Hidden Valley Road

Hidden Valley Road Looks Inside Mental Illness

October 1, 2020
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An EXCLUSIVE AUTHORLINK interview with Robert Kolker

Hidden Valley Road: Inside the Mind of an American Family
(Doubleday, 7 April 2020)

Hidden Valley Road is the best-selling, critically acclaimed non-fiction work by Robert Kolker, the New York Times best-selling author of Lost Girls. It’s the heart-wrenching, true story of the Galvin family who were the envy of other upwardly mobile Colorado families in the 70s, until tragedy hit. Behind the closed doors of the house on Hidden Valley Road was a far different reality. Six of the ten Galvin boys, one after the other, were diagnosed with schizophrenia. And the other children stood by, horrified, with no way of knowing whether they would be next.

“A feat of empathy and narrative journalism”

– Jennifer Szalai, The New York Times

Hidden Valley Road is a riveting true story of an American family that reads like a medical detective journey and sheds light on a topic so many of us face: mental illness.”
– Oprah Winfrey

AUTHORLINK: Mr Kolker, thank you for your time today. We have been looking forward to discussing Hidden Valley Road with you – it was a fascinating read! Your book has helped break down the misconceptions about schizophrenia – that it’s not a disease, but a collection of symptoms that have been bundled together under one name in the DSM [Diagnostic and Statistical Manual of Mental Disorders]. While this mysterious syndrome (as opposed to disease) does run in families, we understand the way it is inherited has long baffled scientists for decades as it does not appear to be passed directly from parent to child.

In fact, of us assumed it was like depression, anxiety, or bipolar disorder, where the patient could be mainstreamed once they were prescribed SSRIs. However, in the case of schizophrenia, it is generally understood that the solution is not medication (although Thorazine at times has helped to manage symptoms), but early intervention and support from family, especially when it first materialises (usually in adolescence) will make a difference.  To make matters complicated, the definition of schizophrenia changes with each generation with each edition of the DSM so that it’s often tailored toward the style of treatment at the time.

Why has there been no unequivocal solution to curing this disorder, and why wasn’t it a priority in the mental health field?

“I was surprised to learn many things when researching the Galvin family’s story…”

KOLKER: First of all, thank you so much for including me in this interview. I’m so grateful for the chance to talk about Hidden Valley Road.

AUTHORLINK: It’s absolutely our pleasure.

KOLKER: I was surprised to learn many things when researching the Galvin family’s story and the history of mental illness treatment. My first surprise was that there has been no significant advancement in the development of new pharmaceutical treatments of psychosis since the development of Thorazine and clozapine more than fifty years ago. Add to that the fact that even after all this time, no one really knows exactly how or why those medicines work.

Then there is the amazing amount of groupthink and tunnel vision that has polluted the fields of psychiatry and psychotherapy for generations. And the sad fact that even after all this time, despite major advancements in treating bipolar disorder and depression and other illnesses, no one can still agree on exactly what schizophrenia is.

You asked why advancing the treatment hasn’t been more of a priority, and I think the answer is that because the vast majority of acutely mentally ill patients have difficulty advocating for themselves, we don’t see them the same way we see other ill constituencies. They fade into the background and are too often overlooked. I found while writing Hidden Valley Road that a lot of people I talked with had someone in their family with acute mental illness but that no one ever really talked about them.

Also: Many clinicians have a bad habit of operating as if the existing neuroleptic drugs that treat psychosis are as effective as, say, SSRI’s are for depression. In fact, they aren’t analogous. Schizophrenia drugs muffle some symptoms but rarely resolve the condition.

AUTHORLINK: That’s really interesting – and a little disconcerting. Dr Lynn DeLisi, an American psychiatrist and years ahead of her time, is convinced that schizophrenia is primarily a genetic disease. She was one of the top researchers at the National Institute of Mental Health and opted to study schizophrenia even though it did not pay nearly enough.

We understand it was difficult for her to be taken seriously at first, however, once the human genome with sequenced, she was able to demonstrate how families like the Galvins can help us understand the condition and how it takes shape.

Interestingly, she published findings, after decades of research, about the identification of Shank2, a gene that helped researchers understand the disease better.

With all you have learned in your journey in researching your book, which theory are you instinctively leaning towards as the cause for schizophrenia? Nurture or nature? Or both?

