that it’s hopeful. It lessens shame and blame.

Now, just about everyone accepts the medical model. We have more effective medications with fewer side effects. I should be happy but I find myself uncomfortable. More and more just about all the questions and all the answers about mental illness are about medication. Mental illness causes poverty and poverty causes mental illness. The same is true of trauma, prejudice, lack of education, lack of skills, loss of spiritual values. Learning how to live well in spite of your illness is at least as important as medication.

I saw a study the other day showing that some atypical anti-psychotic was at least as good as mood stabilizers in preventing suicide. It’s a very good thing to decrease suicide but we should care at least a little if I’m not killing myself because I feel better or if I just can’t remember where I put the damn gun. I want patients and families to have more power. When the interests of patients and families are not perfectly congruent with those of the insurance and pharmaceutical industries, the patients will loose.

I would never advise patients to waste as much time as I do ranting and raving about the insurance and pharmaceutical industries. What is much more important is to make, for yourself, in your own terms, a clear distinction between yourself and your disease and where you want to go as opposed to where your disease wants to take you. Doctors, therapists, medications can only be helpful when they are helping you go where you want to go. Otherwise all the help is just a bunch of crap strewn around a messy room. The road to medical school started with a job mowing lawns I was far from sure I could handle.

People with mental illness are very much like people without mental illness only more so. What we loose with a psychotic episode is the comforting assurance that we can’t loose our mind. When most people look down they see solid ground. When I look down, I’m no so sure.

Crazy thoughts are not the problem. Everyone has crazy thoughts. Hallucinations and delusions tend to catch the attention but aren’t the problem. The problem is that the world becomes discontinuous. We can’t attend to the world and take care of ourselves. So others try to take care of us and they do an imperfect job of it. There is no substitute for being well.

Patients and families should not be left to play one on one with big corporations and providers whose resources dwarf their own. Patients and families should not have to re-invent the wheel over and over.

Even though I’ve only had 4 psychotic episodes and I am now 17 years and 4 months from my last hospitalization, I still worry about it happening again. The bad news is that the worry doesn’t go away. The good news is that worrying about your mental health doesn’t have to stop you from having a full life. I comfort myself with the knowledge that I’m a hypochondriac in other areas. Headaches that last longer than an hour might be brain tumors. George Gershwin died of a brain tumor, why not me? Anxiety or chest pain might be a heart attack. Just because they haven’t been yet, doesn’t mean much, nor do the normal EKG’s or stress tests I’ve had. Tests are often wrong. Doctors are all a bunch of miserable quacks avoiding their own problems by hanging out with sick people anyway.

My job was and remains, to be well enough to be able to politely dis-invite the beneficent attentions of others as many steps as possible prior to hospitalization and involuntary medications.

It was not easy to go from being one of the seven righteous pillars holding up the whole planet and human race to being just another mental patient. I remember talking to a woman who was ending racism and asking her if it was part of a bigger program or if racism was the whole deal. As someone who had gone back to the beginning of time and dealt with issues of whether or not life itself was a good idea, I wasn’t sure that just getting rid of racism was a big enough prize.

When I got a good look at the inner workings of the universe and sadly realized that I couldn’t go back to life on the planet earth knowing what I knew, the voices suggested that I could go back but it would have to be through a psychiatric hospital with the cover story that I was crazy. “Ya. Like who’s going to believe that?”

In the eighties when I was called out of retirement to defeat communism, it was over my strenuous objections. “I don’t even dislike communism all that much,” I objected. “It seems so beside the point.” “The Republicans are going to take credit for this and ride it into the ground,” I correctly predicted. After winning many many preliminary rounds which I honestly hoped I’d loose, I was smuggled into what was thought to be just another psychiatric hospital where the Russian bear took one look at me, declined to dance, and the rest is history. My delusional world always felt kind of tinny and hollow, but that never helped me get out of it.

As a form of gross overcompensation with a chip the size of Montana on my shoulder, I decided to try to go to medical school. I applied to 21 Medical Schools. Most rejected me by return mail, probably on the basis of my age and undergraduate grade point average. I didn’t need a psychiatric diagnosis to be a questionable applicant to medical school.

I gave serious consideration to saving the $50 and not applying to Harvard at all. I honestly think that they admitted me partly to prove that I wasn’t schizophrenic, partly because they thought I’d be a good doctor, and partly just because they’re Harvard.

It’s amazing that I’ve been through what I have and practice medicine. Today I’m glad I don’t see any particular cosmic significance or purpose in these events. I just feel lucky. Today it’s nice to be able to entertain odd thoughts without having to marry them all. Thank God. I can think whatever the hell I want. Entertaining odd thoughts won’t make you crazy. Refusing to entertain odd thought won’t make you well.

