quote:
I am a great believer in Milieu Therapy- changing the social environment in which psychotic people live- especially when hospitalized.
When I escaped from the hospital in which I had been diagnosed schizophrenic and was being held against my will, the change in milieu certainly did me a substantial amount of good.
quote:
These guys and gals clearly had an organic brain problem
s schizophrenia an "organic brain disease"? It was a reasonable hypothesis 100 years ago. After awhile, though, the inability of the psychiatric profession to supply an adequate definition for just what was and wasn't schizophrenia in the first place made etiology a moot point.
In medical research, a diagnostic criterion is supposed to exhibit something called "inter-rater reliability": in double-blind testing, doctors unaware of the diagnoses of previous doctors are supposed to reach the same diagnostic conclusions after examining the same patient in a reassuringly high percentage of cases. In the case of "schizophrenia", the psychiatric profession has failed for over a century to pass that test. In any other branch of medicine, such a diagnostic criterion would have been discarded as having no practical value.
At best, I think they have some support for saying that some people are more likely than others to pass into the mental state called "schizophrenia" under identical circumstances.
In practice, "schizophrenia" is a "disease" consisting of its own behavioral symptoms. If you have the behavioral symptoms, you receive the diagnosis, and there is no corroborating organic test for this supposedly organic brain disease. (That doesn't make it unique among medical ailments, but its a shaky start).
Because I have received the diagnosis, I am one. Neither you nor I nor the best clinical testing laboratory on the planet can support the statement "Gee, I guess someone made a mistake in your case". And less you dismiss that as an exceptional case: I could fill a concert hall with "schizophrenics" who, during a period of involuntary incarceration on a locked ward, were no less lucid than I am. I've been to conferences on the rights of people diagnosed "mentally ill" and I've met them. I am one of them.
In practice, "schizophrenia" is a disease identified by a list of symptoms that includes "has received a diagnosis of schizophrenia". Failure at any given time to exhibit any describable set of symptoms such as those listed in the DSM-IV is never deemed sufficient to rule out "schizophrenia". The diagnosis, dispensed under cavalier and unreliable diagnostic protocols, is, once received, never rescinded. If you are coherent and deny hearing "voices", you are "in remission".
Anyway, on the basis of this very flimsy and shaky construct, treatment is imposed on people who are thought to be incapable of understanding their need for treatment. In actual fact, the treatments they are able to provide are generally dehabilitating, permenantly detrimental to brain and other neural tissues, and unpleasantly experienced, and furthermore don't have much of a "cure rate". (Mostly they seem to interfere with neural activity in a broad unfocused way. Brain is creating undesirable thoughts & feelings & behaviors? OK, dampen all nerve activity. Gee, symptoms lessened!). Yet, despite this evidence which would seem to support the wisdom of choosing not to receive such treatment, the fact of refusing treatment (or attempting to refuse treatment) is cited as proof of the fact that you need it.
The pharmaceutical companies sure do a good job of PR for the efficacy of their "mentally ill pills", though.
Original SDMB thread - Schizophrenia
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