Is Schizophrenia Really a Brain Disease?




Ring of fire

In spite of over a hundred years of research and many billions of dollars spent, we still have no clear evidence that schizophrenia and other related psychotic disorders are the result of a diseased brain. Considering the famous PET scan and MRI scan images of “schizophrenic” brains and the regular press releases of the latest discoveries of one particular abnormal brain feature or another, this statement is likely to come as a surprise to some, and disregarded as absurdity by others. And yet, anyone who takes a close look at the actual research will simply not be able to honestly say otherwise. And not only does the brain disease hypothesis remain unsubstantiated, it has been directly countered by very well established findings within the recovery research, it has demonstrated itself to be particularly harmful to those so diagnosed (often leading to a self-fulfilling prophecy), and is highly profitable to the pharmaceutical and psychiatric industries (which likely plays a major role in why it has remained so deeply entrenched in society for so many years, in spite of our inability to validate it).

Deconstructing the Myths of Madness

The claim I am making here clearly runs counter to the mainstream understanding of schizophrenia, but we find that it’s a relatively straightforward task to back up this claim. We simply need to take the time to extract the actual research findings from the unsubstantiated assumptions and propaganda that are so often used to back up the brain disease hypothesis. I’ll go through the largest of these here:

Hypothesis #1: Schizophrenia is caused by a biochemical imbalance within the brain

This theory originated from the observation that drugs which block the transmission of the neurotransmitter dopamine within the brain (so called “antipsychotics,” originally referred to as “major tranquilizers”) appear to reduce the symptoms of schizophrenia. The reasoning behind the origin of this hypothesis was, since schizophrenic symptoms are reduced when dopamine transmission is suppressed, then perhaps schizophrenia is caused by too excessive dopamine within the brain.

This hypothesis originally appeared quite plausible; however, it has since been seriously discredited:

First, although it is known that an individual’s dopamine receptors (the type of receptors most affected by antipsychotic drugs) are completely blocked within hours of consuming a sufficient dose of an antipsychotic drug, the actual antipsychotic effects often do not become apparent for up to several weeks(even though a significant degree of apathy towards one’s psychotic experiences often does kick in quickly, as would be expected with any kind of tranquilizer). If psychotic symptoms are the direct result of too much dopamine, then why don’t we see a more immediate abatement of these symptoms as soon as the dopamine levels have been effectively reduced?

Second, with the introduction of PET and MRI scans, the dopamine hypothesis was apparently substantiated when it was recognized that  many “schizophrenic” brains do indeed seem to be set up to transmit excessive dopamine. However, it was eventually realized that the vast majority of brains studied had been exposed to long-term antipsychotic drugs, and it’s since been established that the effects of these drugs alone may very well account for these anomalies.

Finally, even many of the proponents of this theory have been forced to acknowledge that we still have not found any clear biochemical imbalance that we can associate consistently with schizophrenia or any of the “mental illness” diagnoses, and that all we can really say for sure is that psychiatric drugs themselves (and virtually any psychoactive drug, for that matter) does lead to the development of a biochemical imbalance in one’s brain.

Hypothesis #2: Schizophrenia is caused by anomalous brain structures

This hypothesis essentially states that schizophrenia is a disease caused by something wrong with the actual structure of one’s brain, specifically with regard to the relative size of the cerebral cortex and/or other nearby regions of the brain. This hypothesis is generally supported by the actual findings of such anomalies of the brains of those so diagnosed. But again, upon closer scrutiny of the research, we find an empty hypothesis that quickly crumbles away:

First, we have discovered that there are many different factors that can lead to these abnormalities, including: depression, alcoholism, early childhood trauma, water retention, pregnancy, advancing age, variations in educational achievement, social class, ethnicity, and head size. It was also discovered that the sizes of these regions of the brain can fluctuate quite rapidly within even healthy individuals, leading to varying results even within the same individual. And once again, what do you imagine we have found that is probably the most relevant factor causing such anomalies in the brain?  You guessed it… the use of antipsychotic drugs themselves. And virtually all of the research that has discovered such brain anomalies in those diagnosed with schizophrenia did not account for this very important factor, meaning that once again, most of the brains studied had most likely been affected by the long-term use of antipsychotic drugs.

A second serious challenge to the validity of the abnormal brain structure hypothesis came when it was recognized that the majority of those diagnosed with schizophrenia do not show any obvious brain abnormality at all. Lewine found that “there is no brain abnormality in schizophrenia that characterizes more than 20-33% of any given sample. The brains of the majority of individuals with schizophrenia are normal as far as researchers can tell at present [emphasis added]”; and this in spite of the fact that most of these participants were likely exposed to other brain changing factors such as trauma and/or antipsychotic medications. Conversely, it is common to find healthy individuals who have no schizophrenic symptoms at all and yet have brain abnormalities similar to those sometimes found in schizophrenics.

Hypothesis #3: Schizophrenia is a Genetic Disorder

This hypothesis is in close alignment with the two brain disease hypotheses (above) and suggests that this brain disease is transmitted genetically. But again we find some serious problems with the assumptions that have given rise to this hypothesis:

This hypothesis is based on a small handful of twin and adoption studies conducted many decades ago which, even when we ignore the many serious methodological flaws with these studies, the only conclusion that can actually be drawn from them is that there may be a hereditary component in one’s susceptibility to developing psychosis. However, this is not any different than the findings that there may be a hereditary component in intelligence, shyness, and other psychological characteristics that clearly are not indicative of any kind of physiological disease. In other words, it’s an illogical leap to assume that a hereditary predisposition for a psychological trait or experience must imply biological disease. Yes, there does seem to be some evidence that some of us may be born with a temperament or other psychological characteristics which make us more vulnerable to experiencing psychosis at some point in our life; but no, this evidence does not lend any validity to the hypothesis that schizophrenia is a genetically transmitted biological disease.

Another important area of research discrediting the “genetic disease” hypothesis is the far more substantial research showing high correlations with environmental (non-hereditary) factors and the development of psychosis/schizophrenia. For example, One study looked at 524 child guidance clinic attendees over 30 years and discovered that 35% of those later diagnosed with schizophrenia had been removed from their homes due to neglect, a percentage twice as high as that for any other diagnostic category; another study found that 46% of women hospitalized for psychosis had been victims of incest; another study of child inpatients found that 77% of those who had been sexually abused were diagnosed psychotic compared to only 10% of those who had not been so abused; and yet another study found that 83% of men and women who were diagnosed with schizophrenia had suffered significant childhood sexual abuse, childhood physical abuse, and/or emotional neglect. Bertram Karon, researcher and acclaimed psychosis psychotherapist, has found evidence of a high correlation between the experience of intense feelings of loneliness and terror within childhood and the later onset of schizophrenia, a finding that is clearly closely related to the findings of these other studies.

Even the strongest proponents of the brain disease hypothesis acknowledge that it has not yet been validated

The National Institute of Mental Health, on its Schizophrenia home page, proclaims confidently that “schizophrenia is a chronic, severe, and disabling brain disorder”, a statement you find on nearly every major page or publication they have put out on the topic; and yet if you spend a little more time looking through their literature, you will find that they admit that “the causes of schizophrenia are still unknown”. Similarly, the American Psychiatric Association also confidently proclaims that “schizophrenia is a chronic brain disorder”, but then they acknowledge on the very same page that “scientists do not yet know which factors produce the illness”, and that “the origin of schizophrenia has not been identified”. The strong bias towards the brain disease theory is clearly evident in the literature of these and other similar organizations, and yet the message comes through loud and clear that we still do not know the cause of schizophrenia. Even the U.S. Surgeon General began his report on the etiology of schizophrenia with the words, “The cause of schizophrenia has not yet been determined”. It would appear, then, that it is simply not appropriate to claim with such confidence that schizophrenia is the result of a brain disorder.

If schizophrenia really is a brain disease, then how do we account for the relatively high rates of full recovery from it?

The recovery research is extremely robust: Many people experience full and lasting recovery after having been diagnosed with schizophrenia. We see this evidence in the vast majority of the longitudinal recovery studies (See Chapter 4 in my book, Rethinking Madness, for a complete list of all major longitudinal studies), including those conducted by the National Institute of Mental Health and the World Health Organization. There is evidence of spontaneous recovery in between 5% and 71% of cases, depending upon the country of origin and other factors, and even as high as 82% with certain psychosocial interventions. It is illuminating to compare the high recovery rate for schizophrenia with the recovery rate for well-established diseases of the brain such as Parkinson’s, Alzheimer’s, or multiple sclerosis: There is no well documented evidence of even a single individual making a full recovery from any of these well-established diseases of the brain.

