Jonathan Rosen has spent the last few years trying to understand the story of his closest childhood friend, Michael Laudor.
Michael Laudor was, by all accounts, a genius. Maybe even a prodigy. Academically, he excelled beyond belief. Things that are hard for most young students, like reading and comprehending large volumes of material, came easily for him. His charm was infectious, and seemed to immediately attract the attention of any room he entered. As he navigated young adulthood and college, and eventually law school at Yale, one thing was clear: everyone was drawn to Michael.
Then Michael did something unimaginable: he killed his fiancée.
The tragedy of Michael’s story is captured in Jonathan’s new book, The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions. It’s a breathtaking account of friendship, the harrowing and insidious nature of mental illness as it takes over someone’s life, and most of all, it investigates the invisible forces—cultural, political, and ideological—that shaped Michael’s terrible fortune, and America’s ongoing failure to get people like Michael the help that they so desperately need.
On today’s episode, Jonathan shares this personal story of extreme tragedy. Which is also, as we discuss, an American tragedy.
Learn more about your ad choices. Visit megaphone.fm/adchoices
My background is behavioral science research by training. Behavioral science informs psychology/psychiatry. Since nobody knows what another is thinking, patient behavior informs the therapist of condition. But, some patients learn from therapy sessions about how to temporarily hide some symptoms of greater severity. But, humans are unable to maintain lies downstream and become exposed.
Outside the hospital, I would think that a designated therapist (or psychiatric social worker) would have observed Michael’s progression into the “danger zone.” Even if pretending “Everything is fine”, body language reveals tell-tale signs of increased pre-occupation or mental fixation about imagined danger. I also would think that therapist would train immediate family and significant other to recognize warning signs. Police and other professionals train people on how to recognize the approach of violence.
On Yale- sounds like well-intended interference. The key to managing patient mental illness is to interview patient often and to observe task performance. Mental illness interferes with task performance- daily activities, hygiene and grooming, home chores and meals, job performance and relationships. Loving another human is a task that can be observed. It sounds like Yale deprived Michael of normal student tasks. If Michael had been in an environment where task expectation were normal- then a decline would have been noticed by other professors or job supervisor.
I have the DSM-5 Manual on my bookshelf. Next to it is “Handbook Of Psychological Assessment” by Wiley, Sixth Edition (2016). Handbook is a roadmap to assessing and diagnosing patients. It is basically a decision-tree based on rules. The key to success is therapist’s adherence to rules. (Jordan Peterson is correct.)
An example of a therapist rule would be to weigh expected mental harm of “Zero privacy + zero security of homeless during nighttime sleep hours” against benefit of patient autonomy. Or threat of harm resulting from automobile collision vs. freedom of mental patient to move randomly among traffic. Once a month in SF, I scream in horror and look away as I watch someone walk towards moving traffic.
My public health/therapist colleagues create a pathway to Hell, when they replace rules with “reasons”. I have a question for the author Jonathan Rosen; “If you could step into a time-machine, what would you change at different time points so as to avoid the tragic outcomes of your friend Michael and his girlfriend?
Thirty feet from my Tenderloin apartment are the homeless with severe mental illness on the street. In 2004, a homeless man slammed an aluminum coffee cup against my face because- “I owed him a million dollars”, half a block from my apartment. Six months ago, half a block in opposite direction- a stranger out of nowhere punched the air three inches in front of my nose. Business owners are terrified. Mayors and governors are not transparent about the homeless and mentally ill, putting everyone at risk.
In 2023, it is not possible to have an honest discussion with mental health directors or NIMH or public health establishment about homeless or mental patients who fall through the cracks; because everyone lies so as to protect a politicized agenda.
In closing; I wasn’t aware that activists are trying to redefine mental illness as “not ill.”
A good friend of mine lost her stepson to paranoid schizophrenia. He was utterly incapable of self care, and eventually was brutally murdered after years of living on the streets. Every judge before whom he appeared, always after some series of crimes, deemed him “competent” and refused mandatory state care. He should have been in a state hospital. He needed help, and that help had to be compelled upon him. Utterly tragic.