LULU GARCIA-NAVARRO, HOST:
What is schizophrenia really? Is it only a psychiatric condition, or does it have its origins in something else? Who is more susceptible to it, and why? These are the questions at the heart of a new book about an extraordinary family. Writer Robert Kolker, the bestselling author of "Lost Girls," tells the story of the Galvin family. They seemed a model for baby boomer America - 12 children with a military dad and a strict but religious mother growing up in Colorado in the 1960s. But over the years, six of the boys were diagnosed with schizophrenia. And now their journey is transforming the science around the mental illness. The book is called "Hidden Valley Road: Inside The Mind Of An American Family." And Robert Kolker joins us now from his home in Brooklyn, N.Y. Welcome to the program.
ROBERT KOLKER: Thanks, Lulu. Hello.
GARCIA-NAVARRO: We can't get into every storyline in this incredibly detailed and richly reported book. But generally, tell me about the Galvins and the time that they were living in.
KOLKER: Well, they really lived in the grandest period of the American century. They were married at the end of World War II. They raised a family in the '50s and '60s through the Cold War and through the American prosperity boom. And their children really were the baby boom. The oldest one was born in 1945 and the youngest one in 1965. And there were 12 of them. So they were famous wherever they lived as this very large family that outwardly seemed perfect in every way.
GARCIA-NAVARRO: Let's talk about why schizophrenia has been such a mystery. There was this debate that you discuss initially, nature, genetics, or nurture - that something in the way someone was brought up triggers schizophrenia. What was the debate about?
KOLKER: Well, at the very beginning of psychiatry, most people who were giving schizophrenia a name believed that it had some sort of physical quality to it and that it might be hereditary. But Sigmund Freud disagreed. He really believed that in - mainly it was something that was inherited, not inherited in a genetic sense but inherited in terms of childhood trauma. And this nature and nurture debate continued for some time. And in fact, the nurture people, the psychoanalysts, really held sway throughout the 20th century at least in America, all suggesting that people who had schizophrenia lived in a world that the therapist had to penetrate and that, with the right kind of therapy, the problem might be solved, and the person might enter reality again. And this completely ignored the genetic aspect of it.
Now we're living in a world where everything is seemingly about genetics. But we're back to a nature-nurture argument because we believe that schizophrenia and other complex diseases aren't just about genetics but are about genes that are impacted or affected by the environment.
KOLKER: Well, it's always been known to be a syndrome as opposed to a disease. It's not like influenza, where you can identify what it is in terms of its, you know, chemistry. Schizophrenia is really a collection of symptoms that are defined and then treated based on those symptoms.
GARCIA-NAVARRO: So you, in the book, talk about a woman called Lynn DeLisi and her work. She believed that families like the Galvins held the key to understanding schizophrenia.
KOLKER: That's right. Dr. DeLisi was a pioneer at the time. She was one of the top researchers at the National Institute of Mental Health. And she became fascinated by the idea that, if you studied a family with a large incidence of schizophrenia in it, you might be able to find some sort of genetic silver bullet inside it that could help us understand how the condition takes shape in the general population. But she went on to assemble the most numerous collection of what she called multiplex families. And the Galvins were one of those first families. And they were the largest family. And it was through the study of those families that, with a lot of twists and turns, she ended up - once the human genome was sequenced - to actively demonstrate how families like the Galvins can help us understand the condition and how it takes shape.
GARCIA-NAVARRO: Yeah. And let's talk about what was uncovered through looking at families like the Galvins because there was a mystery, right? - at the heart of this, about the way the brains of schizophrenics function.
KOLKER: That's right. And her belief was that this definitely was inherited, that environment had nothing to do with it. What they found was, in fact, a genetic mutation that might be unique to this family but is so vital to brain function that it might help us understand how schizophrenia works. And that's really how families like the Galvins can help us going forward. We can look at them and their particular genetic mutation that might be at fault. And while that mutation may not exist elsewhere, it can help us understand the disease and how it affects others. And there are models for this with other diseases.
GARCIA-NAVARRO: So it possibly might be neurodevelopmental - is what they came to sort of believe.
KOLKER: Yes. In the '80s, the new wisdom about schizophrenia was that it was a developing mental disorder, which is to say that, even though people came down with it at the age of 20 or 21, that didn't mean that they suddenly got bitten by an insect and had schizophrenia or - it meant that there was something within their genetic makeup that they had from before they were even born that gave them a vulnerability, a special sensitivity - whether it was the inability to filter out certain stimuli or difficulty in brain development that only manifested itself in the final stages of brain development, which, as we know now, is adolescence.
GARCIA-NAVARRO: How did you come across the Galvins?
KOLKER: A mutual friend of mine and Lindsey Galvin introduced us. Lindsey is the youngest of the 12. And he had known them for years. And the two sisters - there are 10 brothers and two sisters - Margaret and Lindsey - and the family had been talking for years about trying to let the world know about their family's story. And finally, they decided they needed an outsider, an independent journalist who could take the story wherever it led.
GARCIA-NAVARRO: Yeah. Now that their story is finally being told, what do you think we should take away from what they went through?
KOLKER: Well, I mean, these are challenging times independent of mental illness. I think that this is an example of a family that really experienced not just one but two or three or four different horrors all at once and came out the other side. It's about not turning inward when the worst happens in life. It's about reaching out to each other and understanding the value of family and the value of not closing yourself off to possibilities. I really believe there's a lot of hope and inspiration in this story that people can take away from it independent of mental illness issues.
GARCIA-NAVARRO: Robert Kolker is the author of the new book "Hidden Valley Road: Inside The Mind Of An American Family." Thank you very much.
KOLKER: Thank you, Lulu.
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