The mainstream paradigm of care may actually be creating a self-fulfilling prophecy of brain disease

A tragic result of the entrenched belief that schizophrenia is caused by a disease of the brain is that, whether or not schizophrenia is ever determined to be a disease of the brain, our mainstream paradigm of care is actually ensuring that enormous numbers of people actually do develop such a disease (see the figure; I will also discuss this in more detail in a future blog).

So what does cause schizophrenia?

So, if schizophrenia is not caused by a disease of the brain, then the obvious question that arises is, “Well, then what does cause it?” This is an extremely important yet somewhat complex question, which I address in great detail in my book, Rethinking Madness, and which I will try to capture in a nutshell (or perhaps several nutshells) in future blog postings within this series.

For a much more thorough discussion of these and closely related topics, as well as a detailed discussion of the finding of  Dr. Williams’ own recovery research, you can find Dr. Williams’ book, Rethinking Madness (Sky’s Edge Publishing), on Amazon and other major retailers. More information is available at www.RethinkingMadness.com

References

American Psychiatric Association [APA]. (2010). Schizophrenia. Healthy Minds, Healthy Lives [website].

Beck JC, & van der Kolk B (1987). Reports of childhood incest and current behavior of chronically hospitalized psychotic women. The American journal of psychiatry, 144 (11), 1474-6 PMID: 3674230

Harrow M, & Jobe TH (2007). Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: a 15-year multifollow-up study. The Journal of nervous and mental disease, 195 (5), 406-14 PMID: 17502806

Harrow M, Jobe TH, & Faull RN (2012). Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime? A 20-year longitudinal study. Psychological medicine, 1-11 PMID: 22340278

Honig A, Romme MA, Ensink BJ, Escher SD, Pennings MH, & deVries MW (1998). Auditory hallucinations: a comparison between patients and nonpatients. The Journal of nervous and mental disease, 186 (10), 646-51 PMID: 9788642

Hopper, K., Harrison, G., Janca, A., & Sartorius, N. (2007). Recovery from schizophrenia: An international perspective: A report from the WHO Collaborative Project, The International Study of schizophrenia. New York, NY: Oxford University Press.

Joseph, J. (2004). Schizophrenia and heredity: Why the emperor has no genes. In J. Read, L. R. Mosher, & R. P. Bentall (Eds.), Models of madness: Psychological, social and biological approaches to schizophrenia (pp. 67-83). New York, NY: Routledge.

Karon BP (2003). The tragedy of schizophrenia without psychotherapy. The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 31 (1), 89-118 PMID: 12722890

Lewine, R. (1998). Epilogue. In M. F. Lenzenweger & R. H. Dworkin (Eds.), Origin and development of schizophrenia (pp. 493-503). Washington, DC: American Psychological Association.

Livingston, R. (1987). Sexually and physically abused children. The Journal of the American Academy of Child and Adolescent Psychiatry, 26: 413-415.

Mosher LR (1999). Soteria and other alternatives to acute psychiatric hospitalization: a personal and professional review. The Journal of nervous and mental disease, 187 (3), 142-9 PMID: 10086470

National Institute of Mental Health [NIMH]. (2010a). Schizophrenia.

National Institute of Mental Health [NIMH]. (2010b). How is schizophrenia treated.

Read, J. (2004). Biological psychiatry’s lost cause. In J. Read, L. R. Mosher, & R. P. Bentall, (Eds.), Models of madness: Psychological, social and biological approaches to schizophrenia (pp. 57-65). New York: Routledge.

Robins, L. (1974). Deviant children grown up: A sociological and psychiatric study of sociopathic personality. Malabar, FL: R. E. Krieger Pub. Co.

Satcher, D. (1999). Etiology of schizophrenia.

Seikkula, J., Aaltonen, J., Alakare, B., Haarakangas, K., Keränen, J., & Lehtinen, K. (2006). Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies. Psychotherapy Research, 16(2), 214-228. doi: 10.1080/10503300500268490.

Siebert, A. (1999). Brain disease hypothesis for schizophrenia disconfirmed by all evidence.

Woodruff, P. W. R., & Lewis, S. (1996). Structural  brain imaging in schizophrenia. In S. Lewis & N. Higgins (Eds.), Brain imaging in psychiatry. Oxford, UK: Blackwell.

  • Cindy

    I found, as a Case Manager working with *chronic mentally ill* clients in the State system that (1) more than half of them were more disabled by severe personality disorders (borderline, antisocial) than their schizophrenia diagnoses, and (2) my clients responded quite *normally* when presented with standards and boundaries required of the rest of society. I taught them *appropriate* communication skills vs their in-grained manipulative methods, ie, “I’m anxious” vs self-mutilation or *acting crazy*…. Needless to say, I was not very well-likes by my peers or supervisors, as it threatened their importance.

    • http://addiction-dirkh.blogspot.com/ Dirk Hanson

      So what is schizophrenia, then, if not a disorder of the brain? The author has no answers, except to claim, as so many have tried to claim before, that mental illness is some sort of social construct. The fact that this social theory of madness collapses every decade, and requires a new prophet of the “myth of mental illness,” never seems to dampen the enthusiasts.Have we all forgotten the disastrous experience of R.D. Laing and his attempts in the 70s to “normalize” schizophrenia? Must we repeat this demeaning saga, which does nothing to relieve patient suffering, but makes therapists somehow feel better?

      • Ocho Norton

        Mr. Dirk Hanson, what exactly is this “disastrous” experience that RD Laing had with trying to “normalize” schizophrenics in the 70’s? From what I’ve read, he was actually quite successful in bringing patients with schizophrenics to a level where they were functional enough to return home, only to realize it was the stress of their home lives that was actually causing them to relapse and have to return to the hospitals. Can you give any specific examples to contradict this fact?

      • http://www.rethinkingmadness.com Paris Williams

        Excellent question, and a very important question–“If schizophrenia is not caused by a brain disease, then what does cause it?” I mentioned in the closing paragraph of this article that I will address this in future blogs.

        Actually, this question is the main premise of my book, “Rethinking Madness.” The reaason I didn’t just write my thoughts about this question in this posting is that, as you can imagine, this is a very complex question and likely has multiple answers depending on which perspective you approach the question from. It is this very complexity that inspired me to devote an entire book to this question. I’m still working on how to capture the essence of the results of my own recovery research and the implications for the etiology of psychosis/schizophrenia in a single short article, but I do plan to post it here shortly.

        In “Rethinking Madness,” I approach the question of “what causes psychosis/schizophrenia?”, and “how do we support those who suffer from these conditions?” from an existential/phenomenological perspective. This is a big term, but it essentially means beginning with the assumption that all humans (and all living beings) share in common a very core desire to maintain one’s existence, which includes not just surviving but also thriving. The term “phenomenological” implies that this inquiry focuses on the actual lived experiences of people suffering from psychosis–i.e., their inner world and their own personal understanding and experience of self and others.

        What I believe the recovery research suggests is that psychosis is actually perhaps best thought of as a very last resort strategy of a desperate psyche to survive in the face of what otherwise feels like intolerable conditions. In some cases, this is very evident, such as when someone experiences a psychotic break as the result of severe torture, isolation, or other abuse. In other cases, this intense turmoil is less clear to an outside observer, but when we make the effort to inquire into the sufferers’ inner world, we nearly always find that such turmoil is there prior to the development of psychosis. Sometimes this turmoil occurs very acutely followed by a sudden onset of psychosis; and at other times, it builds up relatively slowly and progressively until a “breaking” point is reached.

        In other words, I believe the research suggests that it is not necessary to hypothesize that anything is wrong with the brain in order for one to experience psychosis, as psychosis may be a natural although very risky and precarious process brought on intentionally by one’s own being to cope/heal/grow from/beyond an unsustainable way of being in the world. One of the most fascinating research supporting this premise is the realization that not only is full and lasting (medication free) recovery fairly common, but that it very often entails profound healing and growth to a sense of wellbeing and level of functioning that is significantly better than that which existed prior to the psychosis. It seems that there is something about the psychotic process that allows such a positive transformation to take place at a very deep level of one’s being, when it resolves successfully. Of course, there is also the risk that one remains in a very fractured and chaotic state indefinitely.

