Schizophrenia Is Not An Illness (Part 1)

The APA defines schizophrenia by the presence of two or more of the following, each present for a significant portion of time during a one-month period:

(1)   delusions
(2)   hallucinations
(3)   disorganized speech
(4)   grossly disorganized or catatonic behavior
(5)   negative symptoms i.e. affective flattening, alogia or avolition

Signs of the disturbance must have been present for at least six months and there must be significant deficits in one or more areas of functioning such as work, interpersonal relations or self-care.

The “two or more” concept constitutes a substantial flaw in the so-called diagnosis.  An individual who is displaying hallucinations and delusions (criteria 1 and 2) will be assigned a diagnosis of schizophrenia.  But a person whose behavior is grossly disorganized and whose affect is flat (criteria 4 and 5) can be assigned the same diagnosis.  Superficially these presentations are very different, and the only reason for assigning the same diagnosis is that the APA say so.  This state of affairs is found throughout DSM.  Elliot S. Valenstein, Professor Emeritus of Psychology and Neuroscience at University of Michigan has this to say:

“Although those who directed the DSM-IV project claim that “there has been a stronger emphasis on research data than with previous revisions,” scientific considerations do not play a significant role in the manual.  Instead, the psychiatric tradition and sociopolitical considerations seem to have played the major roles in shaping this document.  Dr. Allen Frances, who directed the DSM-IV project, stated that “we didn’t want to disrupt clinical practice by eliminating diagnoses in wide use.”  Very different symptoms are included under the rubric of “schizophrenia” mainly because they have always been grouped together, rather than because of any new scientific evidence that they share a common etiology.”  (Blaming the Brain, 1998, p 161)

This contrasts markedly with general medicine.  For instance, there is a disease called Wegener’s granulomatosis which is caused by inflammation of the blood vessels.  In the large vessels the inflammation does relatively little harm, but the small vessels can become completely occluded, leading to significant damage in kidneys, lungs, nerve endings, etc.. People with this disease may present very different clinical pictures, but the underlying disease process is essentially the same and the same antibody will be found in their blood stream.

It is widely assumed among the general public that some kind of similar commonality is present in schizophrenia, and that psychiatrists and other mental health professionals are aware of this pathological link.  This is simply not the case.  Selecting two “symptoms” out of five leads to ten different presentations.  Selecting two or more out of five yields 25 different permutations.  Whilst one can acknowledge that a measure of overlap and commonality might exist in these various presentations, there is no evidence that all of these people have the same underlying pathology.  They are assigned the same diagnosis and deemed to have the same “mental illness,” simply because the APA says so.

The central point of this blog is that the concept of mental illness is essentially spurious, and that the vast majority of the problems set out in DSM are problems of daily living and learned behavior.  The so-called diagnoses are routinely presented as explanations of abnormal or unusual behavior, when in fact they are nothing more than labels.

Let’s examine the schizophrenia “symptoms” one by one.

Delusions

A delusion is a false belief.  Now the only way you can discern a person’s belief is through his speech, writing, or other overt indication.  All of these indicators are behaviors.  Speech is behavior, and our patterns of speech are subject to the same behavioral influences as any other behaviors.  So when people express nonsensical ideas (or more accurately, when they speak nonsense) we need to ask why.  Under the DSM system, we don’t ask why.  The delusional speech is simply a “symptom” of the “illness” called schizophrenia, and nothing remains except the prescription of major tranquilizers.  In fact, it is widely believed, and promulgated to students, that nothing can be done to ameliorate delusional speech.

The reality is quite different.  For decades numerous researchers have demonstrated that delusional speech can be reduced and eliminated through appropriately designed behavioral interventions.  Ayllon and Haughton (Modification of symptomatic verbal behavior of mental patients in Behavior Research and Therapy, 1964, 2, 87-97), for instance, achieved a 60% reduction in a hospital patient’s delusional speech by training the staff to ignore these kinds of remarks over a period of 6 months.  The individual in question routinely referred to herself as “the Queen,” and would question staff as to why she was not being afforded treatment befitting this exalted position.  This had been going on for fourteen years.  The staff were trained to simply not respond, to look away, to appear bored, to shift their attention elsewhere, etc., whenever she made these kinds of delusional statements, but to respond normally to non-delusional speech.

The essential point is that delusional speech is behavior and follows the same general principles as any other behavior.  In particular, speech which attracts positive attention and approval is more likely to increase in frequency, while speech which attracts no attention or disapproval tends to be eliminated.  This is as true of everyday conversations as it is of the delusional speech of mental health clients.

