Living with Schizophrenia in Oakland: Esteban Santiago-Ruiz

January 7, 2017: I sit stunned in the wake of the tragedy of yesterday’s Fort Lauderdale shooting. As statements appear in the press that insinuate that these evil acts need to be avenged, I grieve for the senseless loss of life.  I grieve and I also wonder if anyone cares to understand the dilemmas that people like Esteban Santiago-Ruiz face. Having just endured another holiday season as a mad person, I am reminded of the importance of giving social scapegoats a space to celebrate their otherness. As a licensed psychotherapist, I create safe places where the untold story can be heard. I know that a state of victimhood can be transformed to a celebration. I see it happen every day. It helps me exponentially.

Having caught a fever, I spent Christmas day in bed in victim mode, reflecting on the way I feel scapegoated. Instead of working through the pain like usual, I lay incapacitated, overcome. I thought of my project design that could bring specialized groups into the county service system. Turns out eighteen months of pro bono work only further smeared my reputation. I not only am left unnoticed, I know there are rumors based on past politics and current ones that I can do nothing about. I reflected how, when I recently shared these ideas in a survivor work group, I only felt further marginalized. This hurt, as did the fact that my award winning memoir isn’t selling.

Reaching out to family on Christmas Day conjured that same sense of invisibility: I was reminded that most family members look away from me when they talk to each other. I reflected on how I stooped with my bad back under a tarp in a rain storm barbecuing for everyone at the family reunion and how disrespected I felt when not a single relative stopped by to check in with me. I reflected further about a recent interaction with a chronically normal co-worker that turned bully in nature. And somehow as I traipsed off to sleep, my dreams revealed that I am still afraid of losing everything. This overwhelming sense of hurt could easily be a daily state for me if I was locked up.

Maybe what was going on during this fever was that I was transported back to Montana State Hospital, to a fever I had there. There had been ice growing on the inside of my window just above the cot where I stacked wet wool blankets. Two months into my stay, I still had not met with my psychiatrist. I had already been told there was no need to take my temperature, because aspirin relief was not legal for me. Orders had not been written and it was Friday. When somehow I got myself up and out to the front, I begged for aspirin anyway. It annoyed the old hen at the nursing station to the point where she accused me of being sexually inappropriate with her. I had my hand sitting on my hip tucked inside the elastic of the sweatpants I had been given. Jolted out of my misery by the accusation, I tried to tell myself I was just being paranoid. It wasn’t fair to judge the old hen. She probably would not write me up. But the next time I could manage to get myself out of bed, a conscientious staff person who I had built a relationship with leaked the reality of the note to me. It really did happen.

As a master’s level social worker devoted to going where others wouldn’t and as the survivor of multiple molestations, I was deeply impacted. Immediately, I was afraid that my three month stint on that old dank frozen, dirty unit would be extended. I was there because they said I was paranoid. And now it was possible that I could be held an additional nine months. This is exactly what my family was advocating for.

But when mad people let themselves feel victimized and hurt by such circumstances, not only do they hurt, they may also harm their loved ones who helped put them there. Suddenly, everyone else looks like perpetrators. This does not help us in the least. When mad people act like victims and point their fingers at perpetrators, they may find dozens of irrational fingers back at them criticizing their every move. This is what Schizophrenia means to me.

It takes a while to learn, but there are ways to avoid this. There are ways to achieve mental health recovery. Instead, I have learned that we who experience “psychosis” of any form need to celebrate our otherness, our neurodivergence, our madness. We need the space to tell our untold stories. We need to learn from and support each other. This is what mental health recovery helps us do.

Of course, over the holidays, seasonal stories I endure as a licensed psychotherapist in Oakland have added to my sense of hurt on Christmas. I primarily serve individuals who are marginalized in board and care circumstances. I constantly hear reports that end up being very similar to the warehousing I endured on Unit C in Montana. And particularly around Christmas when people are desperate to give others Christmas gifts, there is a lot of theft, or flim flam. As a staff we do our best to undermine the spank of the poverty over the season, but I always find myself paying attention to the individuals who lose during the Christmas raffle. I give those who won’t even take the risk of playing a knowing look.

But because as a staff person, I believe the horror stories and inquire deeper into them; because I share my own lived experience, I have developed a host of techniques and ways to be helpful to individuals who are suffering from “psychotic episodes” or recovering from them.

