Re: Schizophrenia

Chris Evans (
Wed, 25 Nov 1998 18:32:20 -0000

Do I have the energy? Should I get into this one again? Am I
somehow dishonest if I don't?

O.K. I feel I am somehow dishonest if I don't, so here goes.

I hate the way many of psychiatric colleagues (yes, I am a
psychiatrist by training) use the word "schizophrenia". I agree
absolutely that its use is part of claiming a power, a preemptive
power to define. I particular hate the use (what is the grammatical
term?) "John is (a) schizophrenic".

On the other hand it is quite clear to me that a very small minority
of people that I and my colleagues have experiences and describe
or show patterns of experiencing, thinking, construing that would fit
the ICD-x or DSM-y criteria for the use of the S word do themselves
have some sympathy with the use of that word. It is also clear to
me that a larger number of their concerned family and friends find
something in that area useful too. Furthermore it is clear to me
that very many of my colleagues, psychiatric and not, find various
uses of the S word helpful.

I have to construe others constructions, I have no more and no less
capability to interact with them and that is all I do when I throw
myself in here. I have to accept that my construction is not always
what that person expects me to have of their construing and I have
to accept that others can only construe my construing and they
may construe that very differently from how I expect or would like
them to. All this happens in both personal and less personal, more
societal or contextual patterns which more or less constrain the
extent to which I or any other can engage in this construction
game. I do believe _PERSONAL_ constructivism sometimes
underestimates this contextual, systemic, discourse component
though I am not a radical social constructionist at all.

There is an adage in psychiatry about the word "hysteria" having
outlived its detractors. Much the same can be said about the
words that people move around when they don't like what's being
described or don't like their own or others responses to that "thing"
(but note caveat about "only construing" in relation to that word
"thing"!) Great examples are psychopathy, antisocial personality
sociopathy or the S word. However, the issue is not just one about
professional, priviledged, preemptive formation of language
structures. The same can be said about "black", "coloured",
"white", "working class", "shop floor", "blue collar", "Polish", "Irish",
"gay", "homosexual", "straight", "lesbian".

I may not like quite a lot of what some, perhaps many, of my
colleagues do with language to be able to bear what they see and
do. I may not like quite a lot of what they do that arguably flows
partly from that use of language. However, sometimes I feel it
would be dishonest to say that a lot of very ill paid, very brave, very
patient friends and colleagues work within that language system
and sometimes the analyses of the constraints of that system, the
constraints of the S word, seem disrespectful, preemptive and
lacking in curiosity about the minutiae of how they came there and
how they stay there and about just how much good they may do

O.K. flame off. Put on smug, sadly less than asbestos suit of "I've
got that off my conscience and said my piece".

This is an issue that has and should run for 20 years and it will run
for many, many more so it's great to have people come in after
time gaps like that and it's good to have a list like this where we
can disagree and _care_ about the issues!


P.S. I am switching my signature off for this message. Of course,
this and everything I ever say is my responsibility and nothing to do
with any of my employers but it seems more important somehow
to say that and drop the institutional location with this one!