        The research supporting this perspective is very well documented in “Rethining Madness,” along with the in-depth stories of six of my participants as they descended into psychosis and then finally went on to make full and lasting recoveries.

        Thanks for asking the difficult questions! As soon as we just go along with the mainstream understanding unquestioningly, we move from real science to blind faith, and any real hope of moving towards a joyful and compassionate society comes to a grinding halt (in my humble opinion).

        Paris Williams

        • Michelle Marie Allen

          I am a 53 y/o woman who was finally diagnosed 20 years ago with Bipolar I with psychotic features in both the manic and depressed phases of the illness. For the first 10 years of this diagnosis, I was a “bad” patient. By this I mean I was being non-compliant with my treatment plan (medicine and talk therapy) as I believed I was a shaman and could “cure” myself. That old adage, “Physician heal thyself !” comes to mind when I think back on that “delusion”.

          After 10 years of a “revolving door” of being hospitalized ( 7x to be exact!) against my will, I came to the conclusion in what little bit of insight I had left, that I certainly wasn’t getting any better. Boom ! Many years of my life wasted with several suicide attempts, the first being when I was only 16 !

          So… I “gave in” to the “Western ” paradigm of the medical model of treating mental illness. It has now been another decade and although I haven’t been hospitalized since, the medications have left me with impaired cognitive functions rendering myself somewhat useless to society as well as myself, but I am still alive without the severe mood swings which were life threatening. My quality of life, some would say is a tragedy. But who really can judge whose life is more valuable? Society ? I live,I have feelings,I still am intelligent, I still have dreams and MOST important, I have a family who LOVES and cares about me !

          What “proof” does one need to actually comprehend that severe mental illnesses are a FACT of life and very REAL and many families live with these illnesses. To minimize their heartache by getting caught up in the “splitting of hairs” mindset that the brain has NO bearing on the mind and the resulting evidence YOU claim to offer in your book makes you a “vulture” in my book, feeding off of the misery of the mentally ill and their families. Are you getting “fat” off of the sale of your book? Just wondering.

          I was a mental health case manager so aside from my personal issue with mental illness, I bore witness to the “reality” to the pain and damage that the unmedicated mentally ill person incurs as well as the feeling of helplessness the families of the mentally ill suffer.

          I have seen both sides of the same coin but there remains the edge of said coin which teeters precariously in the direction of less compassion because of stigma and concern over who will pay the “cost” of medical intervention for mental illness which is on the lowest level of priorty when it comes to health coverage.

          Have a nice day.

          • nehopsa

            …it is late at night and I probably should not try to but…

            …a vulture? really? Michelle Marie where is your culture?

            I wonder.

            In fact I feel exactly the opposite: the chemical psychiatry just puts shit in your brain. I mean that…to be on par with your level of responding. And, as for the repeated relapses…that is exactly the quality of trying to get off the addictive medication. Once they put you on – my French – shit – you just cannot discontinue it the next day. That is a big no, no, no. And of course, when you go the “no compliance route” you may not even have been made aware of the fact how extremely dangerous it is: once you are on those drugs it is a tedious and long proces of getting off, “tapering” the medication, with multiple points when you easily slip. As a matter of fact, there are drugs that CAUSE psychosis when you discontinue them (“reactive witdrawal psychosis”)as even the manufacturers were made to acknowledge after decades of ill experience paid for by the pain and blood of the mental patients.

            You cannot get off without support and without addressing the conditions around your life that put you in the psychotic state in the first place. To borrow the metaphor Paris Williams uses in his book: it is as if you tried to get out of the chrysalis, not a larva any longer…and not a butterfly yet. Of course you do need to survive on some sort of “stabilizer” since you would not even “hold together” if you follow this analogy, a chrysalis forcefully woken up before the process could run its course.

            Paris Williams is not the first author who suggests a person going through the existential crisis (which is what psychotic process is about) needs to be protected. If you read Lila by Robert Pirsig you find towards the end a similar idea. (Pirsig also “lost his mind” but he was without the benefit of following decades of the “recovery research”; he writes from the inside.)

            You may have opted for a more blunted way of being …and not facing what it is that started you on your psychosis…fine enough as it looks like it works for you. Just don’t call Paris Williams a “vulture” I beg. They are elsewhere: preying on endless misery of people who were forced to lose their lives to powerful wested interests – they are them, the vultures. You ask who makes most profit (and you YOU pay – as you now cannot otherwise).

        • Chucks

          Oh wow great, thanks, we’ll just all go pick up a copy of your crappy book. We’ll have to pay you to be able to disprove your argument. What crap.

          • http://www.RethinkingMadness.com Dr. Paris Williams

            You can actually download FOR FREE my entire doctoral dissertation (the research I conducted on people who have made full and lasting medication free recoveries from schizophrenia and other psychotic disorders) right HERE. No need to buy the book, though the book does reorganize all of this so it’s a little more accessible to the non-professional.

            Believe me, I didn’t write the book for the money (I’m still in debt over it actually). I wrote it because I want people to know that there is much more hope for real recovery than what is implied by Big Pharma’s propoganda.

            I appreciate your skepticism, and I hope you’re willing to direct it in both directions.

            Paris

      • http://www.rethinkingmadness.com Paris Williams

        Actually, R.D. Laing’s work has led to psychosocial approaches to supporting those struggling with psychosis/schizophrenia that have demonstrated by far the highest rates of recovery in the Western world–far better than what we have seen from traditional psychiatric treatment:

        The Soteria house sprouted directly from the philosophy of Laing’s work,and when compared to traditional psychiatric treatment in a well documented experimental study conducted by the National Institute of Mental Health (NIMH), it was found that the residents of the home fared significantly better on all eight outcome measurements, AND this in spite (because?) of the fact that they were not required to be on any antipsychotics, resulting in many of them not being on any psychiatric drugs at all.
        The Diabasis and I-Ward houses also came directly from the philosophy of Laing’s work, and have shown very similar results as the Soteria house–far surpassing the recovery results of psychiatric “treatment as usual.” (see Mosher in the references of this article)

        The Open Dialogue Approach used in Lapland, Finland, has demonstrated the highest recovery rates in the Western world, with a documented (peer reviewed) finding of 82% full recovery rates (asymptomatic and not on any psych drugs). Very similar to Laing’s treatment philosophy, this program uses almost an entirely psychosocial approach, supporting healthy communication among/within the social structure surrounding the individual suffering from psychosis. (See Seikkula in the references at the end of this article)

        It’s important that we don’t just spread around the propaganda that we hear from the psychiatric industry, but actually take the time to look for ourselves at the recovery research. Otherwise we can inadvertently cause much more harm than benefit, even when we’re well intentioned. This research is all spelled out quite clearly, although unfortunately, sometimes we do have to do a little digging to find it.

        Thanks for your comments,
        Paris Williams

        • Laura Blue Bird

          Dear Doctor Williams,
          I am Laura Blue Bird. I am 30 years old. I live in Minneapolis. I am Lakota and white. I have believed and was told several years now that I am stuck taking my medication forever and that I have paranoid schizophrenia which I was labeled with. I have always thought there was a cure and that I could live my life happily and healthier than I am currently living it now. Without having to take medication. I’ve been told that this is a degenerative disease of the brain which I will die with. I was hopeful before I got sick that I could have made something with my life. That I was able to be successful and support myself and a family. But that hope was shattered about 8 years ago. I am currently on disability work at a menial job and I live with my partner. But I want to accomplish my dream of being successful and helping people my main area of interest is holistic and naturalpathic medicine. Right now I think I’m at rock bottom in life in every area of my life except for my job. I am certain I have schizophrenia and depression, because I have delusional thinking followed by paranoia. I want to be able to love people unconditionally, to have sex and feel pleasure, to walk down the street and not have to worry what others are thinking about me, to not have to hide the fact that I have schizophrenia every time I meet someone new. And so much more hopes and dreams. I am interested in this topic of how people have been cured and live normal happy lives. Is there anyway you can help me to be cured?