During my recovery from my last episode a very wise friend told me that other people’s business was not my business. I felt insulted that he bothered to tell me such an obvious thing. He then said that what other people thought about me wasn’t my business. Harder but still not earth shattering. He then went on to say that what I thought wasn’t really my business either, which has kept me puzzled ever since.

I’ve come to believe that I’m at my best and that it’s a beautiful world when my feelings are like the weather and that what I think is not my business.

A surgeon during my core surgery rotation said that he knew who I was, but that he was going to treat me as if I were normal. I sincerely thanked him and said I’d do my best to act that way.

Are people who have been crazy held to unfair standards?

Of course, but it’s not in your best interest to complain. If you’re paranoid and people are looking at you funny it’s best to let it pass. Psychotic people have an uncanny knack for making their own worst dreams come true. Depressing things happen to depressed people way beyond what you would expect from random distribution.

I don’t think the people today who start hearing voices, stop eating and sleeping, and run amuck are likely to get good treatment. Having more knowledge, better diagnostic capabilities, better medications with fewer side effects, can’t make up for the fact that most patients are being treated by doctors, therapists, and hospitals, who are operating under constraints and incentives that reward non-treatment, non-hospitalization, non-therapy, non-follow-up, non-care. Lost to follow-up is the best outcome a health insurer can hope for.

I take Lithium and believe that it has saved my life. I wish I didn’t need medication. I’m not wild about the tremor and think I might be 20 lbs lighter without Lithium, but what I really hate about medication is that it helps me, which means I’m not nearly as perfect as I wish I were. I should be able to maintain my mental health by the exertion of my amazing will.

There’s a big difference between believing you can fly and flying. The romance about creativity and mental illness has come from the hard work of great artists struggling against the illness not giving into it. The best defense against the seduction that mental illness will make you creative, is to actually be creative. Please don’t give the disease that tried to kill me credit for my writing and painting.

Let me be clear that there’s no romance. I never want to dance that dance again. The more times your wheels go into that rut, the harder it’s going to be to get out. I dread nothing more than the next break, and am certain of nothing more than that there’s nothing positive for me in the psychotic state.

You can’t look a the paintings of Van Gogh, and other achievements of manic depressives without concluding that there are positive capacities associated with this illness. But those positives are AS A RESULT OF FIGHTING THE ILLNESS RATHER THAN GIVING IN TO IT.

What you do when you accomplish something is to say, “bugger off disease.” This disease is never your friend.

My illness, my enemy, is a valuable compass. I can usually figure out whether or not something is moving me closer to or further away from a break. And I can lean from others what things they think help defend them against the next break. The way to live a healthy life is to get a chronic disease and take good care of it.

It’s alarming that someone like myself with such a pathetically underdeveloped respect for safety issues became a pediatrician. When asked by parents about car seats, I have to work at not letting it slip that I don’t really care. I also can’t stand it when mothers talk to their babies in high squeaky voices. It’s a true miracle I’ve lasted as long as I have.

I’m supposed to tell adolescents about high risk behaviors. I told one mother who asked me to give her son THE LECTURE, that if one more person told her son about sex, drugs, and alcohol, he was going to vomit. I told him I thought I should have posters on the wall saying:

“If you’re having trouble with decisions, smoke marijuana.”

“Safe sex is better than no sex at all.”

“Drink yourself into a black out whenever you can.”

This is all by the way of leading up to say that alcohol and drugs will almost make things worse for anyone recovering from mental illness but each may have to learn that for themselves.

It’s possible within any given moment of any given day for me to choose between self and disease. I am rarely faced with big heroic choices that will settle the matter for once and for all, though the disease likes to tell me otherwise. I look for the smallest positive step. I try not to argue too much. If I’m right, I don’t need to argue. If I’m wrong, it won’t help. If I’m OK, things will be OK. If I’m not OK, things don’t matter.

Thank you for your time and patience.

The Eden Express: A Memoir of Insanity


Mark Vonnegut (Author)

Book Description

"Most diseases can be separated from one’s self ... schizophrenia is something we are." So begins Mark Vonnegut’s depiction of his descent into, and eventual emergence from, mental illness. As a recent college graduate, self-avowed hippie, and son of a counterculture hero, Vonnegut begins to experience increasingly delusional thinking, suicidal thoughts, and physical incapacity. In February 1971 he is committed to a psychiatric hospital. The Eden Express, an ALA Notable Book first published over 25 years ago, is his honest, thoughtful, and moving account of the illness of schizophrenia. This edition features a new foreword by Kurt Vonnegut and a new preface by the author. "Required reading for those who want to understand insanity from the inside." — The New York Times