from some TV program so there was a story to the science.
Way back in the day the thought a fucked brain was a fucked brain. A
stroke was therefore untreatable. Patients were a write off. There was
never thought of recovery.
One day a gent's father had a stroke and was given the write off
diagnosis and treatment which was best practice medicine at the time.
This gent didn't believe the doctors when they wrote his father off.
This old man's carer brought him home after his stroke. He was expected
to be bed ridden to the end of his days but his carer cared little for
this expectation. His carer forced the man to walk on all fours till he
could walk upright again. day after day was what might be considered
harsh treatment but it became the model for modern stroke rehabilitation
services. The carer Just worked and worked and worked on getting his
father back on track.
It worked. Eventually his father gained a high level of function again.
If I remember right when his father died he was climbing up a mountain
and died of a heart attack at a ripe old age.
The autopsied him and found serious damage to the brain and nervous
system. The bit which connected the brain with the rest of the body was
seriously damaged. Over 90% of the connections were destroyed.
They found all the evidence to point to a disabling problem created by
brain damage. The assumptions of medical science in the mid-20th century
were these couldn't be repaired.
This gentleman's carer forced medical science to consider something. I
think the term is neuroplasticity. It's the ability of the brain to sort
of rewire its functions so a damaged brain can still function highly.
From what I understand it isn't repair or healing of the organic brain
matter which is destroyed by a stroke or other thing which causes
neurological damage (e.g. a virus written into the human geneome which
when activated causes the changes in the brain which are established for
schizophrenia). Neuroplasticity is about damaged brains learning to wkrk
again to the level where the person isn't disabled.
What's this got to do with schizophrenia? Well all carers know is to
make sure the cared for take chemical restraint medication. All NICe
recommend are drugs and a small set of options of relatively brief
interventons which are alternatives to the chemical cosh. Cognitive
behavioural therapy, arts therapy and family interventions.
There is none of the rehabilitation after the initial stage of
schizophrenia. There is no special knowledge or treatment for first
episode psychosis designed to rehabilitate the individual or do the sort
of stuff which happens for stroke victims which might be relvant to
reducing the disability of schizophrenia, e.g. social skills training
(something NICE recommends against and the mental health charities in
the UK agree should be recommended against).
Except there is...sort of. Soteria is one alternative paradigm. It has
curried little favour witht he minastream manetal health movememt and
most of the work in the UK is in the fringe movement. This is a paradigm
which has been shown to offer better outcomes. It is more expensive
though. 6 months of initial hospitalisation where I assume a person
learns a lot and there is an attempt to rehabilitate them to keep their
life skills sharp and help them deal with the reality of schizophrenia
(or bipolar, because first episode psychosis can happen in bipolar too).
Doctors, carers and governments have a cheap option so don't need to
think of real solutions. The chemical cosh does everything they care
about. The drugs are like a lifetime straitjacket and gag in pill form.
Cheap, convenient and even deadly.
They're all bought into the power of the pill. And the idea it is an
illness which can only be 'treated' with 'medication'...
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