“…it’s hereditary, with the possibility of environmental factors that can aggravate matters.”

KOLKER: My short answer is that it’s nature, but with a dash of nurture. Here’s my long answer: I think what makes the most sense to me is the notion of schizophrenia not as a specific illness that you’re programmed to get because of your genes, but instead as a vulnerability one inherits. You inherit the possibility of developing severe mental illness, and the only way of telling of that vulnerability will result in anything of note is seeing how your brain develops over time. (This is why so much schizophrenia becomes more obvious in late adolescence, as the brain is finishing its long construction project.) Where environment plays into it is that, in theory, something in the environment can activate this latent vulnerability. So it’s hereditary, with the possibility of environmental factors that can aggravate matters.

AUTHORLINK: Okay, thank you for that. Reporting on family traumas is nothing new. You once said, “I wasn’t just doing rip-roaring crime yarns; I was looking at issues bubbling up under the surface of these crimes,” you said. “I was the person you would send to interview the grieving family. (LA Times, 7 April 2020). It was a skill you grew up into, influenced perhaps by your mother’s work who spent 25 years as a psychiatric counsellor at your local hospital.

“… I have made it my job to choose subjects that are relatable.”

What do you think she would have said about Hidden Valley Road and the Galvins? Why do you like writing about families?

KOLKER: My mom was interested in families and mental health, for sure, and she was a marvelous listener. She was not a psychiatrist (she had a Masters in counseling psychology), nor was she a theoretician, and so she didn’t some home from work talking about Freud and Jung. Instead, she modelled a certain patience and calm when listening to others talk about their problems. I certainly try to do something like that in my work.

She and I talked about this book project, and she was interested in reading it, but that was not to be. In hindsight, though, I know she was interested in family dynamics and how best to support families in crisis, and so I’m not exactly surprised that I’ve started writing more and more about that over time.

As a journalist, I really was a generalist for a very long time, taking on any assignment that came my way. Over time, I found it less rewarding trying to carve out just a little bit of turf on a competitive subject, and more exciting to be off on my own doing something no one else was doing. There’s a risk when doing that, of course, that what you write may end up seeming irrelevant to most people. So I have made it my job to choose subjects that are relatable. I hope even the extreme story of the Galvins will be interesting to anyone who has had strife in their family.

AUTHORLINK: Which is nearly every family, to an extent! Another promising development in your research for Hidden Valley Road, was the introduction to a researcher named Robert Freedman, who has also been studying the families since the 1980s. He has identified one particular gene that seems to have something to do with brain function that is related to schizophrenia, especially in utero. His hypothesis is to strengthen the gene in with the vitamin choline, which the FDA has recommended.  Have there been any findings available as yet as to the impact of this vitamin? It will be a little challenging having to wait and see!

KOLKER: There will be some time before the impact of choline can be measured, it’s true. But the kids are said to be doing very well, and the FDA has already approved the use of choline by expectant mothers to strengthen brain health. So why wait, I say! Dr. Freedman and Dr. DeLisi have so much to teach us, not just about schizophrenia, but about sticking with one’s dreams despite tremendous obstacles. Their life stories really help make this book that much more meaningful, in my view.

AUTHORLINK: Yes. Your first book, Lost Girls (2013) is the account of a still-at-large serial killer who had targeted five sex workers on Long Island and explored the lives of the victims, and their families, as well as the often inept and negligent efforts of the police to find out who killed them. It was praised for being compassionately written rebutting the assumption that the victims were somehow ‘lost’ already because they were sex workers. It is now a film on Netflix starring Amy Ryan and Gabriel Byrne.

A story you wrote for New York magazine about a charismatic but embezzling school superintendent on Long Island has been made into the HBO film Bad Education, starring Hugh Jackman which premiered on 25 April.

How does it feel to have your written words made into film? Did you have to help out with the screenplays or have a say in casting? Did they meet your expectations?

KOLKER: As a writer for magazines in my thirties, one of the big dreams I shared with my colleagues was that some Hollywood studio would swoop in and pay a lot of money for an article you wrote and then make that article more famous than it ever had been. My career took shape at New York magazine, which is famously responsible for the stories that became Saturday Night Fever, Urban Cowboy, America Gangster, and more recently Hustlers. That never seemed to happen for me until after I left the magazine. A few years ago, I learned that an independent screenwriter wanted to option a story of mine, and lo and behold years later that project became Bad Education. I had next to nothing to do with it, and I’m thrilled with the way the writer, Mike Makowsky, found an exciting way to tell that story onscreen.

