"Freudian" might be the last way one might describe a
recovery-based mental health program that encourages clinicians to be
themselves with patients.
But one might be wrong—at least in part.
"Mental health was described by Sigmund Freud as the ability to work
and love," said Markus Horvath, M.D., a staff psychiatrist at the
Village Integrated Services Agency in Long Beach, Calif., in an interview with
Psychiatric News. "Some consider play an integral part of
mental health as well."
He said that as far as those parameters are concerned, "I think the
Village contributes significantly to our members' mental health."
Horvath noted that Village services have enabled hundreds of its members to
find jobs in the community and establish meaningful relationships with
A number of his patients take college courses or work at jobs in the
community and refuse to be sidelined by psychotic symptoms or other mental
Horvath described one of his patients as a "voracious reader"
and encouraged her to sign up for college courses. She maintains a 4.0 grade
point average despite hearing voices in class, he noted, and is permitted by
her professors to wear a Walkman when the voices get too loud.
Another Village member with schizophrenia under Horvath's care hallucinates"
despite multiple medications at high dosages," yet is able to
take college courses and hold down a part-time job on the side.
One of the aspects that Horvath appreciates about his work with Village
members is that he isn't constrained to "traditional" models of
relating to patients, in which psychiatrists "construct barriers between
themselves and their patients."
Such models "create the illusion that we are very different from
everyone else and that our lives are hunky dory," he said.
Horvath said he believes that when he and other clinicians reveal aspects
of themselves to members, "we have much more credibility with
Some Village staff know too well the problems members have—being
homeless, perhaps, or addicted to drugs. "Their lives were a terrible
mess, and now they are working and helping others," Horvath said."
This creates hope for our members that anything is possible."
Jay, one of the Village members, told Psychiatric News that the
help he received at the Village enabled him to overcome an addiction to heroin
and several other drugs, as well as to learn how to manage the symptoms of his
mental illness. He is now living independently and taking a class at a local
"I want to be a drug and alcohol counselor," he said. "I
can speak from experience."