Question:
Does schizophrenia pass the scientific test of proof?
Answer:
1. SCHIZOPHRENIA HAS BEEN PROVEN TO BE A DISEASE OF THE BRAIN
No, increasing amounts of research has shown that the conceptual
construction that is schizophrenia has no scientific validity. There are
just too many differences between people who have the same diagnosis and too
many similarities between those who have a different diagnosis, to make a
clear differentiation between illnesses possible. The voices research (for
more info on what this is, see address for site below)for instance research
has shown that the phenomenum of voices occurs in all categories of
psychosis, and even in neuroses and personality disorders and in most
importantly perhaps in 'normal' people too.
2. EXPERIENCING HALLUCINATIONS IS A SIGN OF MENTAL ILLNESS
No, some symptoms, such as auditory hallucinations (hearing voices) are
experienced by healthy people and are reported in different cultures as
meaningful experiences. Schizophrenia researchers have not have investigated
this issue and if they think about it at all presume that there is some
difference between the two groups. Marius Romme et al found a number of
healthy people hear voices and concluded that to hear voices is not a
symptom of a disease. Rather it is the inability to cope with the voices
that leads to the inability to function and subsequently to becoming ill.
3. THE SCHIZOPHRENIA DIAGNOSIS IS BASED ON OBJECTIVE CRITERIA
No, terms such as hallucinations and delusions are based on a value
judgement made by psychiatrists and are certainly not clinical descriptions
of states of mind or symptoms of a disease. For instance one persons beliefs
can be anothers delusions. It is difficult to determine what is the truth as
the terms are applied selectively, for instance respected scientists false
beliefs are rarely called delusions. Usually other grounds are applied to
justify using such descriptions such as delusions and hallucinations, such
as low, devalued or degraded social status - or - because of the anxieties
and concerns of those people around the person having the the unusual
experience.
4. THOUGHT DISTURBANCES ARE A SIGN OF SCHIZOPHRENIA
No, There is no difference in the way "normal" people form their imaginings
and beliefs and the way those who have been diagnosed as schizophrenic
construct their delusions and hallucinations. Researchers who use terms such
as hallucinations and delusions never consider there importance to the life
story of the person who has these experiences or beliefs. Recent research
shows that the so called auditory hallucinations of psychiatric patients are
actually meaningful and make sense in terms of their lives and how they
cope.
5. SCHIZOPHRENIA SYMPTOMS HAVE BEEN PROVEN TO BE PART OF THE SAME DISEASE
No, schizophrenia researchers consider that all the experiences and symptoms
of someone distressed by hallucinations etc. as separate symptoms of one and
the same disease. But with the phenomenum of hearing voices, people can
react to the discomfort of hearing voice(s) in any number of ways, for
instance by having concentration problems, experiencing confusion, emotional
alienation or aggression. Are all these behavioural patterns symptoms of one
specific disease or are they in fact reactions to the voices themselves? The
big mistake that psychiatrists have made is to assume that clusters of
symptoms represent "specific diseases" without establishing a unity of
cause, course of development, suitable treatment or prognosis. When one pays
real attention to the experiences of the individual, it is possible in 70%
of the cases to find a coherent pattern of circumstances that coincide with
the hearing of voices. Further, you can also construct a picture of of the
circumstances that cause an individuals inability to cope with the presence
of voices, whilst others can.
6. RESEARCH HAS PROVED THERE ARE SPECIFIC OBSERVABLE SIGNS THAT
SCHIZOPHRENIA EXISTS
No, research has failed to show conclusively that a "marker" (a marker being
a physical or psychiological characteristic that is clearly observable) for
schizophreneia exists. A lot of research has been based on comparing the
ability of people diagnosed as having schizophrenia with a control group of
people who haven't in carrying out experimental which are designed to test
language skills, reasoning skills, perception etc. The researchers look for
differences in performance between the two groups. This is based on the
premise that people with schizophrenia will perform poorly because the
illness supposedly causes impairments in the skills being tested. This
becomes a bit like a self fulfilling prophecy - of course they'll do worse
they're schizophrenic aren't they? There are a number of serious problems
with these experiments, firstly the basis of the diagnosis is unreliable
because of the problems identified above, therefore the criteria for
determining who has schizophrenia in the first place is always contentious.