Lost Girls was a little different. As soon as the book was published in 2013, it was optioned by a major studio…”

Lost Girls was a little different. As soon as the book was published in 2013, it was optioned by a major studio, which sat on it for a while before it went to another studio, and then finally landed at Netflix. I consulted a little bit on the movie, just factchecking really, and so I’m very glad that the finished movie was true to the themes and purpose of that book. It was every exciting also to take my kids to the set and take my wife to the premiere at Sundance. It’s all very strange but good — seeing lots of people making something that is based on what you wrote. The goodwill I experienced from the filmmakers was really stupendous, and I’m still really grateful to them.

AUTHORLINK: You’re an experienced investigative journalist, but most of your work has been in true crime. Did this subject matter, and working with a family riddled by mental health tragedies, present any new challenges? What other subject matter would you next like to try or prefer never to do?

“The biggest challenge, for me, was understanding the scientific side of the story…”

KOLKER: This was the challenge of a career, for sure — telling the story of a family of fourteen people, twelve kids and two parents, each experiencing the family’s story differently. There were some many interviews to pull from, so many different perspectives to honor. But I love intergenerational family sagas like East of Eden and The Corrections, and so I was excited about giving this a try. The biggest challenge, for me, was understanding the scientific side of the story, particularly genetics. My high school science teachers would have been a little nervous had they heard I was working on something like this.

Next, I’d love to continue writing about families. I really feel I’m not done with that yet. One genre I don’t think I’d ever try my hand at is memoir — I really am one of those writers who prefers reporting about others as a way of understanding the world. That said, there is some subject matter that I’d feel uncomfortable reporting on, perhaps because I’m certain there are others who are far more fluent in those subjects. Sports comes to mind. So does technology.

AUTHORLINK: Okay. And here’s another question about your writing style; when writing non-fiction, we understand you’re inspired by Adrian Nicole LeBlanc, Alex Kotlowitz and Kate Boo, whose works focus on the marginalized members of society. Would you ever jump into writing fiction stories, and if so, would the same type of marginalised subject interest you?

KOLKER: I have never been tempted to write fiction. I think I’ve just gone through too many years of training as a journalist to switch over to anything that hasn’t happened. I suppose I’d never say never, but perhaps to my detriment, I was never one of those reporters who has seven unproduced screenplays spilling out of their desk drawers.

AUTHORLINK: Hidden Valley Road was selected as Oprah’s book of April this year. It was announced during the early weeks of COVID which caused her to comment on its timeliness about it being a baffling and horrifying illness. She stated in the Detroit News, (7 April 2020) that she was personally drawn to the narrative, explaining that a young student from the school she runs in South Africa has three siblings diagnosed with schizophrenia. We all somehow know of a family or a person touched by schizophrenia, so her support of this book would have only boosted the advancement of medical research. Have you heard of any such developments? If so, can you briefly discuss them even if they are just a shift in attitude?

KOLKER: I think support from someone like Oprah does two things: It immediately defuses some of the stigma surrounding mental illness, encouraging people not to view mental illness with fear or disdain. And it encourages more families who are living with mental illness to come out of the shadows and get help. It seems a little strange to say this, but I think Oprah understands that by shining a light on a subject that needs care and attention, she can change people’s lives. That’s really the goal for her — or one goal, beyond encouraging a scintillating book club discussion.

AUTHORLINK: Too true. You said once, “Lost Girls was my first book, so I had all kinds of stress and impostor syndrome and doubt and self-doubt. ” Hazlitt, 29 May 2020

You worked at the New York Magazine for 17 years as a journalist, and your work also appeared in  Bloomberg BusinessweekThe New York Times MagazineWired, GQO, The Oprah Magazine, and Men’s Journal. Your 2006 investigation into sexual abuse in the ultra-Orthodox Jewish community helped bring an abuser to justice and was nominated for a National Magazine Award. Your exploration of an eighteen-year murder-exoneration case and the police tactics that can lead to false confessions received the John Jay/Harry Frank Guggenheim 2011 Excellence in Criminal Justice Reporting Award.