          • http://www.rethinkingmadness.com Paris Williams, PhD

            Hi Laura,
            Thanks for sharing a little bit about your story, and I personally can relate to the longing you feel for some basic ease and joy in your life. According to my own research (and personal experience), one of the most helpful factors in recovery is dropping the “disease model” including words such as “cure,” while not denying the reality that you’re suffering with very real and difficult psychological experiences. The research shows again and again (including the latest trial by Wunderlink published in the Journal of the American Medical Association a few months ago) that those who use a drug minimization and reduction method (eventually tapering entirely off if possible) have the highest recovery rates. What’s also important is finding people who will really listen to you and see you not as someone with a brain disease but as someone suffering with very human dilemmas (only perhaps more intensely than the average person). I recommend looking at the RESOURCE pages on my website and trying to locate either a peer group or professional who doesn’t cling to the “disease model.” I also recommend THIS ARTICLE and consider how congruent your own life is with regard to the recovery factors mentioned in this article. You can also find a like-minded community at THIS website.
            Best wishes in your journey,
            Paris

      • Stephen Boren

        How then, if it is supposedly an incurable brain disease, do so many people recover from it and go on with their lives; that is if the biopsychiatrist and quacks don’t get their hands on them first and poke the toxic drugs into them? Some of the most well-known psychatrists today are people who recovered from schizophrenia. And, hearing voices is something that 13% of the human population across the entire world experiences. This points out that hearing voices is just another variation of what it means to live as a human.

    • Paul

      This comment represents why psychological interventions into the area of schizophrenia can be unhelpful. Ironically it’s not too disimulat to saying people who suffer severe mental illness are self absorbed and need to pull themselves together. Words like ‘Judgemental’ become part of the new dogma. It can be self congratually and self assuring to utter such words but can serve to heap guilt onto the patients. This kind of thinking sits well in the world of religion and dogma but should not be entertained in psychology.

      People with severe mental illness want to be able to function functionality should be the goal.

      P.s the problem is that many psychological concepts have a basis but once they are verbalised or articulated they can become dogmatic.

      An example is I’d prefer to use ‘non assumptive’ rather than non judgemental. But now that my word is out their , it follows that compulsively thinking people will be thinking in order to get better I must be non assumptive. In the real world though we all make assumptions , indeed we all make judgements , its called having an opinion.

      Separating ones self from realities of social discourse, ironically, will engender , a more judgemental , stilted , irrational attitude. e.g I am behaving in such a way but persons a , b and c is doing the opposite. People who behave in such way become desensitized to personality and its quaint , uniqueness.

  • Richard Kensinger, MSW

    I readily agree with the above clinical facts. The neurotransmitter “Dopamine” is implicated in a host of other clinical diagnosis such as Parkinsons & even clinical depression to name just a few.

    Psychostimulants such as Ritalin & Cocaine cause neuromodulation of the dopamine pathways & can themselves induce psychotic manifestations.

    Sadly, & true we know very little about the pathogeneses of many d/o’s that we clinicians encounter! We presume that any genetic contributions are polygenic.

    Rich

  • Nancy Milos

    I am no professional. However, I would like to relate something that happened to my brother in the late 1970’s. He had been diagnosed as schizophrenic after displaying many different symptoms for most of his life. My mother didn’t want to put him on drugs if she could help it and took him to Dr. Abram Hoffer, an expert in orthomolecular medicine in Victoria, BC, Canada. Dr. Hoffer put my brother on high doses of vitamins (mega vitamin therapy, it was called in those days) and especially high doses of niacin. There was an immediate improvement in his symptoms and we were so happy with the results. Unfortunately, my mother had a heart attack and could no longer care for my brother. He was put into a government controlled group home and they refused to continue the mega vitamins, had him see one of their own local physicians who put him on an anti-psychotic, an anti-anxiety med and something else that I can’t remember. It was like a switch had been flipped and he was back to his former behavior. It was very sad for our family. Had we been wealthy we could have kept sending him to see Dr. Hoffer and found him a better living situation. Alas, this was not the case. My brother died in the group home several years ago and I regret his quality of life was so poor compared to what we know it could have been.

    • cork horner

      I found your family siutuation very saddening.
      It is a major failing of society imposing these irrational conditions on unsuspecting victims.

    • http://www.rethinkingmadness.com Paris Williams, PhD

      Thank you for sharing this very tragic story with us. Another painful example of the brokenness of our current system…

      Paris

  • http://uk.linkedin.com/in/navery Nicola

    Thank you for writing this interesting post – have recently discovered your blog and looking forward to exploring further.

    I agree that it is time for a rethink. I have completed some study of anatomy, physiology and pathology and ‘biochemical imbalance’ is not a very helpful term and the brain imaging technologies and use are not sufficient to provide a visualisation of what might be happening on an everyday basis.

    The level of experimentation being completed including those self-reporting in communities, online psychological experiments with different networked technologies and other research, may be not a return to previous thinking but building on it – if the networked connections can be visualised and understood at a ‘molecular’ level.

  • http://www.moms4review.com/ Melory

    Schizophrenia is not a physiological disorder, it is a scientific label for an individual that has experiences of a supernatural origin, which science has no evidence of.

    Those diagnosed with schizophrenia hear, see, and feel things that are real and imparted by a spirit. Those with schizophrenia are just some of the saints found in the scriptures.

    • http://www.rethinkingmadness.com Paris Williams, PhD

      I believe it was R.D. Laing (?) who said that the mad person is drowning in the same ocean in which the mystic swims. It’s clear that there’s something about madness/psychosis that often opens a person up we all struggle. One difference is that while most of us are only semi- or even entirely unconscious of these dilemmas most of the time (except in various identity/existential crises), when a person experiences psychosis, these dilemmas manifest in very powerful ways that are painfully apparent. I don’t believe that this idea is not a “romanticization” of madness, as some claim–many people who fall into the seas of madness often remain lost and in deep suffering for many years; but I don’t believe there’s any doubt that they often touch into truths than can provide us with a deeper understanding of the most core existential struggles that we all share.

      Paris Williams

    • Paul

      As someone that has suffered from schizophrenia there is not one shred of me that believes that schizophrenia is anyway rational or has any moral outlook. These principles you speak of when applied to the real world will land you in a whole lot of trouble. This world works by the laws of physics and is based on evolutionary principles. And it dosn’t care about anything else.

      • Skree

        Paul, your post was the first I read making real sense. I too have suffered similar episodes. Schizophrenia is the name given to a whole group of symptoms, it is not one disease as cholera eg. is. If you have more than a handful of symptoms you can be diagnosed as schizophrenic. Roughly 1.1% of people. However 10 to 20% of people are schizotypal, showing one symptom. The idea it is in some way spiritual has caused a lot of harm as has the idea of categorising people. This categorisation is not common with professionals who are aware it is a collection of symptoms. So two schizophrenics may not have a single symptom in common.

  • P

    I wonder what does the author think about Robert Whitaker’s research which seems similar here. Also to offer a short “explanation” to another person’s question above, “what is schizophrenia then?”. In my reading i have understood it to be a deeply terrifying time in someone’s life who has not been able to find the right set of circumstances in which to find help. The issues are troubling enough that the mind or psyche compensates for the stress by developing coping mechanisms for survival. In the face of the trauma that cannot be consciously dealt with , or visited, (for whatever reasons) the mind reconstructs another reality to keep the person from losing it entirely or comitting acts that may harm self or others. I have also read that a “true”schizophrenic episode is actually quite rare and is not as dangerous and unstable as society and hollywood likes to make it out to be. This is from reading insider accounts only.

    • http://www.rethinkingmadness.com Paris Williams

      Well said! Please see my post above on the same subject.

      Paris Williams

      • http://www.rethinkingmadness.com Paris Williams

        btw, I think Robert Whitaker’s work is excellent. I highly recommend both “Mad in America” and “Anatomy of an Epidemic”

        Paris

  • Richard Kensinger, MSW

    An environmental/familial factor known to cause relapse in those w/ schizophrenia, is high, negative, expressed emotionality. Tho in fact this generates relapse of many other BH disorders.

    Rich

  • Louis

    1- Both structural and functional brain abnormalities are present in medication-naive first-episode psychosis patients.

    2- This article shows a very poor understanding of the statistics behind neuroimaging analyses. While it may not be possible to diagnose individual patients from neuroimaging data due to high variance, group-level findings are undeniable, regularly published in high-impact journals and accepted as accurate. Moreover, correlations between clinical presentation and structural/functional brain changes are often reported.