In the same article mentioned above, Ayllon and Haughton describe two mental hospital clients, one with a diagnosis of schizophrenia, the other depression.  Both were females and both spent a good deal of time complaining about their health, even though no physical problems had been detected.  This had been going on for years.  Here again, the hospital staff were trained to ignore the somatic complaints, and to respond positively and attentively to normal speech.  The incidence of delusional speech declined rapidly, and by 18 months had been reduced to virtually zero.  This research was done 45 years ago!  More recent examples can be found at Wilder et al (Journal of Applied Behavior Analysis, 2001, V 34, No 1, 65-68) and Mace and Lalli (Journal of Applied Behavior Analysis, 1991, V 24, No 3, 553-562)

What’s particularly noteworthy here is that mental health staff unwittingly but routinely reinforce delusional speech.  Under the DSM system, this kind of behavior is considered a symptom, and the staff tend to “prick up their ears,” so to speak, when clients emit this kind of speech.  The staff member may even take notes.  Mental health clients are as adroit as anybody else at reading signs of attention and approval, and staff become the unwitting coaches for delusional behavior.  This kind of interaction is a direct consequence of the DSM system, under which schizophrenia is conceptualized as an incurable disease, one of whose symptoms is the presence of delusions.  If one focuses instead on delusional speech as a dysfunctional behavior which is learned, then the appropriate response becomes clear: ignore the delusional speech and encourage normal speech.  Note that this is not the same as trying to talk the individual out of his delusions – trying to persuade him that he is mistaken.  These kinds of attempts are generally unsuccessful, because they provide attention and therefore reinforcement.

In Western culture the three great challenges of early adulthood are: emancipation from parents; launching a career; and finding a life partner.  At the risk of stating the obvious, some individuals are more successful in these endeavors than others.  Most young people, however, manage to stumble through these difficult times and to emerge into adulthood with a reasonable measure of success in these three areas.

Some hapless individuals, however, fail miserably in one or more of these challenges, and a small number of people fail in all three.  Whenever we fail – whenever we don’t succeed in meeting an objective – whether the matter is large or small – we always have two options.  We can recognize the failure and take corrective action, or we can reorganize our thinking so that the failure gets relabeled as something else.  This fundamental truth is expressed nicely in the old adage: A bad carpenter blames his tools.  If I decide, for example, to make a window box and the project is a disaster, I can acknowledge that I need to improve my carpentry skills, perhaps even attend some classes, or I can complain that the tools were no good or the lumber was defective, or that my wife is a nag for asking me to do the project in the first place, etc..  In other words, I can change my behavior (in this case my carpentry skills) or I can change my thinking.  In general the latter is usually easier than the former.

In the case of the window box, the outcome is relatively trivial.  In the case of major failures, however, the outcome is very significant, and the cognitive distortion can be considerable.

Consider the example of a young man who leaves home after graduating from high school, and finds a job in another town.  He is filled with hope and a sense of independence, but after a couple of months he is fired.  He is so dispirited that he doesn’t seek another job, and a month of two later is evicted from his apartment.  Finally, in desperation, he calls “home” and his parents wire him the bus fare and pick him up at the bus station.  For good measure, let’s also say that his girl friend has dumped him

Now if he’s an exceptional young man, he might say something like this:

“Thank you mother and father for rescuing me.  I really didn’t have the discipline, stamina, or interpersonal skills necessary to succeed in the adult world.  If it’s all right with you, I’d like to stay here with you for another year and work on my skill deficits.  I’ll get a job and pay you rent, and I’ll join Toastmasters to help me develop some confidence in my dealings with other people, and I would greatly appreciate any feedback or coaching that you could give me.”

Unfortunately a more likely scenario is that he sulks in his room, neglects his personal hygiene, and persuades himself that he would have been ok if people hadn’t had it in for him.  In a context of significant failure, these kinds of paranoid thoughts feed on themselves, and in extreme cases reach a level that would be described as delusional. A good measure of family tension usually ensues.  Sometimes this degenerates into overt hostility, which further feeds and confirms the young person’s paranoia.