With respect, how can a person with your accomplishments feel imposter syndrome? How did you push through your feelings of self-doubt? How do you feel now? What advice would you give to struggling writers?

“When I was younger, I suffered from all the usual writer problems, including impostor syndrome…”

KOLKER: When I was younger, I suffered from all the usual writer problems, including impostor syndrome — the feeling that at any moment you’ll be found out as someone who doesn’t deserve credit for doing anything, and you’re lucky to have made it as far as you have. For me, part of the way through those problems was by understanding that it was happening at the precise moment it was happening. That helped defuse things. Also, I would try to list the good things that had happened in my career and then end the list by saying “No one is that lucky. This isn’t just luck.” But it’s best, I think, to have good friends you can commiserate with; you can buck each other up.

AUTHORLINK: That’s great advice, thank you! Did you ever write any other books before Lost Girls? Did you always want to be a journalist and a writer? Which book would you have loved to have written?

KOLKER: Lost Girls was the first. I had wanted to write books for a while, and I had written two book proposals that I never made into books. I’m lucky in that I have two amazing agents who give me wonderful advice about the marketplace and what might work best, and they’ve been very helpful to me.

As for books I would have loved to have written: Well, there are a lot of them, but I think Random Family by Adrian Nicole LeBlanc is up there.

AUTHORLINK: As you say in your book, everybody you have talked to who is familiar with this condition recommends early intervention in adolescence in reducing the amount of ‘psychotic breaks’ a schizophrenic person might have in their lifetime. Your book finishes on a hopeful tone when it leans towards the more promising outcomes arising from early detection, “soft intervention” with techniques that combine therapy, family support and minimal medication.

What would help tremendously is a national health care system whereby sufferers can receive good quality treatment publicly if they want. Has there been any move towards this in the US at least, as far as you’re aware?

The best sign I can see is a fair number of mental health non-profits embracing the ideas of early intervention and family support…

KOLKER: Our health system is hardly a system right now. Too many people with mental illness languish on the streets or in jails and prisons, with no system in place to help them. The emphasis on early intervention is a very hopeful sign, but that approach has yet to catch fire everywhere or help people once they are sick. The best sign I can see is a fair number of mental health non-profits embracing the ideas of early intervention and family support — two things that most definitely did not exist in the Galvin family’s time.

AUTHORLINK: Right, of course. And now to finish off on a lighter note, which three people living or dead, would you invite for dinner and why?

KOLKER: I’d like to have dinner with Duke Ellington, Louis Armstrong, and Ella Fitzgerald. I’d hold out hope for a concert afterward.

AUTHORLINK: Wow! Amazing. Mr Kolker, it was such a pleasure talking to you today. We wish you the best with the continued success of Hidden Valley Road and congratulate you for bringing such an important subject in mental health on the table with your book about the Galvin family.

KOLKER: Thanks so much! I’m so thrilled you liked the book, and I’d very grateful to everyone for reading.

About the Author: Robert Kolker is the author of Hidden Valley Road (2020), an instant #1 New York Times best-seller and Oprah’s Book Club selection; and Lost Girls (2013), also a New York Times best-seller and Times Notable Book, as well as one of Publisher’s Weekly’s Top Ten Books of the year and Slate’s best non-fiction books of the last 25 years.

He is a National Magazine Award finalist whose journalism has appeared in New York magazine, Bloomberg Businessweek, Wired, and The New York Times Magazine. His 2004 story in New York Magazine about a public-school embezzlement scandal was adapted for the feature film Bad Education, starring Hugh Jackman. His book Lost Girls was adapted for the 2020 feature film  directed by Liz Garbus and starring Amy Ryan.

Robert Kolker lives in Brooklyn with his family.

About Anna Roins: Anna Roins is a Senior Lawyer, previously of the Australian Government Solicitor, as well as a freelance journalist.

She has studied creative literature at The University of Oxford (Continuing Education) and the Faber Academy, London. Anna is a regular contributor to AUTHORLINK assigned to conduct interviews with best-selling authors. She also tries to write novels in her spare time, reviews books and writes community pieces for reputable publications.

You can find out more about Anna Roins at https://www.facebook.com/anna.roins, and https://twitter.com/Roinsstar.

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