    3- There is no mention of the various functional neuroimaging (fMRI, EEG) studies of schizophrenia and related disorders; an even greater body of literature than structural studies.

    4- The references provided for neuroimaging findings (and most of the article) are not up-to-date, and do not come from serious sources (i.e. established leaders in the field).

    Citing an MRI review paper from 1996 is completely absurd in a field where methods evolve so quickly.

    • http://www.rethinkingmadness.com Paris Williams

      I understand your skepticism, and only referred to those research studies most relevant to the broad-sweep statements I’ve made in this very short article. I discuss all of these in much more depth (including bringing in the most recent and relevant fMRI studies, EEG studies, etc.) in Part One of my book, “Rethinking Madness.” You can download the entire Part One for free here (clck on “View excerpt”):

      http://rethinkingmadness.com/#/the-book/4558919669

      A few quick responses:

      Please reread the section in the article “Hypothesis #2…” The research has shown that many other factors which are often “comorbid” with those diagnosed with schizophrenia lead to the changes that have been found in those so diagnosed (including trauma, the use of psychiatric meds themselves, and others). Also, it’s been recognized that the majority of those so diagnosed don’t show any significant structural abnormalities at all, while many individuals NOT diagnosed DO show such abnormalities.

      Again, please download the excerpt of the book above, which thoroughly discusses these issues along with referencing the most recent relevant research, and then feel free to contact me (contact at the same link) for more discussion.

      I appreciate your willingness to be skeptical of what you read, but I invite you to bring this same skepticism to what you read elsewhwere. While I may be at risk of sounding “paranoid” for saying this, the painful reality is that most of the mainstream media and even many journals are in the pockets of the pharmaceutical industry, which is one of the most powerful industries on the planet, perhaps being second only to the oil industry. And antipsychotic drugs are currently the single most profitable class of all prescription medications in the U.S.(!) In other words, be very skeptical of what you read in the mainstream media, and take the time to look at the research yourself (this is one reason I went through all the trouble to get a Ph.D., to learn how to look at all the information/propoganda out there with a much more informed and critical eye)

      Paris Williams

      • Louis

        Biol Psychiatry. 2011 Jul 1;70(1):88-96. Epub 2011 Mar 31.

        Neuroimage. 2012 Feb 24. [Epub ahead of print]
        Schizophrenia, neuroimaging and connectomics.

        Have a look at these two recent reviews from established research groups.

        I find it unfortunate you were so quick at throwing your “PhD” title out there. From the arguments you are putting forward, there are obviously some serious gaps in your training – especially in the biological and imaging sciences – regardless of which degree you have.

        Have you ever published any of your work in a peer-reviewed journal?

  • cork horner

    Paris, I seek someone of your background in metro Phoenix who also is setup for Medicare payment. Also, I need to find an anger management clinic/group/therapist who can accept Medicare payment, to satisfy the local Phoenix court for someone I am close to .

    • http://www.rethinkingmadness.com Paris Williams, PhD

      Can you please send me this request directly to me at the following address (along with your contact email), and I’ll forward it on in an attempt to find a good fit for you:

  • http://www.rethinkingmadness.com Paris Williams, PhD

    …for some reason, the link didn’t go through. Here it is again:

    Contact Me

    and if it doesn’t come through this time, just got to:

    http://www.rethinkingmadness.com and click on “contact”

  • Paul

    Of course schizophrenia is a disease. It is not made up. A comparison I would make is the throid being over active or underactive. It is malfunctioning in the way it is producing chemicals/hormones. Psychosis is not simply a cognitive problem , how can you argue that psychosis is not as a result of disease. Do you really think its a problem caused by misinterpetation. Psychosis is a complete departure from character , similar to influenza being a departure from good health. It is a diseases my friend they just dont have the numbers yet.

    • http://www.rethinkingmadness.com Paris Williams, PhD

      I have no contention that psychosis could fit the literal use of the word, “disease,” as in “dis-ease,” since by definition, psychosis involves “distressing and/or limiting anomalous experiences.” But the term “disease” as used within the context of terms such as “schizophrenia” or “psychosis” or “mental illness” ordinarily implies that there is some physio-pathological condition within cellular tissue (or within the functioning or organic systems). The scientific community has been looking for well over a hundred years for this (not only in schizophrenia but in all of the so called psychiatric “mental illnesses”), and if you can provide clear and indisputable evidence that such experiences are directly caused by such a condition, then you will likely win the Nobel Prize in Medicine. So far, our findings in this regard are in stark contrast to well known disorders of the brain such as Multiple Sclerosis, Alzheimer’s disease, and Parkinson’s disease.

      Certainly any extreme mind state can be correlated with anomalous/unusual conditions occurring within the brain/body, but it’s a logical misstep to jump to the conclusion that this implies disease. If I found my mother dead, or had a gun put to my head, my brain would certainly exhibit activity far different than what occurs within my ordinary consciousness, but is it really appropriate to consider such grief or fear a “disease”? There is no doubt that mental experiences and physical states are profoundly correlated, but correlation is not causation. Clearly, in the case of finding my mother dead, it would be a grave mistake to say that my grief was caused by the unusual brain activity occurring at that moment and to suggest that therefore I must have a brain disease.

      Likewise, I may be experiencing sensory perceptions that others around me don’t experience (i.e., so called “hallucinations”) or anomalous beliefs that others in my society consider invalid (so called “delusions”), and there may very well be some unusual brain activity correlated with these experiences, but which causes which…? Do these unusual experiences that I’m having cause the unusual brain activity, or vice versa? One of the first tenets of true scientific inquiry is not to confuse correlation with causation; and unfortunately, we find that this mistake–this crucial logical misstep–occurs all of the time within the field of mental health.

      So, returning to the evidence we actually have supporting the “brain disease” theory of psychosis, we are extremely limited in what we can actually say with any kind of certainty (a limitation readily acknowledged my many neuroscientists, psychologists, and psychiatrists within the field); and that is that for those experiencing psychosis, there is a slightly higher chance that their brains will show brain structures or neural activities that fall somewhat outside the standard deviation. But this very same population also has significantly higher rates of trauma, substance abuse, and of course psychiatric drug use, all of which are very well established to bring on the very changes that we find within these brains. And also keep in mind that the percentage of those diagnosed with schizophrenia who show significantly abnormal brain structure/activity is relatively small (around 20-30%), which is actually surprisingly small considering the much higher percentages of trauma and drug use (illicit and psychiatric) we find within this population.

      So, in short, to assume that just because someone is exhibiting unusual beliefs, perceptions, and/or behaviors does not require that anything be wrong with their brain.

      Here are a few quotes I find relevant to this topic:

      “We can say that brain and mind correlate their functions, but we actually don’t know the exact ways in which brain activity and mind function mutually create each other. It is too simplistic to say merely that the “brain creates the mind” as we now know that the mind can activate the brain . . . the mind can directly stimulate brain firing and ultimately change the structural connections in the brain [emphases added].” [Daniel Siegel, neuroscience researcher at UCLA]

      “To claim that an irrational or emotionally distressed state, however extreme, in itself amounts to impaired brain function is simply false. An analogy to television sets and computers may illustrate why this is so. If a TV program or Internet site is offensive or irrational, it does not indicate that anything is wrong with the electronics of the television set or the hardware of the computer. It makes no sense to attribute the bad programming or the offending Internet site to bad wiring. Similarly, a person can be very disturbed psychologically, without any corresponding defect in the wiring of the brain.” [Peter Breggin, psychiatrist specializing in psychopharmacology]

      Paris Williams

      • Paul

        Fear is a dominating emotion felt by people with schizophrenia and even in normal functioning people fear changes how we sense the world. You are familure with the fight or flight reflex action that occurs in the brain when a person is suddenly startled or shocked. It is a fact that brain chemistry changes effecting our hearing and alertness. In schizophrenia where fear prevails it leaves the brain in this prolonged state of chemical imbalance effecting the senses. Your argument seems to boil down as follows remove the cognitive issues causing this fear and the chemical imbalance will stop. i dont believe that. To me this is just indoctrination akin to religion and spiritualisim.

        • Paul

          Let me be fair to you. I am not an acedemic. I myself am schizophrenic and would describe myself as semifunctional.