At this stage, he (or she) discovers that delusional speech has a significant pay-off.  It reduces expectations.  He is no longer expected to find a job, set up home for himself, or find a life partner.  He is referred to the mental health system, where he is given a diagnosis and a prescription for a major tranquilizer.  He may also be awarded disability status with financial and medical benefits.  By this stage the chances of emancipation and functional independence are slim.  (The major tranquilizer, of course, dampens down the problem behavior.  But real improvements in functioning are rare, and the side effects of the drugs can be truly devastating.)  If the parents ask why their son is so paranoid and withdrawn and unmotivated, they will receive the reply:  “because he has schizophrenia.”  This looks like an explanation, but if the parents were to press the matter and ask:  “how do you know he has schizophrenia?” the only possible reply is:  “because he is so paranoid, withdrawn, and unmotivated.”  The “diagnosis” of schizophrenia is nothing more than a label describing the very behaviors it purports to explain.  And a destructive label at that, in that it stifles and suppresses genuine exploration into the true cause(s) of the problem, and genuine remediation of the original skill deficits.

It needs to be stressed that I’m not suggesting that our hypothetical individual is deliberately and consciously faking his “craziness.”  It is simply the case that behavior that is reinforced tends to increase in frequency whilst behavior that is not reinforced or which attracts negative consequences becomes less frequent.  In the case in question, the behavior of launching out on one’s own, finding a job, and a partner, etc., all ended disastrously.  But the behavior of sulking in his room expressing angry paranoid thoughts was rewarded with attention, solicitous concern, home-cooked meals, and an extraordinary measure of power and control over his parents.  The outcome is not surprising.  An essential point here is that delusional speech and normal speech are on a continuum.  People express mildly delusional ideas all the time.  Listen to any talk radio show.  Listen to politicians railing against their opponents.  Listen to religious zealots.  Listen to racial stereotypes.  Listen to people who insist that the Earth is only 6000 years old.  Listen to golfers after they’ve played a bad stroke.  Listen to people who get passed over for promotion, etc., etc., etc..  The processes that promote this kind of mildly delusional speech can lead to severe delusions if the conditions are ripe.

It is noteworthy that our young person’s real problem – i.e. a marked lack of general coping skills – never gets addressed.  The skills we’re talking about here include:

–          critical self-appraisal
–          bringing tasks to completion
–          not procrastinating
–          making good dietary decisions
–          managing money; budgeting
–          interacting appropriately with supervisors and other authority figures
–          interacting with peers; resisting negative peer pressure
–          managing a checking account
–          getting to bed at a reasonable hour
–          “chatting up” prospective sexual/relational partners
–          dating
–          personal hygiene
–          buying and maintaining a car
–          house-cleaning and general management of personal space
–          choosing friends
–          cooking
–          good management of time
–          etc., etc., etc.

Our culture is generally unsympathetic to individuals who are in trouble because of basic skill deficits.  We have helpful programs for vocational skill deficits, but not for the more fundamental skills, such as those listed in the previous paragraph.  Individuals with these kinds of deficits are usually subjected to censure and negative labeling (e.g. lazy, dirty, slovenly, prodigal, brash, stupid, klutzy, etc.)

The point here is that the three great challenges: emancipation from parents, launching a career, and finding a life partner – are just that: great challenges.  They are not easy.  But this fact is seldom acknowledged.  The cultural expectation is that young people should be able to do all this without difficulty.  And the fact is that most of us do manage to muddle through these years with at least some measure of competency.  Others, however, don’t, and some of this latter group crash disastrously and become mental health clients for life.  In this regard it is noteworthy that the majority of people who are assigned a “diagnosis” of schizophrenia are “diagnosed” in their late teens and early adulthood – precisely when the basic skills demands are greatest.

Of course the bio-psychiatric school would contend that these individuals were already “sick” before they started their emancipation endeavors – that they had a brain disease which impacted their ability to function effectively.  This position may be correct.  But the APA’s definition of schizophrenia includes the criterion that “the disturbance is not due to … a general medical condition.”  So delusional behavior that is caused by a brain malfunction is not (by definition) schizophrenia.  If indeed it could be established that there are individuals with compromised brains and that this neurological damage was truly the cause of problems in living, then the disease needs to be recognized as such, given an appropriate name (e.g. Smith’s neuropathy or whatever), diagnosed neurologically, and treated appropriately.  Meanwhile, assuming a neurological deficit on the basis of unusual or abnormal behavior is intrinsically unsafe.  When we are considering people’s behavior, there are always multiple paths to the same place.  Consider eleven people on a soccer team playing a game on a Saturday afternoon. They are all engaged in the same activity (playing soccer), but the sequence of events that led them to this point will be extremely diverse. One player, for instance, might be motivated largely by a desire to please his father, while another might be there primarily to annoy his father.  A third might be simply trying to lose weight.  A fourth is showing off for his girlfriend.  A fifth may be trying to dissipate feelings of anxiety and tension, etc., etc., etc..