The fact is though, whilst the experimental tasks themselves can be
evaluated with great precision the people taking part in them. may or may
not have had schizophrenia in the first place.
7. NORMAL PEOPLE PERFORM BETTER IN PSYCHOLOGICAL TESTS THEN SCHIZOPHRENICS
No, although 80% of studies report they have found a difference in
performance between people with schizophrenia and so called "normals"
(unsurprisingly people with schizophrenia did worse). The differences
themselves though were very small ones, although still arguably
statistically important. However, in the test results of individuals taking
part in these tests, are a lot of overlapping scores, some people with
schizophrenia doing better then those who didn't. This being the case we can
conclude that most of these tests could not find any real difference between
most people with schizophrenia and the "normals" and even when they could
the difference was very, very small. Small differences can be important and
they have been used to give added credibility to the schizophrenia
hypothesis. That is until you consider some of the less obvious reasons why
there might be even a small difference. Significantly these other reasons
although referred to are not seen as being important enough to have an
effect on the results for instance many of the studies reported that the
subjects with schizophrenia were on neuroleptic medication. It must be worth
asking the question if the fact some of the test subjects were drugged made
any difference to the results? I wonder if the experiementers ever
considered giving the "normals" the same medication to see if this made a
difference in the outcome of the tests (no, that would be unethical wouldn't
it!). Another difference between the the two groups of subjects that is
disregarded is the difference in education, economic and social status which
can in itself make a big difference in your ability to successfully complete
the tests. It is well recorded that amongst the insane there are a higher
proportion of poor and uneducated people and this is certainly the case in
schizophrenia.
8. RESEARCH INTO SCHIZOPHRENIA TAKES INTO ACCOUNT ALL POSSIBLE FACTORS
No, for instance one factor not assessed in these experiments is the effect
on a person of being a psychiatric patient, this is another distinct
diadvantage facing the test subjects who have been diagnosed as having
schizophrenia. The problem with patient staus is that it institutionalises
you, it robs you of your own initiative, your own self motivation, you
become part of a regime that makes most of your choices for you. Inevitably
then, these experimentors usually recruited "docile", cooperative patients,
this kind of experience has an unknown effect on the subjects, but it is
unlikely to help. So, if you put aside for a moment the issue of
schizophrenia, one group of the subjects being tested are at a distinct
disadvantage - the schizophrenic subjects are probably drugged, less well
educated, poorer and institutionalised and remarkably they still do nearly
as well as the "normals".. Personally, I'm amazed that this hasn't become a
finding in its own right. Sarbin reckons that any of these hidden factors
could account for the difference in the results, which means in the end they
prove nothing.
9. THE BRAINS OF PEOPLE WITH SCHIZOPHRENIA ARE DIFFERENT FROM NORMAL PEOPLE
No, biological, neurological and anatomical studies have been no more
fruitful in finding the magic "marker", which is unfortunate, as then there
would be something you could actually point to and say look there it is!
These studies had pretty much the same problem as the the search for
psychological factors. One example of this search to locate the cause of
schizophrenia in the brain is to see if people diagnosed with schizophrenia
had differences in the size of the hemispheric ventricals (the walnut like
parts of the brain). Some studies reported that they found, by using
computer topography (a sort of computer generated map of the brain),
initially reported that the ventricals of people with schizophrenia were
bigger then those of normal subjects, but subsequent follow up studies
failed to find a way of using this observation as a diagnostic instrument or
even failed to find the difference at all. Other experiementors have looked
elsewhere in the brain but also failed to discover any feature that could be
regarded as unique to schizophrenia. However they are still looking§
Can you come up with a number 10?
For another way of thinking about distress caused by altered perceptions
check out http://www.delphi.com/hearingvoices and take look at the message
board.
