4. Fads and Myths Cloud Understanding

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This is the fourth in a series of seven articles called “Breaking the Silence,” by Patricia A. Forsdyke Past President of the Kingston and Napanee Chapter of the Schizophrenia Society of Ontario

Schizophrenia is the same disease the world over, yet developing countries cope with it differently. I learned a lot about this at the World Psycho-Social Conference in Germany this year.  In India, the family is not blamed for causing the illness. It is considered a matter of fate. The extended family system in India helps families share the burden, but as India moves rapidly towards a smaller family structure, it is feared that the mentally ill will suffer the same plight as in the West.

In China, there is the problem of saving face. Much is done by barter, but shame prevents families from bartering care for their relatives. A few more privileged families manage to get relief from caregiving by bartering goods.

Unlike in the West, however, China and India have not had to correct the legacies left by fads that have had such a destructive influence on Western psychiatry in the middle of this century. Terms such as the “schizophrogenic” mother (the refrigerator mother) were coined, suggesting that mothers were to blame for their children “going mad.” This was a terrible period for mothers of the seriously mentally ill. It was the unkindest cut of all.

This was the period in which I worked as a nurse. I remember one wretched mother visiting her daughter who was so ill she spent most of her time in the padded room. How could we be so insensitive and naive to even think that her mother would have the power to cause such a terrible illness?

Freud and his colleagues added to the confusion. Although Freud never actually claimed that psychoanalysis could cure schizophrenia, psychoanalysts nevertheless got into the act. Using psychoanalysis to “handle” schizophrenia is like hitting an already wounded family with a 10-ton truck.

Germany is still heavily influenced by therapy of the Jungian school. At a recent conference in Hamburg, a German whose wife had schizophrenia told me how annoyed he had been when a family new to his support group and new to the illness was referred to a Jungian analyst. The family had taken it as a good sign that their teenager had at last shown some emotion. He had burst into tears. The young man was probably totally overwhelmed by the therapy. A more destructive approach to his illness I can’t imagine. Medicine and gentle encouragement was what were needed.

Though most doctors have accepted intellectually that schizophrenia is indeed a brain disease, old ideas die hard. Fingers are still pointed at families. How else can one explain why physicians fail to serve patients in an emergency? Where else in medicine do you hear the words “family therapy?” The family’s members are not ill. They are simply in need of information. With diabetes, it would instead be more appropriately termed: “family education.”

To make matters worse, we have had medical people such as Dr. Thomas Szasz, who has had much influence for decades, claiming that mental illness does not exist. Another confused physician, Dr. R.D Laing, insisted that schizophrenia was simply a healthy reaction to a mad world. Despite their profoundly dangerous views, they were both guest speakers at Queen’s University.

Szasz, now an elderly man, was invited by the medical students four years ago. A huge crowd turned out to hear him. Szasz must have made millions out of his book The Myth of Mental Illness. I myself bought a copy in 1962.  In 1994, I challenged Szasz as he played word games with a somewhat captive, but supposedly open-minded, university audience. A student yelled at me: “Sit down lady. Do you have a problem?” There was a big problem. I was utterly dismayed that Szasz held such sway with the crowd, given that the verdict on schizophrenia was clearly in. Medical science has shown that schizophrenia is a brain disease.

Szasz holds that schizophrenics really know what they are doing and that they are simply acting. He views them as deviant and believes that they should have liberty until they engage in criminal activity, and then they must be punished. But prison, of course, does not make them well. He refuses to acknowledge that flawed biology is the culprit.

Perhaps the most painful moment for families during the lecture was when Szasz ridiculed a fraternal twin whose brother was very ill with schizophrenia by arrogantly employing more word games. A junior member of the Department of Psychiatry challenged Szasz, only to receive the same treatment.

Dr. R.D. Laing came to Queen’s around 1980 to explain how schizophrenia was really an adaptive process in reaction to a perplexing world. He packed Grant Hall, whereupon he railed against the mad world. He appeared flushed by his own success. A classic case of denial perhaps: Laing had a child suffering from schizophrenia.

In the West, we have easier access to the tools for treating mental illness, yet we have more impediments to treatment: quackery, the libertarian influence, the present Mental Health Act, inadequate follow-up care, too few psychiatrists tending the seriously mentally ill, and a critical reduction in properly trained professionals.



Read previous article in series, “Violence A Real Danger If Disease Not Treated”          Read next article in series, “We Must Stop Blaming Families “