Similarly, it is clear that genes and physiology have an impact on people’s actions, and it is possible that one person’s delusional speech is the direct result of a brain malfunction.  Another person, however, could be emitting very similar behavior without any neurological problem; the delusional speech in the latter case being the outcome of the kind of failure-ridden psychosocial history described earlier.  The brain is a pattern-seeking apparatus.  It looks for regularities and patterns in the data it receives and stores these patterns for later use.  When it can’t discern a pattern (for whatever reason), it makes one up.  In the case of our hypothetical young person mentioned above, the correct pattern was his significant lack of skills in a wide range of areas.  This is a difficult thing to accept, so his brain invented the notion that other people were out to get him – were sabotaging his efforts.  From his point of view this is a perfectly valid explanation for his failures.  Of course, it’s not the true reason, and other people see him as paranoid and delusional, and if he is referred to the mental health system, he is given a diagnosis of schizophrenia.

The problem areas which the APA label as schizophrenia constitute an extremely complex topic, and inevitably this blog post has become very lengthy.  I have more to say on this matter, but I thought I’d post this and continue with more thoughts on schizophrenia in the next post.  Meanwhile, your comments – as always – are welcome.

Next post:  Schizophrenia is not an illness (Part 2)

  • Anonymous

    Your disgusting view of the people labeled ‘insane’, your dehumanizing, sickeningly bigoted view, that they ‘run wild in streets’, shows your ignorance and mindless unfamiliarity with the reality of the problems that get called so ‘medical’ problems. You know nothing. Your comments are nothing but a rehash of the worst falsehoods around this issue.

  • Anonymous

    Thank you Guy for that pile of falsehoods. Everything you’ve written is wrong. Psychiatry is not real medicine, its ‘diagnoses’ are invalid, the people you call ‘patients’ are not real patients of any real doctor. How dare you compare the pseudoscientific quacks in psychiatry to the true heroes of medicine, surgeons. Psychiatrists and people that believe in psychiatry’s pseudoscience are not fit to shine the shoes of a surgeon. Someone go fetch a bucket and mop, and clean up this psychiatric true believer’s vomit from this page. It stinks of gullibility.

  • Anonymous

    Psychiatrists are quacks. Cardiology and psychiatry don’t belong in the same sentence. It’s deeply sad how thoroughly you’ve been brainwashed into this belief in psychiatry Guy. It’s a good thing nobody listens to you.

  • But they are not treating the scans, and instead are treating this constellation of behaviors that they are labeling “schizophrenia” which includes many with perfectly “normal” scans. I would like to see the fMRI scans which not only show abnormality but also provide the pathophysiological explanation for the associated dysfunction. Unfortunately, many people are at risk for getting labeled “schizophrenic” simple by virtue of the fact that they appear to possess greater insight regarding this thing we call “reality.” Rejected and ridiculed they can become dysfunctional.

    Myself, I dumbed it down and went into hiding.

  • Certainly there are people with brain abnormalities who as a result can not function. Not to be demeaning and just for demonstrative purposes, let’s call them brain damaged. Yes brain damage can result in “disfunction.”

    According to some sources there are 5 million people in this county who are predisposed to seeing though the mask of mass societal dissociation. What those people are seeing can be scary, especially when most everyone else around them appears to be wearing blinders.

  • Francesca Allan

    No, you’ve got it very wrong. Our homeless who suffer from mental disorders sufficient to meet DSM criteria are mostly neither on medication nor “running wild in the streets.” They are homeless because our society doesn’t give a shit about people unless they have some economic worth.

    Really not sure what you mean with your penultimate sentence. “Safety more for the patient”? Are you suggesting that mental patients are safer ON medication? That’s not at all clear. The side effects of psychiatric medication are both horrendous and well-documented.

    Is your last sentence intended to mean that the proof of the efficacy of psych meds is that crazy people aren’t running wild in the streets? Again, most of those crazy people aren’t medicated. In fact, they’re outside of the health/welfare system altogether. Considering the horrendous conditions in which they live, most of them do a heroic job in surviving at all. It’s also worth noting that even a “sane” person would likely soon suffer mental distress if forced to live in those conditions.

  • Francesca Allan

    I think I can speak for most commenters on this blog in saying yes, absolutely, we all would be very interested in scientific evidence that mental disorders are brain diseases. However, to date, there is no such evidence (unless something very, very new has been published).

