"http://en.wikipedia.org/wiki/Schizophrenia
"Schizophrenia (pronounced /?sk?ts??fr?ni?/ or /?sk?ts??fri?ni?/) is a
mental disorder characterized by a disintegration of the process of
thinking and of emotional responsiveness."
I agree more with the second line.
"t most commonly manifests as auditory hallucinations, paranoid or
bizarre delusions, or disorganized speech and thinking, and it is
accompanied by significant social or occupational dysfunction."
I'd always perceived the classic meaning of schizophrenia or dementia
praecox (and here I'm including bipolar and using Bleuler's the
schizogruppen concept where he actually termed it "the group of
schizophrenias" way back when he changed the word to suit his new
conceptualisation).
I'm pleased to see they've tightened up on the etymology of schizophrenia.
" Despite the etymology of the term from the Greek roots skhizein
(???????, "to split") and phre-n, phren- (????, ????-; "mind"),
schizophrenia does not imply a "split mind" and it is not the same as
dissociative identity disorder—also known as "multiple personality
disorder" or "split personality"—a condition with which it is often
confused in public perception."
The term is in fact a new term and unrelated to the Latin or Greek
roots. They were chosen by Bleuler to describe the medical concept but
the term was dementia praecox before, a latinisation of Kraeplin's
medical concept. He saw what he saw in dementia patients in people with
dementia praecox (which covers many more disorders than the modern term
schizophrenia). It's not like agoraphobia which literally means fear of
the market and has a lineage where etymology that looks at the latin
root is relevant.
The Wiki definition is probably in tune with the modern psychiatric
definition though I think many psychiatrists if probed would have
different interpretations of what they perceived as schizophrenia.
There's no biological test though it's a supposed biological disease.
What I perceive as the fundamental 'disorder' pathologised by Kraeplin
or Bleuler is the internal experience. It's the experience of hearing
voices or having strange perceptions in consciousness or other form of
unusual internal experience. The rest is all symptoms.
What I've described there is the positive symptoms. I think they cause
the negative ones. This is based on my personal experience rather than
psychiatric evidence but it's fairly obvious. previously I'd mistaken
the etymology of schizophrenia to mean shattered mind because when I
went through acute psychosis I felt my self shattered. The same result
might be achieved by torture. That's really what psychosis feels like to
me: a form of torture if the delusions or hallucinations aren't positive.
Some of the things that are noted as pathological in schizophrenia are
natural human reactions to intense soul pain. Lets take the
inappropriate laughter thing. That can be a coping mechanism that's
simply not acceptable in society. It can be the whole "the diffrerence
betweeen tragedy and comedy is time" as well as if you've had enough
misery in your life then you'll be able to laugh about it or you'd just
kill yourself if you can't find another way. After a while I just got
used to laughing at stuff to stop myself from crying.
Another is social withdrawal. Derrr. In a world that doesn't understand
experiencing psychosis is hell on earth. Depending on the experience
itself it can wreck social contact. This can be because the delusions
make it hard to interpret what people are saying because there's a
different interpreation that happens, e.g. someone might say "What
country are you from?" but the first bit of the word country is made
more loud by psychosis so it is heard as "cunt" and the cunt bit refers
to me. It becomes easier just to leave all that behind and survive life
alone. People with schizophrenia are often very sensitive as was noted
in Jung's paper in the early 20th century and his book Psychological
Types. Being misunderstood, misundestanding everything that's going on
around and being surrounded by people wiout understanding or compassion
would make any person want to withdraw. Poverty of speech might occur
for the same reason.
Blunted effect is another symptom. It's simply burnout. That's my guess
from personal experience. It's exhausting being tortured. The trauma of
war has also been noted to produce this symptom.
To me there's a core experience: the delusions or halluncations. Then
there's everthing that people do to cope and how it manifests on the
outside. The latter is all that psychiatrists see and judge upon. I
don't know if they see the symptoms the way I do but from my personal
experience of psychosis, paranoia, mania and other extreme states it's
all about the internal experience and the outward manifestations. People
learn to cope in different ways but these methods are pathologised by
people who don't understand when they happen. They don't see the misery
behind it. They just read media stories about killer psychos and think
that's all there is to the experience.
I think this distinction between cause and effect (cause being the
positive symptoms and effect being the negative ones) is important when
consider the impact of society on the indivudal. The distress levels
caused by society and local cultures related to the outcomes. I guess
this might be the big factor in the result that people in developing
world countries with schizophrenia do better than in developed ones. The
local culture is less stigmatic having not experienced "The Great
Confiement" (Foucault's term for the period where the mad were put into
asylums and disappeared from the view of society for enough generations
for people to forget that people are mad). The positive symptoms may be
the same but the impact of society makes the neghative symptoms worse.
I'm afraid I've not read the paper that guess at what causes the strange
result that people do better in the developing world (it's a very well
know result in mental health though). It's just a guess based on
personal experience of a period of paranoid psychosis.
Historically the internal delusion has been the fundamental
characteristic of the schizophrenias and schizophrenia. The Rosenthal
(or Thud) experiment demonstrated this in the 1970s when the researchers
were immediately hospitalised upon disclosure that they heard voices.
The current psychiatric definition is more complex and requires things
like occupational and social impact. Some people survive or cope while
others have their minds shattered by the experience.
If people understood the internal torture that most people with a
diagnosis of schizophrenia, schizoaffective, bipolar or the dissociative
disorders went through they'd stop stigmatising the experience and help
these people. The negative symptoms are simply the result of a normal
human being going through one of the worst experiences of the human
condition. The period when psychosis is most intense is horrific. The
social outcomes can mean people's lives are destroyed for ever when they
don't have to be.
No comments:
Post a Comment