Original SDMB thread - The Role of Culture in Mental Illness




Originally posted by AHunter3

there is also no such thing as schizophrenia.

Bullshit. I mean, pardon me for accepting the word of the Surgeon General and the Encyclopedia Britannica (to name just two) over yours.

Appeal to authority. Spurious logic. I am not alone in my contentions.. But OK, I was being deliberately incendiary since it is no fun being on a soapbox without a "Them-representative" to square off against in front of the others, and I guess you'll do.

There are several levels of credibility you could assign to psychiatry's claims for the existence of "schizophrenia", or, for that matter, to my claim that there is no such thing as "schizophrenia". Does it completely fail to exist in the sense that unicorns fail to exist, and am I making that claim? Does it exist only in the same sense that "stress" exists, i.e., something that is so broadly defined that it is indistinguishable from that which is "ordinary" and "normative" (and is that the essence of my claim that it is a nonreal phenomenon)?

Or perhaps it exists in the same sense that PMS exists: within a continuum of experience that includes virtually everyone (or virtually every woman in the case of PMS) except to the matter of degree, but for those it affects to a greater degree it constitutes a genuinely disabling phenomenon; but still failing to constitute sufficient reason for denying its alleged sufferers the right to hold positions of responsibility, as some have claimed that it does. Is that the type of claim that I am making? Or, with respects to the OP, perhaps I am saying that "schizophrenia" exists as a diagnostic and patient-identity phenomenon the same way "multiple personality disorder" exists, but that the diagnostic criteria are so sloppy that their reasonably objective application is impossible, and that the structure of myth that has grown up around it, e.g., the "typical history" of child sexual abuse ritualized in satanic practice followed by the splitting of the self into several "selves" with no recollection of experience if experienced by a "different self", etc? Is this closer to the claim that I am making?

To be sure, the allegory I use in the paper I cited above assigns "schizophrenia" to the same type of nonreality as "witchcraft". Yet at various times in my life and in various contexts I claim to be a schizophrenic and a witch.

One gets a large part of one's identity from one's social environment, and much of that through the process of having an identity attributed to you by others. And our culture tends to attribute negatively-tinged identities to those who are weird or disturbing or whose behavior cannot be readily understood and predicted by others. But science (and medicine, which distinctly seeks to be viewed as a science) attempts to focus on those things that can be said to have an objective existence. BECAUSE they are viewed as bastions of objective appraisal, their claims should be subject to much more skeptical inquiry, and in most cases, via the peer review process and the application of stringent research methological standards, they are. This is not the case for psychiatric research, though.

So in what sense might "schizophrenia" exist? Well, I think it is true that under certain circumstances, people's minds tend to go through a surrealistic (and disconcerting) phase in which the everyday meaning of things is confused with metaphorical and symbolic meanings; things take on great impact and import, a heightened drama; and as subsequent thought processes are built upon the existing structure when this is the existing structure, it is easy to end up embedded in a richly textured mental world that has a lot of emotion invested in it, but which is not coherent or comprehensible to other people. I also think that some people, by virtue of whatever factors make them up as an individual (perhaps including their genetic makeup, perhaps including variations in metabolic chemistry), are more inclined than others to slip into this type of mental state, or perhaps to be less able to re-integrate the fruits of this mental world into the everyday world and get their feet back on the ground, than other folks are. I think this is a genuine phenomenon, having been through it myself, and we could call it "schizophrenia" and perhaps could call folks who are more inclined than others to experience it "schizophrenics".

But it is not a disease. The metaphorical meanings and the dramatic impact of them on the person who experiences them are not merely "brain static" and do not lack real meaning. And it is not caused by "chemical imbalances in the brain". (If you had had the opportunity to check the brain chemistry of a sample of recently widowed and raped Bosnian women in Serbian concentration camps during the ethnic cleaning and mass rape venture of Slobodan Milosevic a few years back, you might find that their brain chemistry differed from that of a random sample of Baltimore Maryland shoppers. This does not mean that the differences in what they were feeling and thinking is caused by the difference in brain chemistry.)

The ability to point a finger and say "that's 'schizophrenia' does not mean that 'we can help you', which is another strand of the belief system difficult to untangle from the whole idea of "schizophrenia". Jab wrote:


They can't help you if you won't let them.

Generally speaking, they can't help you period. More to the point, I wish it were true that they can't HURT you if you won't let them. But because of the widespread belief in "schizophrenia" (defined as, and thought of as, THEY think of and define it, not as I've discussed it above), psychiatrists have been given the authority to impose treatment, and their treatment does not help "schizophrenics" cope with and integrate their schizophrenic experience. Their treatment does, however, damage people, and the institutional experience is devastatingly horrible overall.


See my next post on this same thread


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