    Even very prominent forced drugging enthusiasts like Fuller Torrey of the Treatment Advocacy Center are forced to admit that there is NO OBJECTIVE TEST that can reliably distinguish a “schizophrenic” brain from a “normal” brain.

  • Francesca Allan

    TA, as I’m sure you know, lots of researchers have commented on the vexing phenomena of schizophrenics who have normal scans and normal folks who have schizophrenic scans. It’s worth considering that even if we did somehow find a correlation, we still wouldn’t know whether such abnormalities were the cause of the disorder or merely the result, i.e. what a brain happens to look like in that state.

  • Francesca Allan

    I would absolutely love it if objective testing were the protocol for psychiatric diagnosis. Then when somebody was wrongly accused of a mental illness, she could demand a brain scan in her defence. Would have saved me years of heartache. My brain scans are beautiful according to the neurologist who treats my epilepsy. On the other hand, no psychiatrist (and I have seen dozens) has ever ordered any such test. What would be the point? There’s no psychiatric information to be gained from them.

  • Francesca Allan

    Guy, it’s actually people like you who perpetuate the stigma as you attempt to “teach” people that schizophrenia (with its various subcategories) is some sort of discrete and meaningful category that is required to help people suffering mental distress. It is not. It is a very loosely defined term that can be applied to vast numbers of people. It has been wrongly applied to me.

    Your claim that schizophrenia can only be treated appropriately with medication is just ill-informed. There are numerous studies showing better long-term outcomes with minimal or even no medication. You are also wrong that schizophrenia is “easily, safely, and effectively treated.” NONE of these three claims is accurate.

  • Francesca Allan

    On a completely different note, if anybody’s been following Guy’s comments could they please point me towards an earlier discussion we were having about unipolar morphing into bipolar? It was under one of the depression articles, but I cannot remember which one. I really wanted to return to that conversation.

  • Francesca Allan

    Guy, you start your comment with “Now, there are times when problematic behaviors shouldn’t be listed as
    mental illness. Adjustment disorder is an extremely vague and useless
    diagnosis, because it tells us (mental health professionals) nothing
    about the patient.”

    This criticism applies to every DSM diagnosis although I agree with you that “adjustment disorder” is more egregiously frivolous than most. All a DSM diagnosis can tell a professional is that at the time of assessment and in the opinion of the person doing the assessing, Patient X meets enough criteria to be assigned Diagnosis Y. Reliability is notoriously low. Remember Rosenhan in the 70s? Not much has changed since then.

    The concepts of what constitutes a diagnosis and, within each diagnosis, what constitutes enough criteria from the appropriate checklist are simple metrics designed entirely by majority vote of the APA’s DSM committee. Over 50% of the members of the DSM committee receive funding from Big Pharma (see Dollars for Docs).

    This is just not how real medicine works. Psychiatry is in a class by itself.

  • Anonymous

    Guy Stridsigne you should genuinely ask yourself why it is that you’re ‘fetching links’ about mere ‘research’ rather than referring to any real life practical scenario where MRIs, fMRIs, PET scans or autopsies are used in the ‘diagnosis’ of so-called ‘mental illness’. Such technologies are NEVER used in so called ‘clinical practice’. Ask yourself why, I’ll give you a clue since you seem to be a slow learner, it’s because there are no objective tests for the fake disease labels psychiatry puts on people. ‘Fetching links’, isn’t evidence, isn’t ‘doing work’. It’s gathering links to failed research that led to absolutely no innovation in ‘clinical practice’. You’re a tragic figure Guy, we can’t wait until you tire of coming here, which will be soon.

  • Anonymous

    Guy Strychnine or whatever your name is. You have no proof that the ‘schizophrenia’ label refers to a real disease. Your opinions are trash. You are the one misinforming people. Why do you feel the need to come here and spew your vomit of quackery? People are laughing at you. You admit you didn’t even read this blog post, and then you impulsively feel the need to barf up half a page of psychiatric lies for us? Just go away and preach your psychiatry religion to people who care to listen.

  • Francesca Allan

    Weird, I thought I posted a comment in response to this but it seems to have disappeared. Anyway, Guy, before you waste a lot of time on this, you might want to consider that even prominent drug enthusiasts like Fuller Torrey of the Treatment Advocacy Center are forced to concede there is no objective test for any mental illness. Hold up 2 brain scans in front of a researcher and he won’t be able to reliably tell you which one is “schizophrenic.”

