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Archive for November, 2008

“You can’t talk to a disease:” Peter Breggin on how biological psychiatrists refuse to understand people labeled with schizophrenia

Biological psychiatrists–nowadays most psychiatrists–are fond of saying You can’t talk to a disease. The communication of so-called schizophrenics makes no sense at all to these doctors who want to control symptoms, such as hallucinations and delusions, with drugs, electroshock, and incarceration.

The idea that these extremes of irrationality are due to a disease is inseparable from the survival of psychiatry as a profession. If schizophrenia is not a disease, psychiatry wold have little justification for using its more devastating treatments. Lobotomy, electroshock, and all of the more potent drugs, including neuroleptics and even lithium, were developed at the expense of locked-up people, most of whom were labeled schizophrenic. The search for biochemical and genetic causes keeps psychiatrists, as medical doctors, in the forefront of well-funded research in the field. The notion that patients have sick brains justifies psychiatry’s unique power to treat them against their will. It also bolsters psychiatry’s claim to the top of the mental health hierarchy. In short, if irrationality isn’t biological, then psychiatry loses much of its rationale for existence as a medical specialty.

60 Minutes Dramatizes Psychospirituality in Schizophrenics

On July 27, 1986, 60 Minutes produced a show entitled Schizophrenia. It was based on biopsychiatric theories, and one of their experts declared, We know it’s a brain disease now. It’s like multiple sclerosis, Alzheimer’s disease. On the show, vignettes of patients were presented to impress the audience with the bizarre quality of their communications, and hence the absurdity of any psychological meaning or underpinning to their disease.

The first 60 Minutes patient, Brugo, bolsters his identity with spirituality, as well as religion, and declares that he’s not extinct: And I’m Croatian Hebrew, which is Adam and Eve’s kin. And I have been Croatian Hebrew for centuries and cent–upon centuries. And I’m a Homo-erectus man, and I’m also part Neanderthal, and I mean to keep that heritage, ’cause I’m not extinct.

Packed into these few remarks is symbolism about his desperate need for personal value and dignity, his identification with religion and humanity, and perhaps his awareness of primitive impulses stirring inside himself, as well as his fear of personal extinction. Here is more than enough material to stimulate anyone’s desire to communicate with him.

The second patient, Jim, is dismissed by the interviewer because he is convinced he was shot to death when he was a baby. Yet his brief remarks seem like a metaphor for child sexual abuse by a male: I had my head blown off with a shotgun when I was two years old. And–and before that, things happened in my crib. I remember all these things and stuff, but I just remember, you know. I remember all this stuff.

A therapist with experience in listening to people immediately would wonder about what lies behind Jim’s direct hints about terrifying memories from early childhood, not to mention the symbolism of the crib in relation to his present trapped condition. More than one patient of mine has begun with just such anguished fragments of memory before discovering the agony of his or her abusive childhood and its relationship to current entrapments.

Another 60 Minutes patient, Ronnie, clearly is struggling with his own identity and his separateness or isolation from other people. He, too, talks in psychospiritual terms, again with undertones of possible sexual abuse. I thought everybody’s bodies was connected to mine, and their–their spirits were–I was–I was laying in bed and I played–you know how we live, where, you know, like you’re smashing some air for yourself? Well, like, I was smashing every spirit next to me, and the–all kinds of bad things were happening.

Still another patient Lynn, identifies herself with God and with being different, and clearly tells us that her wisdom is more than she can handle. She’s practically inviting us to ask her about the inner knowledge she cannot bear: I’ve got the wisdom of God in me, and I have to learn how to cope with it. Nobody seems to think you’re suoppsed to survive when you’re different. [Crying] But I know–as–like the words in Job said, all I can say was, Have pity on me, my friends. I’ve been touched by the hand of God.

Brain Disease or Psychospiritual Crisis?

The patients’ quotes were selected by 60 Minutes to demonstrate that so-called schizophrenia is a biochemical disease rather than a crisis of thinking, feeling and meaning. Yet people with real brain disease–such as Alzheimer’s, stroke, or a tumor–don’t talk symbolically like these people do.

Instead of metaphors laced with meaning, brain-damaged people typically display memory difficulties as the first sign that their mind isn’t working as well as it once did. They have trouble recalling recently learned things, like names, faces, telephone numbers, or lists. Later they may get confused and disoriented as they display what is called an organic brain syndrome. In fact–and this is very important–advanced degrees of brain disease render the individual unable to think in such abstract or metaphorical terms. The thought processes that get labeled schizophrenia require higher mental function and therefore a relatively intact brain. No matter how bizarre the ideas may seem, they necessitate symbolic and often abstract thinking. That’s why lobotomy works: the damage to the higher mental centers smashes the capacity to express existential pain and anguish. As we’ll find out, it’s also why the most potent psychiatric drugs and shock treatment have their effect.

Objects or Beings?

How are we to approach people who get labeled schizophrenic? Do we think of them as troubled humans struggling in a self-defeating style with profound psychological and spiritual issues, usually involving their basic worth or identity? Or do we view them as if they are afflicted with physical diseases, like multiple sclerosis and Alzheimer’s disease, in which their feelings, thoughts, anguishes, and aspirations play no role? Do we try to understand them, or do we try to physically fix them? Do we look for profound hurts and failed psychospiritual efforts in their lives, or for biochemical aberrations in their brains? Do we wonder about what meanings and values they are seeking–and how they became so helplessly mired down in the process–or do we search for the biochemical imbalances that have twisted their brain processes?

If people who express seemingly irrational ideas are best understood mechanistically, then these people are broken, disordered, or defective devices. If we take the viewpoint that they are persons, beings, or souls in struggle, then an infinite variety of more subtle possibilities comes to mind for understanding and helping those who seem mad, crazy, or deranged.

If we are beings rather than devices, then our most severe emotional and spiritual crises originate within ourselves, our families, and our society. Our crises can be understood as conflicts or confusion about our identities, values, and aspirations rather than as biological aberrations. And as self-determining human beings, we can work toward overcoming those feelings of helplessness generated by our past spiritual and social defeats.

By contrast, the typical modern psychiatrist–by disposition, training, and experience–is wholly unprepared to understand anyone’s psycho-spiritual crisis. With drugs and shock treatment, the psychiatrist instead attacks the subjective experience of the person and blunts or destroys the very capacity to be sensitive and aware. No wonder the treatment of mental patients often looks more like a war against them. It often is.

Peter Breggin (1991). Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the New Psychiatry. New York: St. Martin’s Press. 23–26.