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10th Apr 2014: Schizophrenia; Reflections by an Insider by Kenneth Wilson

Come along to The Counting House at 7pm for a talk by Kenneth. Share a crust of bread, and hear the reflections he has to share…

Title of talk:

Schizophrenia: Reflections by an Insider

Bullet points of what you would like to talk about:

1. I’ll begin by introducing concerns over the viability of ‘schizophrenia’ as  a term. The condition that this traditional term refers to is real, in my opinion, but the term comes with so much stigma that the diagnosis is almost as bad as the condition itself – therefore I’d like to advocate a much less stigma-laden term. I don’t know what the new term is to be but I think we need one.

people

2. Considerations in 1. raise issues of labelling and stigma. In giving this talk I do not claim to be an expert on the condition from which I suffer other than in the sense that I experience it directly and my psychiatrist, let us say, doesn’t.

3. Social withdrawal is an example of a problem that people with schizophrenia can be faced with. One can feel as though one is unable to function normally in social contexts and so one ceases to make the effort. By the same token, the label one has been given can lead the ‘sane’ to hold one at arm’s length. People can be ostracised as a consequence of mental ill health. To my mind it can be a close run thing as to whether being ostracised is a consequence of a medical condition associated with an individual or a function of societal attitudes or both.

4. Are we all on the ‘spectrum’ of mental illness? When I was an undergraduate psychology student, we were all told that mental illness affects 10% of the population. Nowadays the proportion of the population affected, according to the experts, is much larger than it was. How do we explain this change? Does modern life, the ravages of capitalism, mean that increasing numbers of people suffer from mental illness? Or, is it that psychiatry has expanded and extended its tendrils into society? Is psychiatry intent on stigmatising us all? If we are all on the spectrum of mental illness does this mean that the dividing line between the sane and the insane is blurred? If I were sane, I’d object in the strongest terms to the claim that I am on the ‘spectrum’!

5. The mass media is a powerful force in modern society. At times, the medical profession, politicians, the courts and the police all jump to its tune. What image of schizophrenia does the mass media portray? – almost always a very negative one. Shock horror stories sell. Treatment of the mentally ill – including schizophrenics – is often manipulated by the mass media. In my opinion, as a rule, the mass media presents a distorted and frankly unhelpful portrayal of mental illness and schizophrenia in particular.

6. I began by considering the abandonment of the term ‘schizophrenia’. Here I would like to make it clear that I do not deny that this sort of condition is real. But what is schizophrenia? Is it a well understood condition, with that understanding based in science? At the time of speaking, there is no scientific test for the condition. In light of this simple fact, how would a psychiatrist know if someone is schizophrenic? Studies have shown that to an important degree the diagnosis is subjective and so misdiagnosis is not all that unusual. It is no wonder that in the absence of a solid scientific basis, psychiatry makes mistakes.

7. Psychoanalysis, stemming from the tradition begun by Freud and Jung, is also often criticised for being unscientific. If meds based psychiatry is more scientific than the talking cure: to what extent is this the case? Are the routinely prescribed meds such as chlorpromazine really the wonder cures the pharma companies and the overwhelming majority of psychiatrists claim they are? If the commonly prescribed meds were really as good as all that, then why all the very, very unpleasant side-effects?

8. Due to the accidental discovery of new anti-psychotic compounds in the 1950s, all over the world the large, long term stay hospital-prisons were closed down. But let us look at this a little more carefully. The closure of the large long term stay hospital-prisons seems to be an unqualified success: but is it? If the new anti-psychotic compounds are really not as good as all that, perhaps the mentally ill have been thrown to the lions. I am not advocating that the old hospitals be reopened. Personally I, like many other users of the psychiatric services, would rather take my chances in the community. However, I am suggesting that the new meds come with a whole set of problems which haven’t been faced before. The new meds are cheap. Closing the large, long term stay hospitals can almost certainly be seen as a cost cutting exercise!! It is not that the new meds are as good as all that: it is that they are cheaper than being cared for by another human being.

9. Psychiatry tells us that the schizophrenic suffers from a psychosis and the appropriate meds can counter the influence of the psychosis such that the condition can be managed. We have already considered reasons as to why the term ‘schizophrenia’ ought to be abandoned. What about the term ‘psychosis’? Surely we can’t abandon this term because it sounds scientific….

 

A few paragraphs about you:

Age 49. Completed bachelor’s degree at Edinburgh University. Went on to complete PhD in philosophy at Aberdeen Uni. International teaching career including time spent working in Greece, Turkey, the UK, the UAE, Kuwait, Saudi Arabia, Oman and Libya.

In the course of his international teaching career in schools, colleges and universities across the Middle East Kenneth took a keen interest in the culture and history of the region – though he never became a Muslim

 

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