  • Anonymous

    The hilarious thing is that this piece of work says ‘do you discredit MRIs’. I’m sorry, fool… in psychiatry, MRIs discredit themselves by NOT EVEN BEING USED ANYWHERE BUT IN FAILED RESEARCH IN RESEARCH SETTINGS AND NEVER EVEN USED IN PRACTICAL SETTINGS AT ALL.

    What part of shiny machine used in research but not in daily practice of the field, do you not understand? What kind of a planet do I live on, where some people use a shiny machine in research, but not on the ground in practicality, and you morons consider the machine to have ‘proven’ a fact about millions of people that have never been in such a machine? What kind of a sad, pathetic fool are you?

    It would be like oncologists finding tumors in a few hundred human bodies in human history, and then just assuming millions of people have tumors because ‘let me find you a link from the internet with shiny pictures’. It would be like assuming you have kidney disease because some other guy, somewhere, some other year, in a research study, had a picture taken of his kidney therefore your kidney must be diseased.

    IF YOU TRULY ARE A SO CALLED ‘MENTAL HEALTH PROFESSION’ (CODE FOR QUACK), GUY, THEN I WOULD STAY MILES AWAY FROM YOUR HARMFUL LIES. I WOULDN’T WANT YOUR FALSE, DISCREDITED, ‘KNOWLEDGE’ ANYWHERE NEAR ME OR MY FAMILY. YOU’RE A DANGEROUS PREACHER OF LIES. It’s people like you that would have been convinced from a few measurements of skulls in the 19th century that black people were ‘inferior’. Because all it takes for a pathetic fool like you to believe a biological fact has been ‘established’ about a group of people, is for some failed research to be ‘published’. No, you don’t require your ‘mental patients’ or your black people to be actually tested, no, provided some research some place had a picture of a diseased brain or an inferior brain or whatever hideous bullshit you believe, you’re off to the races with believing that’s been proven, even if none of the millions of people labeled ‘schizophrenic’ were ever put in an MRI the day they got their ‘diagnosis’, you’re happy to denigrate and dehumanize millions by using evil phrases like ‘naked in the streets’ and ‘bizarre’. You’re a hideously misguided person and instead of coming here and spewing your DSM label quackery that you’ve been indoctrinated with, you should be hollering on the street with a cardboard sign selling pencils from a cup.

  • Francesca Allan

    No, Anonymous, we want Guy here. I’m always interested in hearing what the other side has to say. What’s great about Phil’s website is that everyone has a voice. This is exactly the kind of debate we should be fostering everywhere. This is what’s going to bring the fraud of psychiatry into the spotlight.

  • Anonymous

    DO NOT BREAK OUR TRUCE. I will be polite and not offer any further comment to you.

  • Francesca Allan

    But it was you who broke our truce! Why are you making decrees in capital letters?

  • Anonymous

    DO YOU NOT SEE THAT IT SAYS ”

    Anonymous > Guy Stridsigne XX minutes ago, next to my comments, that means I am replying to his comments, not yours. Read carefully. I did not break the truce. If you believe so, state which comment broke it. Either way, get back on track with the truce immediately is what we need to do.

  • Anonymous

    I see I made an error in not replying to HIS comment ONCE here. It was a mistake.

  • Phil_Hickey

    Guy Stridsigne,

    What you are doing here is trying to impose arbitrary limits on the discourse. A vast amount of psychiatry research has been flawed and even fraudulent. So if I see indications of that, I will obviously mention them. Why would I not? But I would be happy to look at any reference that you send, but please don’t inundate me. Send me what you consider your best evidence first. Meanwhile, you might want to take a look at some of the critiques I’ve done. You’ll find examples here, here, and here.

  • The Right Hon. Cledwyn B’Stard

    “Do you enjoy harming and misinforming people?”

    Do you?

    You ask a question, and then assume the answer, perhaps so that you can revel in the hatred you feel all the more.

    As for saying “these individuals would NEVER be able to fully participate in their their lives (without medication).”

    The data seems to suggest the opposite; that the “medications” create the very problems they purport to remedy. Also, what did you hope to acheive by capitalizing the word letter “NEVER”, and the other words you capitalize? Bit childish isn’t it?

  • I have a study to propose. Let’s take a group of anomalous sensitive persons (ASP) aka high schizotypy and highly superior autobiographical memory (HSAM) and have them submit to fMRIs. Maybe what we are seeing on the fMRIs and identifying as schizophrenia is none other than divergent thinking.
    Surely we would NOT want to label and treat people simply because they think differently, especially when their thinking, although often hard to follow, nevertheless turns out the right answers.

