Photographer: me Model: me
I am in the midst of preparing my presentation on schizophrenia. It's part of my assessment for my course, we are doing a module on psychopathology. I dont know how I ended up choosing schizophrenia as a topic, it was one of those things, choose a psychosis and there I was volunteering for schizophrenia. Today The Guardian published an article on schizophrenia and opened up a discussion about the illness. It is heart rending to read that attitudes to schizophrenia have not really changed since 1911. Life for people with the illness is still stuck in the middle ages, says the author of the piece, Rachel Whitehead.
Is schizophrenia a biological illness? Are 'schizos' dangerous? Is medication the only cure? Indeed is there a cure for schizophrenia?
Contrary to popular belief psychiatry is not an exact science. So psychiatric evaluations of schizophrenia should be questioned. Central to psychiatry is the notion that the different disorders it investigates are classes of disturbances of the mind and deviations from normality. The pathologies are categorized and symptoms are described in detail (through the DSM, an ongoing project periodically reviewed) and diagnoses are provided on the basis of such classifications.
Psychiatry has been subject to severe
critiques by insiders i.e. psychiatrists themselves who are dissatisfied with
the current models, as also outsiders. The current dominant model of
psychiatry is a biological one, linking up psychiatry with neuroscience, and
locating the mind in the brain. Therefore mental illness is viewed as a disease
of the brain, something which has a physical cause and which can be cured when
the appropriate medication is identified. Not so simple. The biological nature of schizophrenia has not been proven.
Schizophrenia is a condition that is profoundly misunderstood and often
vilified by the popular press. In general people think of schizophrenia as inducing a split
personality of the Jeckyll and Hyde variety and schizophrenics are viewed as
violent murderers. Yet schizophrenia has nothing to do with personality split:
there is a split, but that is in the perception of reality. It is equally a
fallacy that schizophrenics are violent murderers or that they are developmentally
retarded, and with low intelligence.
Photographer: Steven Beard. Model: me
The term schizophrenia has now been used for exactly a hundred years. An unhappy birthday, says Rachel. Rethink Mental Illness will be launching a campaign on Tuesday asking people to send a clear message to government that people with schizophrenia deserve a better deal in every area of their lives
I was intrigued by the comments left by readers. One of them, Veravera, wrote:
"Schizophrenia is essentially a socially created illness so medication is not the answer. Rather than simply sectioning people and loading them up with medication we need to look at the underlying issues. The problem is that the way we treat mental health issues in this country is based around short term interventions and an obsession with risk. However, with the cuts I can't see things changing. It is not the people that are bonkers rather than that the system is bonkers."
Amen.
(The photo by Neil Huxtable was taken in a disused mental asylum in Surrey)
I read once in a book (a mystery novel, of all books) that in ancient Greece there were actually two main "schools" of medical thought and practice. According to this book (whose title I can't remember), the Hippocratic system laid great emphasis on the individual patient--but there was another system, the Cnidian system (from the island of Cnidos where it was first conceived). Some spot research on my part has found this:
ReplyDelete"In Cnidos diseases were supposed to have been elaborately categorized according to the organ affected, a system with some resemblance to the practice in the Mesopotamian lands east of Cnidos. Treatments which were linked with and listed with each disease were simple and sparse.
In contrast, the Hippocratists, it was assumed, made virtually no classifications and used empiric rather than theoretical bases for the management of patients. With respect to treatment, however, Hippocratic methods were not much different from the Cnidian." (From Health Guidance . org, http://www.healthguidance.org/entry/6336/1/Pre-Hippocratic-Medicine-The-Philosopher-Scientist.html
But the mystery novel went on to make the point that modern medicine is based more on a stereotypical "Cnidian Sentences" approach than on an individualistic, "Hippocratic" one. This approach has made it easier to tack a diagnosis on a person, particularly a psychological diagnosis, but harder to deal with individual variants; and I suppose the individual variants are more common and significant than patients who fit stereotypes.
We've applied the "mass production" model to medicine for far too long. Seems to me it's time to try something different. But it'll take a complete retraining of many in psychology...
You are very right Jochanaan. In this particular case it is our own attitude to mental illness that needs changing. Prejudices are deep rooted. I suffered from depression a couple of years ago. Depression can be pretty debilitating but it hardly signals a deterioration of brain power. Yet I recall being shouted at and verbally abused by an otherwise normal, polite, affable person who thought that my depression meant I should be confined in a hospital room as I was 'dangerously deluded' i.e. unable to form any judgement.
ReplyDeleteOne of the views on schizophrenia reported by Rachel in her article was Churchill's, who apparently advocated mass sterilization for the mentally ill! No better than a Nazi...