I don't think Szasz's argument is that medications never alter behavior.
His argument is more along two lines: 1) altering behavior chemically is
not proof of disease; disease may be present, but the mechanism(s) behind
it are still as yet unidentified in the schizophrenias; and 2) willingly
ingesting a chemical substance (whether a "medication" or a "street drug")
is quite different from being coercively forced to take a chemical
substance. If someone chooses to take anti-psychotics, that is a choice to
be respected. However, most dispensi of anti-psychotics is psychologically
coerced at best, and physically coerced at worst. The coercive component
of psychiatric treatment is what Szasz objects to. A PCP approach seems
consistent with this, because it tends to respect the active construing of
the person, and any decisions that develop from such construing.
JON
At 11:26 PM 11/25/98 EST, you wrote:
>In a message dated 11/25/98 7:54:30 AM Central Standard Time,
>a.c.downing@newcastle.ac.uk writes:
>
><< Doesn't this gloss over the fact that their deviant contruals are even
more
> trouble to themselves? Paranoid thoughts and terrors are no fun, even if,
> from within the frame of reference of the sufferer, they may seem
> justified; a lot of schizophrenics are very unhappy; a lot commit suicide.
>
> I'm not trying to argue against the idea that a constructivist account of
> delusions, in schizophrenics and others, has a lot to offer but there is
> now plenty of evidence, e.g. from abnormalities in eye movements, from
> brain scans etc. and from genetics, of an underlying neuropathology in
> schizophrenia. Therefore, an adequate constructivist account of the lives
> and thoughts of these troubled people must encompass the neuropathology
> which can distort the inputs to their construing, and perhaps also some of
> the processes of construing at all.
> >>
>I want simply to say that I agree with the above. Medicine has progressed
>beyond the old days of sedating people. Counseling does not change or
>eliminate the thoughts created by a biochemical imbalance. It is outside the
>"range of conveniance" for PCP. This is no different than trying to talk
>someone through a heart attack by counseling methods to reduce stress. It
can
>help but will not likely stop the heart attack.
>
>To this day, I have trouble using the words psychotic or delusions to
describe
>content of perception in counseing or in diagnostic interviewing. My PCP
>background prevents from doing anything but interpreting the context of the
>observations of the person. On the other hand, schizophrenia has
relevance as
>a medical model for me in that it means amongst other things that unpleasant
>sights and sounds for a person will be removed for that person by medication
>(they are able to respond to medication). The medications used today are
>increasingly specific and effective. Once a person takes the medication, I
>generally hear the spontaneous reply from the person that the "old person"
has
>returned. This is then a rich reply with many constructions that will follow
>about before and after in counseling. This is the counseling's range of
>conveniance. I may have wanted to believe Szaz's point of view earlier, but
>cannot when I see the tremendous and rapid change brought about by
medication.
>Most recently, a formerly homeless person who lived for ten years on the
>street cursing at the air living in a 90 gallon garbage can. She now
lives at
>home pleasantly without syptoms as a result of risperidol. She is glad she
>is there. She does not remember how she was. It is hard for others to
>believe the change. Therapy did not do this! Now, counseling will help to
>place her life experiences in perspective......
>
>John Fallon
>
Jonathan D. Raskin, Ph.D.
Department of Psychology-Jacobson Faculty Tower
State University of New York at New Paltz
75 South Manheim Boulevard
New Paltz, NY 12561-2499
office phone: (914) 257-3471; fax: (914) 257-3606
e-mail: raskinj@matrix.newpaltz.edu
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