And suddenly the person who is down because his Christmas gifts were stolen at his board and care can talk about how the voices respond by telling he is going to go to jail. Then I can tell him about how that’s what I believed was going to happen to me when I ran away from my job at a notorious section 8 housing authority and tried to escape to Canada to seek asylum. That is what landed me in Montana State Hospital. Then, someone else can relate similar experiences. Suddenly this person who has never admitted he hears voices in ten years of treatment doesn’t feel so alone. Perhaps, a few stories later he can celebrate his otherness. Now he and I are no longer marginalized victims. We become proud others. And we prevent the whole system that for years has suppressed and ignored from being attacked as perpetrators.

In Oakland, the more we dig, the more stories of real gang, and police harassment surface. At times we uncover never before told experience of police beatings. I find I no longer feel alone in those instances I bumped heads with the police in the days that led up to my hospitalization. In fact, I don’t feel so bad because I was not nearly killed the way my fellow victimized friend was. And together we become able to accept the tragedies that have held us down and heal. While there are ways we’ve had it worse, there are always ways we’ve had it better. I believe we can all walk away with a sense of better understanding the world.  We can be proud of being others. Now we have mad brothers and sisters.

A few days ago, I was presenting to one of our senior Ivy League psychiatrists. I tried to explain what it is like for a paranoid person who objects to the life of crime to be followed for real and what they have to learn to do to avoid being hurt by real crime rings. The psychiatrist who I have always felt snickers about my street informed content, got confronted by one of my peers, an ex-con who has endured brutal police beatings and been tortured to the point where he lost an eye. This co-worker, and age cohort to the psychiatrist, lifted his head and explained that that is what happens to squares on the street for real.  They often get set up and victimized. This is part of how prisons become so filled with mentally ill. This was such an enormous moment for me. I have been working on the unit for fourteen years and I am grateful to have some back up. While these dilemmas do not afflict everyone in the mad community, it is a very common reality for many of us.

This is another example of what happens when silenced stories get revealed, there is such a sense of relief, comradery and connection. Suddenly the recipient feels like less schizophrenic and more like the subjugated person that they really are.

And then, to learn about the fate of Esteban Santiago-Ruiz, an Iraq war veteran, who had become lost to contact from his family as he cycled through a system that tries to forcefully suppress his trauma and experiences. I spend my livelihood forging a way for people like Esteban to rise up and experience recovery. I see it work time and time again. I have never had a person who revealed the truth about their suffering go postal. But when Esteban contacted the FBI, and cycled through the system in Anchorage, it didn’t help. He boarded a plane and flew home. At the airport he killed at least five innocent people.

Now many outraged individuals will believe mad people need to be locked up and go directly into marginal poverty in order to be controlled. Will my right to prevent these occurrences come under further attack and marginalization? Will I lose my wife and my house and end up in a FEMA camp bearing a microchip that says I am autistic?

Though I never came close to shooting, I can relate to Esteban because I too at one point reached out to the FBI in desperation.

It happened a year after I was released from Montana State Hospital. The only job I could find was at an Italian Delicatessen. My delusion was that my family was a mob family and that the mob was picking on me. In spite of hundreds of resumes and job applications, the only job I could find was at an Italian Deli. My aunt, the rare relative who seemed willing to support me, got me the job. Every day I encountered individuals during my two hour commute (ten miles on a bike, one hour on BART) to the wealthy suburb where I worked. Everyday there was an individual who I believed to be following me. Some were real out-of-state gangsters I recognized from my job at the section 8 housing program. Some appeared just to be purposely dawdling, trying to get my attention in effort to mock me. I ignored them entirely and chose to keep my job and risked the uncertainty.

I ignored them, that is, until the day after 9-1-1. On that day a Muslim man was taunting me in a crowd of people in a festival. Thinking it might be a test to see if I would turn a blind eye to terrorism, I called the FBI and left a very careful short and discreet report.  I was afraid of failing the test, but I was also afraid of being taken back to the hospital.

My therapist was appalled. She always sided with the poor kids who were loved had automobiles, and sold drugs. They spent eight hours a day carving me up, and she always took up for them and my family, though she said she didn’t. She judged me for being a drain and a drag to sit with. Paid 250$ per week by my family while I could barely afford food, I couldn’t share with her what was really happening. I learned time and time again that she wouldn’t believe or care about what I was going through. All she did when I called the FBI was, without an ounce of curiosity, threaten me. I would get in real trouble if I ever did that again.

A day later I saw the Muslim man again by chance and went up and talked to him. He said he washed dishes at a restaurant around the corner from where I worked.

