By all outward appearances, the Galvins seemed to be an ordinary, albeit exceptionally large, family. Parents Don and Mimi met in New York and married toward the end of World War II. Don built a career in the military, and the couple eventually settled in Colorado Springs, Colorado, site of the US Air Force Academy.
Between 1945 and 1965, the Catholic Galvin couple had 12 children: 10 boys and then two girls. They were a good looking and athletic bunch, with the boys letting out their (oft-times violent) energy at home, as well as on the football field or hockey ice.
Life at the Galvin home moved along relatively normally… until it didn’t. First, eldest son Donald, Jr. was diagnosed with schizophrenia as a young adult. Then, like dominoes, five of his brothers also succumbed to psychosis. Astoundingly, half of the Galvin children were diagnosed with schizophrenia, arguably the least understood and most stigmatized type of mental illness.
Compounding the family’s pain and suffering, the second eldest son Jim sexually abused his young sisters for years — something that only came to light years later.
Award-winning journalist Robert Kolker knew nothing about the nature of mental illness, but beginning in 2016 he took a deep dive into the subject to write “Hidden Valley Road: Inside the Mind of an American Family,” one of 2020’s bestselling and most critically acclaimed non-fiction books, according to The New York Times. Kolker traces in fascinating detail both the heartbreaking story of the Galvin family, and the evolving history of the understanding and treatment of schizophrenia over the last century.
The Galvins, having enrolled in academic studies, are themselves playing an important part in advancing research into the disease.
Kolker, who is Jewish and originally from Columbia, Maryland, first heard of this most unusual brood when sisters Margaret Galvin Johnson and Lindsay (née Mary) Galvin Rauch approached him about writing their family saga. Enough time had passed since the most traumatic events in the family’s life for the sisters and their surviving brothers to share their experiences in hopes that they could help others. Father Don was deceased, but octogenarian mother Mimi was still alive and time was running out for her to tell her side of the story, especially now that recent genetic research had disproved earlier theories that her parenting style had caused her boys’ mental illness.
Kolker quotes Mimi, who ran a tight ship and was emotionally reserved: “I was crushed, because I thought I was such a good mother. I baked a cake and a pie every night. Or at least had Jell-O with whipped cream.”
Kolker, 51, thought carefully about how to portray the Galvins. He wanted to be truthful about the sometimes horrifying manifestations of schizophrenia, while not sensationalizing them.
“How do I make sure not to write about the mentally ill members of the family like they are monsters? I didn’t want the book to be ‘Invasion of the Body Snatchers,’ where one-by-one a child becomes sick and that is the last you hear from them,” Kolker told The Times of Israel in a recent video interview from his home in New York.
“I wanted to write about them as human beings, just like other human beings. As soon as I met them, I realized that isn’t hard at all. They are very much their own people. It’s not like they fell off the face of the earth when they got sick,” he said.
No one’s fault
Kolker said he relied on his strengths in narrative journalism to make “Hidden Valley Road” a family saga, while weaving in more technical chapters on researchers’ and physicians’ evolving approaches to schizophrenia. What was originally thought to be a condition that could be cured by psychoanalysis is now understood to be a genetically-based neurodevelopmental disorder that begins in utero.
“We know much more [about schizophrenia] now than we did 50 or 60 years ago when the children in [the Galvin] family were growing up, but there is still a lot more to know and understand,” Prof. Yoav Kohn told The Times of Israel.
Kohn is the director of the Donald Cohen Child and Adolescent Psychiatry Department at the Jerusalem Mental Health Center and the Eitanim Psychiatric Hospital. He is also a clinical associate professor of psychiatry at Hebrew University-Hadassah School of Medicine, and the chairman of the Israel Society of Biological Psychiatry.
The discovery in recent decades that schizophrenia is a disease with a substantial genetic component is a breakthrough, but not yet a game changer.
“It’s not that it is 100 percent genetic, but if a person is born to a person with schizophrenia, then they are 10 times more likely than the rest of the population to develop the disease themselves,” Kohn said.
