I. THEORIES OF SCHIZOPHRENIA AND ITS TREATMENT

1. What is schizophrenia?

Richard Warner in his book Recovering from Schizophrenia: Psychiatry and Political Economy
[1994 pp 3-11] states that schizophrenia is not a disease of the brain but is a functional psychosis,
an illness of the mind.

The term 'schizophrenia' is categorised in the 3rd edition of the American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disorders [1987] (DSM III). See
Appendix.

Warner goes on:

Schizophrenia is a psychosis, a severe mental disorder in which the person's ability to
recognize reality and his/ her emotional responses, thinking processes, judgement and
ability to communicate are seriously damaged. Schizophrenia can be episodic. It is
associated with persecutory voices, feelings of being controlled by outside forces, that one's
thoughts are tampered with or broadcasted.

Schizophrenia is most likely to begin in late adolescence or early adult life. It has different
forms such as paranoid, hostile, religious [1994 pp 7-8].

There are two main features of schizophrenia: (a) Positive symptoms: Hallucinations and
delusions, (b) Negative signs: blurred feelings, lack of spontaneity and illogical thinking.

Philip Thomas in Chapter 2 (pp 31–44) of his book The Dialectics of Schizophrenia [1997], puts us
through the various possible causes of the condition, the most prominent of the physical causes
being genetics and family, nutrition, and viral infection: (1) We inherit certain characteristics
from our parents that can bring about schizophrenia. (2) The lack of certain fatty acids in the
brain. (3) Immigrant mothers catching the flu virus which affects the development of the brain
of the foetus.

The psychological theories are based on the discoveries of Freud, Jung, Abrahams, Klein, Bion
Bick amongst others. These theories look at the development of the human personality, through
the use of various defence mechanisms in the mind. Klein's theory of the paranoid/schizoid
position supposes that the early ego splits its part-object into a loved part-object and a hated part-
object to protect itself from imagined internal and external persecutors.

According to the socio-economic theories (Ch 3, p 51), schizophrenia is more likely to occur in
poorer, inner-city areas where people are socially disadvantaged. Schizophrenia is a response to
extreme life stresses such as unemployment, discrimination, housing problems.

2. The discovery of schizophrenia

Warner cites as the two main players the German psychiatrist Emil Kraepelin and the Swiss
psychiatrist Eugene Bleuer. Kraepelin observed the condition watching the behaviour of asylum
dwellers. He saw how damaging asylum life was and how people's mental abilities and
emotional responses deteriorated. He called this cracking up process the 'fragmentation of the
integrity of personality' and named it 'dementia praecox'. Treatment-wise, asylum conditions
offered no therapy, no privacy except seclusion, long, boring hospital stays in coercive,
controlling regimes. When patients were released, social factors such as poverty and

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