I have spent my professional career working with people with severe mental illnesses and conducting research to isolate interpretable findings that reflect core pathologic changes and are potentially reversible. I worked for many years in the 'backwards' at Elgin Mental Health Center learning to understand and interpret the mental distress experienced by those with chronic psychosis. I began to believe the view the these illnesses were predestined for life-long disability and patients were unable to connect with the world ('dementia praecox') was a self-soothing response developed by clinicians. I subsequently worked mostly with patients in a clinical research setting at Illinois State Psychiatric Institute until coming to Northwestern about 10 years ago and spending a lot of time delivering acute inpatient care. Subsequently, I began working with an outpatient clinic research program for adolescents with early psychosis. I found this work very rewarding and that myself and the social worker, Kevin Murphy, appeared able to help many of these young people 'reverse course'. It was at that juncture that I started learning about First Episode Psychosis programs and began studying what kind of program we wanted to put together. The result was the Recovery from Early Psychosis Program (REPP) which has become the focus of my clinical energies (see below or copy/paste https://www.nm.org/conditions-and-care-areas/behavioral-health/behavioral-health-services-downtown/northwestern-medicine-recovery-from-early-psychosis-program. I am a strong believer that there is a widespread tacit agreement amongst psychiatric researchers to downplay our ignorance of higher brain function and to promote the view that schizophrenia is a homogenous disorder in which any findings that differ from normal contribute to the disease. I view the brain as a complex mystery but that we have tools to isolate specific processes that are directly related to the psychiatric disorder.

I have focused most of my career on linking the water imbalance that is found in about 25% of schizophrenic patients to structural and functional deficits in the central nervous system. Our current efforts are focused on establishing whether neuroendocrine deficits, particularly oxytocin, are responsible for increased vulnerability to psychological stress and impaired emotion recognition and social functioning in this patient population, and whether neuropeptide therapy can reverse these changes.

REPP aims to help the young adult continue to develop their identity as an independent person after the onset of an acute psychotic illness. One’s late teens and twenties normally require a tremendous amount of personal growth and the individual can often avoid traumatic outcomes by just ‘riding the wave’. Unfortunately, individuals experiencing a psychotic episode do not have the luxury most young adults possess: a peer group traversing similar life events with an increasingly broadly defined set of ‘normal’ ups and downs. Following a psychotic illness, in contrast, the individual has limited emotional and cognitive reserve, is typically isolated and may be stigmatized, and yet must confront some of life’s most challenging issues without the option of ‘riding the wave’. Recovery from adversity in itself usually promotes personal growth not seen in other young adults, but requires considerable commitment from the individual and support system. Recovery requires time for healing but also reinvestment in activities with others. Typically, the psychotic episode must first be processed in order for the person and support system to ultimately treat it like any other medical problem: something that requires attention but does not define the person. All this takes time: for healing, to develop and sustain the necessary courage and skills, and to identify and utilize needed supports. REPP contains elements designed to give the individual the tools and confidence to address these issues and resume his/her journey to independence and fulfillment.