As detailed in Chapter 16 (The Pearl of Galway) of Stalking Irish Madness, the ground is now shifting beneath psychiatry’s feet. Apparently this chapter was easy to overlook. Why? I have no idea. Here I devote a whole chapter to the great work of the Hearing Voices Network. Maybe I should have devoted the entire book to their work, but then it would have been a much denser narrative and, I suspect, few would bother to read the book.

This hearing-voices movement represents nothing less than a revolution within mental health. I dare say that when the history of mental health in this century is written, it will be seen as singling a shift from flat-world to round-world thinking within psychiatry itself.

In Chapter 16, I describe in detail a group of schizophrenics in Galway who have found a way to recovery from the psychosis of auditory hallucination–and visual and tactile hallucination too, once they have first learned to identify and manage the auditory hallucinations, and this after they’ve first learned the skills necessary to manage the dominant of their auditory hallucinations.

At one time it was thought that encouraging schizophrenics to “dialogue” with their voices, as this technique is sometimes known, was akin to advising them to drink the fruit of the poison tree. Now it is seen as absolutely necessary for the mental well being of millions of schizophrenics worldwide.

In Europe, this new attitude of open-mindedness has not been missed. In Europe, this new willingness to take the symptom of auditory hallucinations seriously has flourished. In Europe, schizophrenics are now leading normal lives because they’ve acquired the skill set necessary to cope with the experience of auditory hallucination a day at a time. In Europe, the scoffing is stopping. They are round worlders and we, I can assure, remain the flat worlders here.

For the suffering family members who have been told for lifetimes that there’s nothing we could do for our schizophrenics, this shift is massive. It means the auditory hallucinations are not “nothing.” It means that we no longer live on the sharp end of “nothing can be done.”

The movement that has been slow to root itself in America. As a result in our so-called progressive modern era it remains all too easy to keep schizophrenics draped in the dark corners of society.

The change is slow because we find it very hard to wrap our own heads around the irrefutable fact that auditory hallucinations are real. Now, however, the psychiatrist have been led to the truth through scans that show the region of the brain that lights up when we listen to sound also lights up for schizophrenics when they have no outside stimuli present. Think about the implications of that statement for a moment and you’ll begin to understand that the flat world is over. It’s a concept alien to us, which explains why my Chapter 16 is too easy to ignore, overlook or dismiss.

I reckon your rebuke smarted not because it was the only unfavorable one for me. At every turn we family members of the 2.4 million American schizophrenics have been told to stuff it basically, because there was nothing that could be expected to be done for people who hear voices. Now we know different. Now we know that this quiet revolution is making giant strides, not just in Ireland and Holland but throughout Europe.

How did you miss the big takeway? Did you skip Chapter 16? The fact that you acknowledged leaving my book–for another favorite author who came in over your transom–told me you weren’t paying attention from the get-go. I come from the one-day-at-a-time and the one-book-at-a-time school and believe a book should be read uninterrupted if it’s to get a fair shake, especially a book of this nature.

I only hope that my PEN prize will amplify the message that there is much, much help on offer. The situation is not as dire as once thought. Not by a long chalk. There is help out there if only we pay attention to the symptom set described by schizophrenics themselves at last. If we take the time to listen, there’s much for us to learn from the least of our brethren.

I mention it only to point out that, unlike the “one of the best books of 2008″ distinction from Slate, a list that was indeed formed by letting each editor make a pick, as you point out, the Ken Book award selection was made by a vote of the entire board. I’m told the vote was “unanimous.”

I may have over-reacted, but sorry to say to Sandra, who just weighed in, that I am not feeling “embarrassed,” as you suggest I should. If there’s one truth I’ve come to know in this world, it’s that mental health means not stifling emotions out of fear of “embarrassment” or, worse, being labeled as one who should be made to feel “embarrassed.” You don’t have to be a sibling, parent or child of a schizophrenic to grasp this key concept, but it helps enormously.

If one is ever “embarrassed” then the key emotion is guilt. Families of schizophrenics confront feelings of “guilt” at the utter helplessness of watching their nearest and dearest vanish before their eyes. Unless and until we accept our powerlessness along with our loss — in a word, forgive ourselves and forgive the world — then the guilt again will rear itself. So “embarrassment” doesn’t even begin to get it. Try writing a family memoir about your deepest pain — it’s like running through the town square stark naked.

The only way for me to come to terms with all the madness in my family was to forgive it at its widest and deepest. For me this meant finding forgiveness for myself, my family, my schizophrenic ancestry, for the small people of the world (forgive me) who judge schizophrenia so harshly, and for schizophrenia itself. Why? Because I do believe, as a sort of psycho-spiritual truism, that you can never truly understand something until you forgive it. All my life I’ve had it backwards. I’ve tried to understand schizophrenia–and all sad things in this sad world–first, and then forgive them. It’s a completely counter intuitive to forgive and then understand, but for me it’s the only way and so that’s how my story gets written as I venture back to Ireland looking for answers and, ultimately, the essential peace of mind that only forgiveness can ever bestow.

I’ll step off again. If people want to travel through Ireland with an ornery bachelor in camper van as he comes to forgive and ultimately understand schizophrenia, then they’ll read Stalking Irish Madness. If not, then who cares? There’s bigger things to fret about than the bruised ego of memoirist coming to terms with his sisters’ insanity. I may have one of the most schizophrenic families ever documented — and it may stretch back 160 years — but this too is not forever. As Yeats wrote, “What they undertook to do, they brought to pass. All things hang like a drop of dew upon a blade of grass.”

Patrick Tracey

I did find the story of Mr. Tracey’s family to be interesting and compelling, and I’ve even noted here that I am in the minority when it comes to not loving this book.

The beauty of the blogosphere is that it allows all of us to share our ideas and opinions, and I welcome that here, but please, let’s be nice and refrain from calling each other’s ideas “utter nonsense.” I wouldn’t do that to my readers (or to any of the blogs I read), and I ask for the same here.