          • http://www.rethinkingmadness.com Paris Williams, PhD

            I appreciating your willingness to disclose your diagnosis. I am very familiar with how entrenched particular mind states (such as fear) can become within psychosis (having been there myself). And while it’s important to acknowledge the very real suffering that can occur when someone struggles with such a powerful mind state as fear, it’s also important to recognize that it’s very well documented that many, many people (myself included) have spent long periods of time in such difficult mind states and then went on to make full and lasting recoveries (med free), with many of them going on to experience a sense of wellbeing that far exceeds that which existed PRIOR to the psychosis. Of course, not everyone experiences this, but many do… and if we don’t acknowledge this, then we just perpetuate a false hopelessness that unfortunately often becomes a self-fulfilling prophecy (which is also documented).

            btw, in my book, “Rethinking Madness,” I document the cases of six individuals who experienced very difficult states including profound confusion and even prolonged periods of terror, some for many years, but who then went on to make full med-free recoveries, with all of them arriving at a general sense of well being and functioning that EXCEEDED that which existed prior to their psychosis.

            Paris

    • http://www.rethinkingmadness.com Paris Williams, PhD

      p.s. One more significant piece of evidence suggesting that schizophrenia/psychosis is likely not the manifestation of a brain disease is that many, many people make full and lasting recoveries after being diagnosed with schizophrenia (see my other article on this website–“Full Recovery from Schizophrenia?”); whereas with the major well established diseases of the brain–such as Multiple Sclerosis, Parkinson’s Disease, and Alzheimer’s Disease–to the best of my knowledge, there has not been a single documented case of someone making a full and lasting recovery.

      Food for thought, anyway…

      Paris

      • cork horner

        Paris, there is mounting scientific clinical evidence those neurological diseases are the result of inflammation and oxidative stress which nutrition has a powerful impact on.

        • http://www.rethinkingmadness.com Paris Williams, PhD

          Cork,

          Based on the research I’ve been poring over the last many years, it seems quite apparent that a number of factors (including nutritional deficiencies, various stressors, lack of sleep, etc.) may all play a role in pushing one towards a “breaking point. So the idea that these factors may play a role in the onset of psychosis is not mutually exclusive with the idea I’ve been referring to in the posts above (and to which I go into great detail in “Rethinking Madness”)–that psychosis, rather then being some meaningless manifestation of a diseased brain, is actually a meaningFUL yet attempt of a desperate psyche to return to a relatively harmonious and functioning system after being pushed so far out of balance (as “M” alludes to below). Again, what we see in psychosis is the workings of a profound wisdom that exists within all of us (and indeed within all living beings) that continuously strive towards survival, healing, and growth (although of course we are not always successful and all living beings have their limits).

          Paris

  • M

    Having been diagnosed with Sz at age 19, I now know that it is caused from “stress”, in my case not being able to adjust to a situation. There was a great deal of fear and anxiety.

    Physically, I lost much sleep and stopped eating. I believe now that the sleep deprivation caused the hallucinations, as it seemed “dreams” we’re bleeding into my waking life.

    Irrational thinking resulted in attempting to make sense of all of it, since the brain and body always seeks homeostasis.

    The “treatments” made everything worse. The humiliating and dehumanizing treatments became incorporated into my identity, as well as numbing me to my own thoughts and feelings.

    By then I was fully engaged in the MH system and it took years to get out of it.

    • http://www.rethinkingmadness.com Paris Williams, PhD

      Thanks for sharing this. Unfortunately, stories like yours are all too common. It’s definitely time for a “rethink”

      Paris

  • Paul

    For me just because their is not a physical ‘test’ for schizophrenia does not automatically infer that their is no disease. Would you be suprised to know that in early stages MS their is no physical test either or indeed many neurological conditions. The ‘test’ is do sympthoms get worse or indeed do they match a perscribed list of sympthoms. People with neurological diseases are left a long time in limbo as to their diagnosis. The fact remains that psychosis is an absolute change in mind state, a complete departure or break caused by physical anomalies in a malufunctioning brain. It is also plausible to say that their may not be a physical test for schizophrenia in this generation or indeed many generations to come , the lack of this proves nothing. I have studied biology myself and if we look at the basic cell structure , it is mind blowingly complex in its function.

    • Anonymous

      There are some major problems with your logic:

      1) Clear neurological damage can readily be seen withing MS, Alzheimer’s, Parkinson’s, and other well established brain and neurological disorders–damage that cannot be attributed to other factors such as psychoactive substances, trauma, etc. It’s true that this damage is often very difficult to assess while the person is alive, and so often requires a biopsy or postmortem study to confirm–however, such confirmation is very well established. This has simply not been the case with those who meet the diagnostic criteria for schizophrenia or “schizophrenia spectrum” disorders. There is no postmortem study or otherwise that has conclusively determined that schizophrenia is caused by a brain disease. Again, as mentioned above, we have only found brain anomalies in about 20-35% of the cases of those so diagnosed, and these can be readily attributed to other factors (see posts above).

      2) It is VERY common for people to make FULL and lasting recoveries after being diagnosed with schizophrenia. In many populations, such as those in so called non-industrialized countries and those receiving certain types of psychosocial interventions, complete remission is actually the most common outcome. The World Health Organization has carried out by far the largest, most extensive recovery research on schizophrenia, following over 1,000 participant (who were carefully diagnosed) from over 13 countries (of a full range of socioeconomic status) for over 25 years. Their conclusion: “The overarching message [is that] schizophrenia is largely an episodic disorder with a rather favorable outcome for a significant proportion of those afflicted.” We simply do not see anything like this kind of recovery with any of the well established neurological disorders. Please see my other post in the Brain Blogger entitled, “Full Recovery from Schizophrenia?” for more information.

      Also, the recovery research is documented and explained in much more detail in my book, “Rethinking Madness.” And you can download the entire section documenting this research for free HERE (and clicking “View Excerpt”)

      Paris

    • Anonymous

      …furthermore, how do we explain the very robust finding that those who do make full recoveries very often do not just return to the pre-psychotic degree of functioning and wellbeing, but often undergo a profound process of healing/transformation into a new way of being (of understanding and experiencing themselves and the world) resulting in a significantly higher degree of wellbeing and ability to meet their needs. There is clearly something very different occuring within this process (when resolved successfully) than what occurs with the simple recovery from a physiological disease.

      Paris

  • Paul

    My point is not completely negated. MS is a physically diagnosed disease yet in a living being it is very hard to diagnose. My point is that just because their is no physical test it does not mean that their is no disease. Anyway I could never imagine schizophrenia being physically diagnosed without data being gather from the experiences and physiology of a living being. That goes with most diseases

    • Anonymous

      …but you’re still operating under the assumption that there is some single disease entity we call “schizophrenia” awaiting discovery.

      This is an unfounded assumption, although of course it is a widespread one, so I understand how easy it is to adopt this as “established fact.” All that we know for sure is that many people experience anomalous perceptions and/or beliefs, or exhibit unusual behavior, and that our mental health care establishment has made a decision (not based on any biological findings) that we should lump all of these kinds of experiences under a common label (i.e., “schizophrenia”). These are major assumptions, completely unsubstantiated, and yet we generally hold these as gospel within our society (a trend reinforced by billions of dollars from the pharmaceutical industry’s marketing campaigns). There is lots of evidence that if we are exposed to a false message again and again, we are likely to come to see it as unquestionable “fact.”

      I have documented all of the research which is used to support the brain disease hypothesis of schizophrenia as well as the arguments against it thoroughly in Part One of “Rethinking Madness,” and would be happy to continue this dialogue with you after you peruse this section, since I don’t have the time to go over all of this again here. There is a link to where you can download this for free in one of the above posts (June 28 at 9:13 am).

      Paris Williams

  • PK Grunden

    I am not a neuroscientist or a clinical psychologist but I did work closely with psychiatric patients for a number of years and I observed that there were “schizophrenic” patients who had critical episodes and then did relatively quickly stabilize on what could be characterized as a higher order of psychic function (or at least potentially so), and there were others (in my experience more common)who manifested the classical symptoms which were quite probably intractable over the longer term. The conclusion I reached was that the diagnosis “schizophrenia” is too broad and imprecise AND that the psychiatric establishment does not have an adequate framework for grasping the differences involved. In particular, there is a “scientism” that dominates the field and which is invested in variously crude forms of biological determinism that cannot appreciate the phenomenological dimensions of psychotic experiences and thus rarely responds with appropriate or adequate treatment. In my observation, this was rooted in the doctors’ medical training and strongly reinforced by material incentives offered by drug companies and insurance providers. Nursing staff, social workers, and patient care technicians were disciplined in this framework accordingly and those who had misgivings about participating in it did not often last long in the job. I find it encouraging that there are therapists like Paris Williams, Paul Levy, and others, who are exploring more multidimensional approaches to alleviating these all too real and yet not strictly material forms of suffering. They are carrying on in the spirit of RD Laing while, one hopes,learning from his mistakes, and creating a foundation for a new spiritual psychology of the future.