I looked at him. We both knew there was no restaurant around the corner. I apologized to him anyway.

I never saw him again. Strange?

I do not think it is okay to randomly shoot people. But so rarely is there consideration that the media response might escalate the occurrences. It is not fair to use this kind of tragedies to spread hatred and ignorance about what so many individuals go through.

It’s true my beloved co-worker, the ex-con, does fly through that same Fort Lauderdale airport several times a year. It terrifies me to think that for all he does as an elder in the community, for all the family he looks after, for the support he has given me, that he too could fall victim to such a desperate and random tragedy. But I am also not going to judge Esteban until I know all the gory details of the trauma he endured in Iraq and elsewhere. I believe he and many like him do not have insurance that covers treatment that helps humanize what they go through. In many places, treatment doesn’t even exist. They most certainly didn’t in Montana. And the program I have built in the outpatient hospital clinic is the only of its kind. I believe it has had quite a profound effect. I believe it helps individuals get what their insurance pays for, treatment.

While I am grateful for having enough at my disposal so I do not, as a scapegoat, have to live in a state of victimhood, judgments about Esteban are a threat to my very existence. It does make me worry about returning to the torture of the incarcerated state of victimhood. Even with all I have learned and created, incarceration pains me so bad. It set me back two and a half years in the past. It remains to be seen what my future will hold as the reality of my existence remains distorted in the public.

Author: Tim Dreby

I am an award-winning author and practicing psychotherapist

6 thoughts on “Living with Schizophrenia in Oakland: Esteban Santiago-Ruiz”

  1. Touching story to which I can relate. I, like the author, have recovered from schizophrenia though the diagnosis is not very useful. I experienced paranoia but was lucky to find a healing combination of therapies, peer support, holistic health, and selective medication. I went on to become a psychiatrist and have written a soon to be published book, “heartbeats of hope.” We need to find nonpathologizing, respectful ways to reach the Estabans of this world. Peers and humanistic clinicians using Emotional CPR ( and Open Dialogue can often reach and facilitate recovery with persons with schizophrenia in ways traditional clinicians cannot.

    Liked by 1 person

    1. Thank you so much Dr. Fisher for reading my story. We recently hosted a Emotional CPR training on our unit and it had real impact.

      Just like when agencies fight over resources we consumers need inter-agency collaboration, so is true of different modalities in my opinion. I believe they all have their place and when they work together, resources don’t get wasted.

      I was one of the casualties of the Alameda COunty Choices program and am a real believer in the need for grassroot local responses to complex problems. We in Oakland had Arizona come in and tell us that in recovery race doesn’t matter. I objected to this openly having done a lot of growing up in the ghetto. I also tried to promote the recovery ethic of risk sharing. The result was that both sides gutted and burned me. This is an example of what happens when modalities and agencies go to war over funding. Consumers don’t get help and money gets wasted and then people say recovery can’t happen. There is little trickle down.

      Just like we do in ECPR listening and being genuine is so important. Telling East Oakland that European therapies are the solution because of research conducted in a different social service system can cause objection. It hasn’t worked for me. But bringing people together and learning about shared experiences that is really powerful.

      But it’s hard to get anyone to listen to you when politically you are a burned course.

      Our ECPR trainer told me, “Wow, your crows was really responsive to this training.”

      “Yes,” I said we have really great people down here.”

      Many now are taking my suggestions to socially integrate more now with the peer movement now, thanks to your work.


    2. This is a profound account, God bless you xx you are close to the heart of real Love. Whatever happens, pray to your guardian angel for protection and you will be ok. I am a survivor of psychiatric abuse and at the moment, my only long-term support is from my constant and ever-loving husband (xx Jim) i can only imagine what it must be like to be a war-veteran. I cried for Aleppo ,”( and i didn’t know any of the people there, i live in relative safety in Ireland but my heart is soft and i can actually feel other peoples’ pain. Lord have mercy on the dead, their heartbroken relatives and also be lenient on wrongdoers who often don’t see any other way forward. Mary xx

      Liked by 1 person

  2. Thanks, Clyde.You bring your personal life experiences up to date with current events in a loving way.

    I was being followed, had drugs snuck into my food, and heard whispers of negativity about me. Did my dentist implant a radio with a filling?

    They say that paranoia is a heightened state of awareness. There is always some grain of truth within the paranoia. It took me eight years and five hospitalizations to finally understand what was going on via an excellent therapist that I had to wait two years to see.

    She explained to me that I was creating these scenarios to feel more important. My life had been one of low self-esteem.


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