As of yet, researchers do not fully know which genetic variants cause the disease. Unlike diseases such as cystic fibrosis and Huntington disease, which are caused by a mutation on a single gene, schizophrenia is caused by a combination of many dozens of genetic variants. The specific combination can differ from person to person, and the variants can also be found in individuals who do not have schizophrenia. This makes it very hard to use genetics as a basis for prediction, diagnosis, or treatment.
Although schizophrenia’s prevalence is at a constant rate throughout the world, studies have been done on groups with close genetic isolates in the hopes of advancing the genetic understanding of the disease. According to Kohn, such studies were conducted some 25 years ago in Israel among Ashkenazi Jews and Muslim groups, but they did not yield useful results.
“Multiplex” families such as the Galvins were recruited for these studies. Kohn did not recall any families with as many children, but there were some where — similar to the Galvins — half the siblings had schizophrenia.
Crucially, there are environmental factors that increase or decrease the chance that someone with a genetic predisposition will eventually exhibit symptoms of schizophrenia (typically in late adolescence or early adulthood).
“For instance, if a woman is sick with influenza during the second trimester of her pregnancy, her embryo is at risk of developing schizophrenia 20 years later,” Kohn said.
“Another environmental risk factor is cannabis. It is well proven that cannabis use in people with a genetic predisposition is a major risk factor for psychosis — not only while the person is under the influence of the drug, but also after the cannabis use is discontinued,” he added.
Big questions with few answers
In interviewing the Galvins, Kolker said it was clear that family members were searching for possible explanations for the tragedy that befell the family.
We try to shape order out of chaos
“We try to shape order out of chaos. I say that as a value-neutral thing,” Kolker said.
Some family members speculated that father Don suffered PTSD as a result of his war experiences, and that led him to tolerate the nonstop brother-on-brother violence in the household. Could this stress have been too much for some of the boys to handle, the trigger for their psychosis? Could it have been academic pressure or failed early marriages that caused the breaks?
Donald, Jr. eventually shared he had been sexually abused by a priest who had taken a special interest in the family. When reports surfaced that the priest was suspected of being a sexual molester, Mimi seized on this as a possible explanation for why Jim abused his sisters, and why he, Donald Jr., and other older brothers may have abused some of their younger brothers.
“I had to be very careful about how I wrote about sexual abuse. I didn’t want this book to suggest that mental illness causes sexual abuse. There is no data to suggest that schizophrenia causes pedophilia,” Kolker said.
According to Kohn, sexual abuse, especially at a young age, is a major risk factor for psychiatric disorders later in life. However, these are most commonly depression, suicidality, PTSD, and personality disorders.
They lose their sense of reality and judgement
“In addition, most people with schizophrenia are not violent, aggressive or dangerous to other people. They lose their sense of reality and judgement and can sometimes behave in ways that harm other people, but this is a minority,” Kohn said.
It regrettable that the Galvin sons were born before the medical and science community gained a better grasp on the nature and treatment of schizophrenia.
Today, professionals are on the lookout for signs of atypical development among young children, as well as prodromal (less severe pseudo psychotic) symptoms among adolescents (which were exhibited by some of the Galvin boys). Psychotherapy for those with schizophrenia and their families is oriented toward living and coping with the disease. And although the medications available for treatment are not yet perfect, they now at least produce fewer side effects.
Kolker was quick to emphasize that Galvins’ story is not all negative. At its core, it is an example of how a family facing an overwhelming tragedy remained intact.
“Why wasn’t this family cast to the winds? Why aren’t some of them living on the streets and others just disowning the whole situation? I would ask this question a hundred different ways to everyone, especially the sisters,” Kolker said.
This is a story about how they moved through their trauma
“This is a story about how they moved through their trauma, and as the years went by, processed it and found ways to live. I think there are important lessons we can all learn from a family like this,” he said.
The Galvin sisters asked Kolker to write “Hidden Valley Road” as a way of helping them continue to process their family’s story. But more so, it was a way of reaching out to other individuals and families suffering from acute mental illness, schizophrenia in particular.
“This is a story of the damage that can be caused if you suffer in silence, and the help you can get if you reach out to others,” Kolker said.
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