As a 'subjective observer' of schizophrenia, I can't argue with any of the
points, nor would I want to. What I did find intersting tho, was the
perspective you added on the issue below ( # 8 ). I often criticise and
regret the system the way it is for the simple fact that it perpetuates sz
(and other illnesses) in the way it (mis)treats people with illnesses. I'm
sure the arguments and discussions have all been said before, here and in
other places, but I just wanted to underline the point that there are so
many 'rogue' factors to the research and 'evidence' that is banded about
that sz can never be fully understood since so much of it is caused as a
consequence of sz, as a consequence of treatment for sz and as a consequence
of the consequence of treating sz even! I mean, sz can cause people to
dissociate themselves, to the point they withdraw from social contact and
cannot function as an individual.. so what do we do? Medicate them.. so they
are so letharged that even if they now wanted to engage in some
socialisation, they haven't got the energy or focus... then we treat them
for remaining withdrawn and force treatment onto them that are often
inappopriate or inadequate in places that do little to inspire or motivate
people to feel good about themselves.
As for a number 10 ... hmmmm......
PEOPLE WITHOUT SZ ARE MORE RATIONAL AND STABLE AND LESS VIOLENT THAN THOSE
WITH SZ ....... ?
I suggest there are a good few people out there without sz who easily
undermine this possible theory. Unfortunately, the media and the civil
service doesn't even attempt to disprove this theory, as it obviously
wouldn't serve the public interest to know that they are more at risk of
being violently attacked by a road-rager, or a mugger or even a close family
member. Some interesting reading I did recently (at least, interesting to
me!) that sectioned patients with a home office restriction (compulsory
hospital order) are only 13% likely to reoffend in the first 2 years after
release.. compared to 53% of prison inmates. Generally, the types of
offences are the same, however, when I emailed the Dept of Health (UK) to
discuss this matter, they advised that restricted patients were more
comparable to those criminals serving life sentences and out on parole
[lifers]. I argue that sz who act unlawfully and require in-hospital
treatment are not all murderers/repeat sexual offenders/arsonists/etc and,
by and large, commit relatively minor and even non-aggressive acts of
unlawful behaviour. In fact, I'd be interested to find out just how many sz
'murderers' are released on parole compared to inmate lifers without a sz
diagnosis. I'm guessing the difference will be highly in favour of the
inmate lifers.
The points are synthesised from research carried out by people I know
notably Phil Thomas, (a thoughtful and sometimes dissident psychiatrist),
Mary Boyle (author of "Schizophrenia, a scientific delusion?"), Richard
Bentall (another cutting edge psychologist), Ron Coleman (survivor and
recovered 'schizophrenic' and much more) Prof Marius Romme (a psychiatrist
and all round nice guy and a founder of the voices work) and a guy from
Canada called Sarbin who did loads of research into schiophrenia research
and found it full of holes ...
My route into this has been through working with people who hear voices -
check out the site on http://www.delphi.com/hearingvoices
for more on this. Basically the voice experience which is intrinsic to the
schizophrenia hypothesis turns out to be experienced by 'normal' people and
by people with all sorts of other mental illness diagnsoses. Since it is a
primary or first rank symptom this is problematic to say the least. When it
was shown that voices are related to life experiences and are resolvable by
the individual who hears them (they recover) this was even worse news for sz
which presumes voices as meaningless hallucinations of a diseased brain that
can only be treated like heart disease by long term medication regimes. I
could go on about this all night ...
However, my main point is that the dominance of schizophrenai is blocking
all sorts of other initiatives and since the research into proving sz is a
disease is so closely allied to the treatments (eg medication) it is hard
not to be a little suspicious of the mindset that is driving the model
forever onward and outward. There is very little space given to the
arguments against the existence of sz and even less tolerance (you'll notice
my posting has been removed from this site after one day apparently its too
old, funny all the other ones that are contemporaneous are still there ....
coincidence or am I getting paranoid. Or maybe people don't want a message
that questions sz on a site devoted to sz.