  • Nightingale said “We ha€™ve been given a strange anomaly that allows us to literally experience ourselves in both mental and physical realities . . . individuals who are very sensitive to their physical and social environments and are subject to suggestive sensitivity.” Her observations are spot on.

    I am one of the lucky ones. As a kid I learned to emulate the “normals” around me. On those occasions when my acting job failed me there were others there to protect me.

    Her troubles stir the ghosts of Tom Joad and John Brown within me.

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  • Len Lemieux

    Accordingly to your logic Dr? lol…..You are Schizophrenic, since your ideas are so against mainstream thought, that they can be thought to be delusions…..I don’t know how you got your degree, but you are not using it well in my opinion. People with this illness have a difficult enough time in the world, without a health professional telling them what they are dealing with isn’t real. I can only imagine the amount of complications this might arise in many situations. In fact, you might personally be contributing to a person’s suicide that suffers from this illness……….As I do. Your delusions make it easy to understand why you are a blogging Dr. online for the most part. Shame on you for trying to feel important at other people’s health and welfare.

  • Anonymous

    He didn’t say your problems aren’t real he just said he doesn’t believe they are a “health” issue or a “disease/illness”. Why do you believe your problems are an illness? Because someone with a “degree” told you so? You’re being very rude claiming Dr. Hickey is contributing to suicides. Please read the blog and other posts to get more of an idea where this persepctive is coming from.

  • Rob Bishop

    Humans suffer in a myriad of ways. We all agree on this. Yes, “mainstream” thought is that all cognitive difficulties are biological defects, but there’s a huge community of scientists and professionals that claim cognitive challenges such as depression, anxiety, violent rage, addiction, and obesity are not due to brain malfunction or neuro-chemical imbalances. Your angry reaction is due to the fact the beliefs you’ve been taught are being challenged.

  • all too easy

    It is true. Every time robbie boy preaches, it causes many a great deal of boredom and anguish.

  • all too easy

    No completely objective test…

    U b whistlin Dixie, babe

  • Compassionate Reader

    You have some valid points, but in my opinion you are confusing people who are merely deluded and/or extremely selfish and have not learned to integrate themselves into a community and people who truly suffer cognitive ailments. The schizophrenics I have met are completely detached from reality in their episodes which have no basis in anything logical or sensical. There is no experiential basis for it, not disappointment, not failure, not a failure to meet one of your narrow three criterions for life success: Breaking away from parents, getting a soul-sucking job, getting married. Some would say following this boxy life by numbers, life on rails is schizophrenia. In other countries, children do not ever break away from parents, and the grandchildren children do not break away from them and this is beneficial to society. There is nothing wrong with children being with their parents. In some places and or times, even in affluent areas, there are no “careers” to be had. Some people do not want to get married, or re-married as it were. In essence, you are saying “It is all in their imagination” when actually they are suffering something more akin to wires in a machine being unattached and then permanently rewired the wrong way.

  • Anonymous

    Is it ‘logical and sensible’ to be name-calling people ‘schizophrenics’ and claiming with zero evidence that just because someone’s thoughts are unusual and bizarre to you, that the way they are making meaning of the world at a given moment is an ‘ailment’? This is the standard argument, what we see above in your comment, it’s very common and part of what holds psychiatry’s stranglehold on this area together, which is this, because the experiences, thoughts, beliefs, etc., of people you name-call as ‘schizophrenic’ are so alien to you, so far out of your personal experience, because you have zero personal experience with the far extremes of the human mind, any such extreme must automatically be dehumanized into the product of a ‘disease’. The ‘wiring’ metaphor, just an excuse to blame a biology you can’t, nobody in the world can, prove is really diseased.

  • Rob Bishop

    Human suffering occurs in the mind. Addiction, depression, anxiety, rage, and so on. Some might say suffering is “All in their imagination” but that’s just semantics. For example I know many addicts who are “completely detached from reality in their episodes which have no basis in anything logical” but that does not mean they are biologically defective.

  • Rob Bishop

    We all hallucinate and “hear things that aren’t real” every night when we dream, and we consider that “normal.” Just wanted to mention that little fact . . .

  • Phil_Hickey

    Compassionate Reader,

    Thanks for coming in.

