'Schizophrenia', or more specifically the word ‘schizophrenic’ is often wrongly applied to people (and sometimes organisations) to say that they seem to have two contradictory personalities, whereas the term was originally intended to convey the idea that the affected person’s thinking was fragmented.When used in psychiatry, ‘schizophrenia’ refers to a collection of unusual experiences or symptoms such as: hearing voices, having hallucinations, having strange beliefs or delusions, feeling paranoid or being out of touch with reality.
Schizophrenia is classed as a ‘psychotic disorder’ along with bipolar disorder and a few other conditions. These disorders affect a relatively small proportion of the population compared to the so-called ‘neurotic disorders’ such as anxiety, depression and phobias, which are much more widespread.
Nevertheless, the topic of psychotic disorders and schizophrenia in particular seems to dominate many of the key debates in psychiatry, clinical psychology and, more widely, thinking about mental health services and legislation in society as a whole.
To some extent this may be down to the unusual and sometimes dramatic thoughts, experiences and behaviour associated with the condition. It may also be the result of the often over-played (in the media) fear that schizophrenia is associated with the risk of violence.
Psychiatry has tended to view the contents of the experiences of someone with schizophrenia as intrinsically meaningless but indicative of an underlying pathology in the brain. However, this has been contested for many years by service users, psychologists and a number of critical psychiatrists.
Former consultant psychiatrist Philip Thomas published a book called Psychiatry in Context: Experiences, Meaning and Communities arguing that standard bio-medical approach to schizophrenia is wrong to dismiss the content of what a person’s voices are saying to them, or to regard their utterances as meaningless.
Drawing on the experiences of the Hearing Voices Network, where voice hearers share their experiences and coping strategies, and the Soteria movement that provided social and emotional support to people with psychotic experiences, Thomas suggests that medication alone is not sufficient to meet the needs of people diagnosed with schizophrenia.
In 1994, Richard Warner pointed out that recovery, or at least better social inclusion following psychosis, was significantly higher in the developing world than in the developed world, despite its greater wealth and greater access to psychiatric services and medication.
His explanation for this was that in the developing world there was less stigma attached to psychosis and there was a much greater emphasis on social integration. So there seems to be not only a medical and psychological aspect to supporting people affected by schizophrenia but also a social one.
Unfortunately social support for mental health does not attract anything like the funding or interest that it deserves. With more awareness days, let’s hope that more attention can be given to what we in our communities can do to help rather than just relying on advances in neuroscience and psychopharmacology.
Useful links:
Improving Mental Health through Social Support: Building Positive and Empowering Relationships
Psychiatry in Context: Experiences, Meaning and Communities
Recovery from Schizophrenia: Psychiatry, and Political Economy
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