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  • http://neuroamer.wordpress.com Neuroamer

    How do you explain genetic syndromes such as DiGeorge syndrome, where patients have 30x the risk of schizophrenia or psychotic symptoms than the rest of the population?

    Schizophrenia is a highly heterogenous disease, that is probably many different syndromes, many of which will involve interactions between genes and the environment. There are problems with diagnosis, and we are struggling to identify the genetics and mechanism, but denying the biology involved is dangerous.

    • PK Grunden

      I would agree that denying the biology involved is dangerous; conversely, emphasizing the biology involved to the exclusion of all else is–lucrative? Ideological? At the very least, it is convenient for various “interested” parties and for that reason should be subject to fierce scrutiny.

    • Anonymous

      To “Neuroamer,” I agree with you on both counts:

      (1) that what we label “schizophrenia” is highly heterogeneous and likely points to a number of different experiences–we essentially label beliefs/perceptions/behavior that are significantly out of alignment with society’s consensually sanctioned beliefs/perceptions/behavior as psychosis, and if these are “bizarre” enough or last for long enough, then we call it “schizophrenia.” Such experiences are likely to often have a wide variety of different possible roots–e.g., trauma, the ingestion of psychoactive substances, physiological/nutritional deficiencies/anomalies, awareness of deeper truths that are difficult to integrate, or simply a lack of desire/willingness to conform to the norms of one’s society.

      And (2) that it’s important to acknowledge that there are almost certainly significant physiological correlates with any of these experiences/behaviors that get labeled schizophrenia/psychosis (or any extreme state of mind). I would go even further and suggest that mind and body can be seen as essentially two sides of the same coin, and virtually any activity within the mind has a physiological correlate and vice versa.

      …but I believe that our mainstream understanding is flawed in several important ways:

      –we mistake correlation for causation: In other words, we assume that such anomalous experiences/behaviors must arise from a physiological anomaly–when there’s plenty of evidence that psychological/mental anomalous/extreme experiences can be the cause of anomalous physiology (e.g., trauma or significant learning/experience of any type leading to observable changes within the brain).

      –we assume that anomalous experiences/behavior must arise from a physiological disease. Just because someone exhibits either psychological or physiological traits that deviate from the norm does not automatically imply disease (e.g., would we consider genius or shyness to be diseases?)

      –and finally, after studying this topic extensively, I find that very often what so often gets labeled “psychosis” or “schizophrenia” is an actual desperate strategy by an organism/psyche in dire straits, resorting to such extreme strategies of profound shifts within one’s personal paradigm and a profound reorganization of one’s self at a very deep level when other less extreme strategies have so far failed in allowing this individual to continue to exist in a sustainable way. What places an individual in such dire straits? As you alluded to, a number of factors can contribute to this, including significant psychological/emotional trauma, significant physiological trauma (such as even perhaps very real neurological/physiological/nutritional disorder). Sometimes it’s very apparent for an outside onlooker that an individual is caught in such an existential crisis (such as with severe torture, abuse, or neglect); and other times, it’s not so apparent to onlookers, though of course it’s likely very apparent to the individual him/herself.

      I believe that this topic is one of the great remaining mysteries of human experience, one that I have found greatly humbling, but also one that I believe contains important insights for the very survival of the human species. I appreciate the willingness and interest of people like yourself who are willing to explore this topic with an open mind.

      You can read more about my thoughts on this in my book, Rethinking Madness, or by waiting for future posts, which I intend to continue releasing every month or so.

      Paris Williams

      However, where I believe we make some major mis

  • Richard Kensinger, MSW

    The clinical profession better serves our clients across many BHC conditions by adopting integrative paradigms of care such as the following 3; biopsychosocial(spiritual); diathesis stress which highlights genetic vulnerability + stress, & epigenetic which indicates that our environment directly influences genetic expression!

    Rich

  • http://tedestrandmetoden.se Anders Tedestrand

    Very interesting and probably logical.

    There is, in my opinion two things that influence our development from birth and to whom we should be. The sensitivity and the imprint we are exposed to in the context we are formed in.

    Complex conditions can not be solved with the treatments we use today. They consist only of the call to the support member.

    For all the complexity of first having an overview of how the construction should go to the what has decayed. Look around you, in which area do you solve complexity without a map, plan or similar, even in nature to ask questions in our DNA to build up that which decays.

    I have a very long process with several severe complex conditions. Somehow my system process forward at a glance that I attached to the paper, and today as the missing map in psychology and substance abuse care.

    Information and links on my website: http://tedestrandmetoden.se all information is regrettably only available in Swedish, use google translate if possible.

    Method is now scientifically evaluated and critically reviewed, the evaluation shows credibility and usually fast processes.

    I strive for validation, and I can well imagine that even very difficult conditions such as schizophrenia can be improved with a glance – map.

    Google has translated what i write, sorry:)

    Anders Tedestrand

  • John Sawkins

    “There’s none so blind than those who will not see”.

    I find myself in total agreement with Paris Williams. Every scientist to whom I have tried to dispute the myths of “genetics” and “brain chemistry” trots out his view that it’s all factually uncontestable and if only I would apply his so-called rational thought to the issue, it would be perfectly obvious to me, too. Unfortunately, the parts of the brain that supposedly conduct logical and rational thought-processes are anything but rational! They simply make the information fit into their existing paradigm. Any view that conflicts with their Weltanschauung is dismissed. Ironically, many scientists reject other peopl’s belief-systems as unscientific; and yet they themselves are blinded by their own propaganda. Belief in genetics and brain chemistry is so entrenched that any alternative gets rejected without any attempt to weigh up the evidence (usually in the form of lived experience as opposed to the received wisdom of academics).

    Society operates like a perfect macrocosm of the brain: if we follow our gut-reaction, we are accused of being hypersensitive by those in power who control us (i.e.those with a similar lack of empathy to sociopaths). Our sensitive side submits to our more dominant rational side, despite knowing instinctively that the bully is wrong.

    • Paul

      If you have any alternative testable claim that we can actually see the inputs and the outputs and we are able to objectively analyse the data therein then out with it. A psychologist is a scientist by training , if their is another belief system then it does not belong in this profession. Filling schizophrenics up with ideas that are untested and are based on experience based reasoning is not the way to go. Get it published , let people scrutinize it and then if it has value (all psychiatrists and research people are not in the pockets of pharamceutical companies) it will be accepted because it is based on something concrete. I wish I really do that there was a framework that could be accepted by people smarter than myself I really do. It is clear the current drug regime is not working as we would all like , but give us something else then.

      • http://www.RethinkingMadness.com Dr. Paris Williams

        You’re in luck! I have already done exactly what you’ve requested–publishing thorough critiques of the “brain disease” theory of schizophrenia/psychosis as well as a sound alternative theoretical model:

        First, I have published these in the form of my doctoral dissertation. You can download the entire dissertation for free HERE.

        My research consisted of three in-depth qualitative case studies (a single-case study followed by two multiple-case studies) of people who had been formally diagnosed with schizophrenia and/or other closely related psychotic disorders, and who then went on to make full and lasting medication-free recoveries. Anyone who has gone through the process of conducting doctoral dissertation research will know that this among the most heavily scrutinized research that is done, since it is overseen by a dissertation committee comprised of university professors, all of whose reputations are at stake when they sign off on the research.

        Second, I have published a book that has converted the findings of my own research into a format that is more accessible and enjoyable to the layperson–this book includes a thorough review of the research on the brain disease; a number of alternative models that have been presented over the past fifty plus years; biographical accounts of people who have descended deeply into madness and then went on to make full and lasting recoveries; and my own novel integrative model of psychosis.

        You can find more information about the book (“Rethinking Madness”) HERE.