    I don’t believe I’ve ever said that emancipation from parents, launching a career, and finding a partner are the three criteria for success. What I’ve said is that they are the three great challenges of our culture, and are accepted as such by most members of this society. The notion that there are alternative objectives and lifestyles is obvious. As is the notion that some people – who accept these challenges – can find themselves living a very unsatisfying, treadmill kind of existence.

    But the reality is that most people accept these as the fundamental challenges of early adulthood, and they judge themselves, and incidentally are judged by others, in accordance with how they have succeeded in these areas.

    I have over the years worked with hundreds of people who have been labeled “schizophrenic”. But I have never met one who hadn’t “crashed and burned” in early adulthood in one or more of these areas.

    I have never said that “it is all in their imagination”. The point is that when we feel that we have failed at something, we always have two broad options. We can recognize the failure, and take appropriate steps to guard against a recurrence. Or we can change our thinking to make it seem like the failure wasn’t really our fault. The latter is usually easier than the former.

    And people who are trying to cope with truly massive feelings of failure can easily develop truly massive thought distortions. The point is that thought distortion is an ordinary human activity. The only difference between ordinary thought distortion and the extreme variety is one of degree.

    There is not one shred of evidence that the individuals who get labeled schizophrenic have “wires” (by which I assume that you mean neural mechanisms) wired the wrong way. If you know of any such evidence, I would be glad to see it.

    Feel free to continue reading Schizophrenia Part 2 and Part 3, and come back if there are other questions, thoughts, disagreements, etc.

    Best wishes.

  • Call me Mike.

    I need some help. I had not been diagnosed with schizophrenia but it caught my atention. i experience some wierd brain activity. I have a critical cognitive mind. most of the times i can predict people„s actions, well, not big ones but small things based usually on a particular distinctive personality features. I allso can reconstruct backwards, actions wich seems not to be normal, most of the times with succes. allso i don„t learn anything mecanicly, just study it and integrate it in my „ data base„. but what i found interesting is that i allso experience some of the schizophrenia paranoic sindroms ( except halucinations, hearing things, aggresive manifestations and I allso have an unusual mental strenght.) Should i go and see a psychiatrist? Really. I need help.

  • jackie chanman

    I googled this and… holy shit is the author the dumbest mother fucker in the world. Your entire thought process, logic, and article are all based on ignorance. “criteria 1 and 2) will be assigned a diagnosis of schizophrenia. But a person whose behavior is grossly disorganized and whose affect is flat (criteria 4 and 5) can be assigned the same diagnosis”

    This is not how psychology works. It is not a checklist or an if -> then clause. No psychologist will assign a diagnosis based on so little information or without any sort of context. The author of this article is a prime example of what happens when someone learns just enough information but not enough to be educated in the subject, to become dangerous. The author is the type of person that goes on webMD and tells everyone they have cancer because of a cough.

    The lists you find online are for those people wondering if they should see a psychiatrist or doctor. “If you or your family member are displaying 2 or more of these symptoms of schizophrenia please consult a professional”.

  • Rob

    You offer no evidence “professional” diagnosis is based on something other than a checklist.

  • Circa

    First of all, it is psychiatrists, not psychologists, who are primarily responsible for using DSM checklists.

    Secondly, diagnoses can – and very often are – based on such limited evidence. Anger (even justifiable anger), for instance, is often diagnosed as mania or psychosis.

    Lastly, if you want to be taken credibility, deal with the issues and abandon the shit talking. Disagree with the author, fine, but please don’t be so offensive as you do so.

  • Circa

    Sorry, should have read GIVEN credibility.

  • Circa

    My God, I need more coffee! It should actually read “attain” credibility.

  • Rob

    Click on your avatar when you’re logged on and you can edit your post.

  • Circa

    Thanks for the tip. So far, I’ve always been posting as a guest but that’s easily changed.

  • Ilia Eli Isakov

    Shame on you and this article. Peoples schizophrenia have negative symptoms which has been shown to mirror dementia with or without psychoactive drugs. Its an organic brain disease and your pseudo behaviorist theory is another step in the wrong direction. People in world war II were as helpless as anything, they did not create a false reality in the ghettos, which would have deemed them all paranoid and schizophrenic against the natzis. Nor do autistic people who are socially and developmentally behind create schizophrenia because they cant deal with societys demands to “marry, get a career” and so on. This is intellectual riff raff, put it next to a sink and run it dry.

  • Phil_Hickey

    Ilia,

    If you can cite any research that proves that all the individuals to whom psychiatry has given this label have a specific brain pathology, I would be happy to take a look.