Schizophrenia

There’s an interesting article Inquiry into the Schizophrenia Label (ISL) on Robert Whitaker’s website Mad in America. Apparently Philip Thomas, M.D. and other researchers have been asking mental health clients how they perceived the schizophrenia label. They received nearly 500 responses, and found that more than 80% of responders described the label as damaging and dangerous. They question the validity and usefulness of the “diagnosis” and tentatively suggest that it may need to be discarded. ...

It was widely reported last week that James Holmes, the alleged cinema shooter, will be pursuing a “mental illness” defense. Details are scarce because the judge has issued a gag order, but it is likely, given the available information, that the lawyers will argue that because of his psychiatric history he is incompetent to stand trial. It is also likely that they will bring in some eminent psychiatrist(s) who will confirm his “diagnosis” and claim that at the time of the offense he didn’t know what he was doing, or something similar. ...

Every society in every generation makes errors. Some of the errors are minor. Some are major. One of the great errors of the 20th century was this: we accepted the spurious notion that a wide range of life’s problems were in fact illnesses. This spurious notion was initiated with good intentions – to provide shelter and humanitarian care for a relatively small number of individuals whose plight was truly dreadful. But then the concept of mental illness took off, fuelled largely by the efforts of psychiatrists to legitimize their status as “real” doctors. ...

Hallucinations In Schizophrenia Part 1, we noted that the APA lists hallucinations as one of the primary “symptoms” of schizophrenia. The APA defines an hallucination as follows: “A sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ.” (DSM-IV-TR, p 823) In other words: seeing, hearing, smelling, tasting, or feeling something that isn’t really there. Typically the individual who has been “diagnosed” with schizophrenia reports that he hears voices that accuse him of some wrong or exhort him to some action, and sometimes threaten him with punishment or retribution. A number of points need to be made. ...

Delusions, contd. In my last post I pointed out that schizophrenia as defined by DSM is a confusing collection of human problems with no evidence of a common etiology or indeed any valid justification for including them under a common heading. I discussed delusions and made the point that cognitive distortions of this kind are a normal response to failure. When the experience of failure is profound and pervasive, the delusional speech tends to be commensurately extreme. Delusions are not symptomatic of an underlying illness, but rather are a normal human reaction to severe stress or profound failure, particularly in the late teens/early adulthood phase of life. This is the time of life in which our general coping skills are subjected to their first serious tests, and when people experience profound failure at this time, there is a risk that they will drift towards delusional speech. Onset of delusional speech is typically later for women than men, and probably corresponds with the process of giving birth and caring for small children. The potential for strong feelings of failure is high at this point of life also. ...

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. ...