        (I apologize for being a little slow with subsequent posts–I’ve been very busy lately).

        Paris Williams

  • Paul

    Thank you , I’ll read this. I would also like to say something about what motivates myself as a person. I have a problem that I want to resolve as best as humanely is possible. Hope for me is the search for truth. And with schizophrenia the only truth is what can be verified scientifically because in its context everything else in my opinion runs the danger of being delusional. From an analytical point of view schizophrenia is pathological , its sufferers in large part do not hold and special gift , they are not stable enough to exibit there good qualities in a substantial professional sense ( and they have many good qualities as do I ), are a challenge to their carers , they have no strong sense of themselves and are victims to an uncompromising and indifferent wotld , they are laiden with fear and guilt, they are suggestive, they smoke too much , their condition and their lifestyle make them more likely to die of cancers and cardiovascular diseases , statistically its uncompromising and unforgiving. Most live compromised existances. They are patronised by terms such as “quality of life” which in fairness is reality but it is also humiliating. So out of all this wheres the hope , hope is to set aside the delusion and live for what is real , thats the journey and its damn honerable.

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  • http://thebipolarone.com/ The Bipolar One

    I’d certainly consider it a “brain disease” or mental illness as it is more commonly referred to. However, as with all mental illnesses I believe there is so much more to be learned. 100 patients may be diagnosed as having some sort of mental illness and only 50 of them could actually be suffering from a neurobiological ailment. There may be many cases where it is anything but a malfunction of the brain but there still remains to be those which are hardwired mental illnesses. Essentially, I believe there are “true” mental illness cases such as schizophrenics.

  • http://ebooks.thieme.com/ Ryana Disuza

    Schizophrenia cannot be considered as a brain disease. This is a state of mind which does hamper a person in certain ways. It can be considered as a state which is characterized by the coexistence of contradictory or incompatible elements. You can get to know about the fundamentals of neurology which too deals with the aspect of schizophrenia also from here

    With this eBook you can get to know that Schizophrenia cannot be considered as a brain disease.

  • SUZANNE

    Listen, I am a mother of a young man who had a breakdown @ 15 years ago. I can tell you from experience that drugs are not the answer. Thank god for my common sense and my 10 acres where I could hide my son from the medical people and psychiatrists. They are the ones that are scary. Not people like my son who has been labeled schizophrenic. One psychiatrist told me that my son would have to be on drugs for the rest of his life and that talk therapy does not work for someone like him because of his diagnosis. I would not believe him. I even brought in books by people like Breggin and whitatker and others. He asked me why I was reading such negative books. I said are you kidding? These books make sense to me and give me hope. He told me that if I didn’t allow my son to be on the drugs, I would create further brain damage. He was the head psychiatrist at the hospital in the town I lived in at the time. I fired him and took my son out into the country where we lived and let him act out his altered states of being and kept him safe. He taught me a lot about what had caused this break down even though he was completely mute for months.
    I trusted that given the right environment, patience, compassion and nutrition, my son could get better. (I had kidnapped him out of a very destructive cult) I know that psychosis and altered states of being are very valuable and I believe it is natures way. It tells a story if only we will listen and try to understand while at the same time keeping one in a safe environment. There were times when I was horrified and in disbelief at what I was seeing and hearing. Yet, I knew that is was the only way to allow my son true healing. By allowing him to go though these processes to tell a story in a safe and supportive environment. I can’t say it was easy it wasn’t. There were seriously times when I was horrified and even scared. Had I the support from other family members, maybe it would have been easier. I did what I felt was best for him in the long run even though family did not support me.
    If anyone from the medical community had experienced his out of body and altered states of being, they would have said he is broken and ill for life. I was even told to make him a ward of the state at one point. I am happy to say that most of his psychosis has subsided. Naturally! He is not 100% and is in therapy to this day. Yet his true self is still there and not damaged by drugs. People like myself and my son are the ones who should be studied. Those of us who take this lonely route. I have been told I am crazy and that I am doing my son harm and that I am depriving him of treatment. Mr. Williams, I have been through so much with my son and I want you to know you are on the right track. Your book is a breath of fresh air. So far, of all the books I have read, yours is most accurate. There is something to be said for those who have lived the hell and not just studied about it. I would love it if you would ever be interested in including my son in a study. He is in Sacramento. We have been to hell and back though this lonely journey and it is not over yet. I have fought back “the experts”. With my support my son is one of the few who has been labeled mentally ill who believes the drugs will only add another layer of complexity to what is going on and with a very strong chance of creating life long brain damage. Something he truly does not have. Westerners have so much to learn about this subject. The sooner we open our minds and stop being brainwashed by the drug frenzy going on, the sooner we will be on the right path to true healing and understanding. Thank you again for this wonderful book. I hope this will be the start of a new beginning. Would love to hear from you. Our story has much to offer.

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  • anonymous

    Dear Dr. Paris Williams,

    I have schizophrenia. I contend that your etiological approach to schizophrenia has value and meaning. Based on an introspective analysis over the past 10 years, I was able to identify one fundamental element in my state of mind which has persisted over the course of the “disorder” and independent of the fluctuating symptoms commonly, and fallaciously in my opinion, INTRINSICALLY associated with the disorder. That is, a profound alteration of the sense of self which is present even in times of full recovery. I believe this alteration is the principal gateway for psychotic experiences.

  • G Thib

    Hi Williams – I am curious as to whether a heightened sense of fairness contributes to schizophrenia. My thought is that people who have traumatic things happen to them or have done something themselves that they believe to be punishable may develop traits of schizophrenia as a way of coping. – Grace

  • elizabeth

    Thank you so much for all your work and compassion. I will keep reading and learning.

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  • Paul

    I think that full recovery from schizophrenia for most given the data I have looked at is unachievable. I say this because I have read quite alot on the subject and I myself suffer from this condition. I have begun to find stability in my life , however I am not fearless as I was before the onset of the condition. The principles I believe in now are as follows. Independence of mind is paramount , the illness because how it presents itself , makes the mind suseptible to group ideology. The desperation to connect with individuals makes the person abandon all personal feelings to satisfy an ideology of some kind. The self is totally denied to satisfy someone elses goals. And yes those goals may not even be a delusion. The reality is that all persons are deceptive , will be selfish in the persuit of their needs , will exibit speech and behaviour that is inconsistent , duplicitous even , will play people off in a group dynamic way , will pick on people ,will attempt to help people not because of altruisim but because it makes them feel better about themselves , it may even increase their social standing. This is nothing to take personal , its scientifically proven that all healthy and successful people behave in this way. The reason we schizophrenics abandon ourselves is because hallucinations are telling us that we have done something wrong , interpreting hallucinations as signs , etc is a falsehood.This is why I have a serious problem with trying to somehow negotiate with or trying to explain these experiences outside of the scientific model.

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  • http://www.schizlife.com SchizLife

    Thanks for this article. I read a lot by guys like Stanislav Grof, John Weir Perry, Ken Wilber, and the like. They place a lot of emphasis on the spiritual aspects to this illness, very much in a shamanic light. Supposedly, if allowed to progress in a supportive atmosphere without medicine, the individual is likely to work through the illness and restructure his cognitive framework, becoming a much more mature and capable person. There is much to be learned still concerning schizophrenia, for sure.

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  • Bert Gold, Ph.D., FACMG

    With respect, my opinion is that you are not very scholarly in your approach to this very complicated disorder (which is probably a catchment for many different disorders). You are apparently not familiar with this important anecdotal story: http://www.time.com/time/arts/article/0,8599,1656592,00.html Nor, have you carefully read one of the most famous books on the topic, “Is there no place on earth for me?” by Susan Sheehan. I will not delve into my credentials or experience, but let’s just say we disagree and that it is IS possible that I have studied the issues longer and a lot deeper than you have.

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Paris Williams, PhD

Paris Williams, PhD, works as a psychologist in the San Francisco Bay Area. He holds a PhD in Clinical Psychology from Saybrook University. He offers the rare perspective of someone who has experienced psychosis from both sides -- as a researcher and psychologist, and as someone who has himself fully recovered after struggling with psychotic experiences. In his book "Rethinking Madness," Dr. Williams takes the reader step by step on a highly engaging journey of discovery, exploring how the mainstream understanding of schizophrenia has become so profoundly misguided, while crafting a much more accurate and hopeful vision of madness.
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