Re: [Fwd: A Neuroscientists Says No to Drugs]
Sat, 5 Dec 1998 01:11:25 EST

As may be apparent, I feel fairly strongly about this issue and it hits a
chord. I have been a very silent person on this list for the past few years.
There is much that is misunderstood about schizophrenia. It is an awful
disease. I work with those with very chronic schizophrenia every day. The
stigma is horrible. Many people do not believe it is a disease and believe
many people are faking the illness. Clients are afraid of the medication
because if it is discovered (unlike other medications like insulin, which also
alters behaviors) they will be fired and they will be shunned. While I once
participated in the academic argument of whether a delusional person had the
right to be delusional (he does), I can no longer participate in this
discussion in the same way. I may be experiencing guilt for having
participated in earlier years in this discussion. From books, I never saw how
terrible the disease is and how awful those people feel that are "allowed to
experience the world with severe symptoms of schizophrenia." While some
appreciated my defense of their freeedom, many patients were glad someone got
off there high horse and got them the help of medication instead of doing
nothing. They expressed that they were unable to "get it together" and were
glad that someone helped them. I no longer believe that chronic schizophrenia
is something that is the result of poor parenting, toileting, overly loose
construing, etc.... While I want to always ask questions, I fear that some of
this discussion posts ideas that mirrors many people in society who have not
and do not understand people with a chronic mental illness. There are
multiple causes of schizophrenia and the exact mechanism is not understood.
The diagnosis is used too often and imprecisely.

Most people do not see a schizophrenic with florid symptoms and then the same
person with medication. While the causal mechanism can be debated, the effect
can not.

In a message dated 12/4/98 4:45:01 AM Central Standard Time, writes:

<< It would no longer be a question of
reducing conscious psychological construing and its modes
(intersubjective intentionality) to a level of 'harder' science if that
science is defined in traditional mechanistic ways , but of framing the
latter within the former.

This is not to say that pcp has some special privilege over genetic,
neural or biochemical models in general. It depends entirely on the
specific theoretical overview implied by those models. What philosophy
of pathology is implied by the seemingly neutral obseration that
schizophrenia is correlated with certain MRI patterns or with
ventricular enlargement, or that its behavioral symptoms are altered by
drugs? >>

Agreed. No philosopy is implied. Schizophrenia is a medical model label. It
has validity in this realm. I agree and keep the medical model subsumed under
a PCP framework. I think "as if I am a doctor using the medical model" in
this case as it helps me to anticipate the events best. I have and do use
other models.

In a message dated 12/4/98 9:55:47 PM Central Standard Time, in writes:

<< As a result, Mr. Valenstein writes, one study found that the drugs
helped only about 60 per cent of schizophrenics. >>

I am not aware that a 60% success rate was that large a failure.... I am
sorry to say, but I wish there was a 60% success rate for many of the other
psychiatric illnesses from medication. Questioning the usefulness of many
other diagnostic categories would get less argument from me. Schizophrenia
is an imperfect grouping. That is known. It is probably a collection of
several diseases. There are many different medications using different
chemical pathways. No single medication works in all cases. Talking
therapies can be just as effective in work with depression, not schizophrenia.
Efficacy studies have consistently shown that talking therapies are
ineffective with chronic schizophrenia without concurrent medication.

The dopamine theory has many problems. It is very much simplified. It dos not
fully explain why some people develop schizophrenia and others do not. There
are are other pathways and variances. Medication for schizophrenia is still
imprecise and medicines have not been found to be effective for all people.
Years ago, they were also dangerous and harmful. Nowadays, I believe the
drugs are effective and the grouping has validity.

In a message dated 12/4/98 4:45:01 AM Central Standard Time, writes:

<< Backround thematics
don't dictate contents of thought, but the style of processing. >>

In the case of chronic schizophrenia, thought processes and content are
altered from previous patterns. The previous patterns and content return upon
the use of the correct medication. Overall, the concept of background
thematics is an interesting one still though. The problem is that I find that
only broad themes of content and strands of thoughts are consistent accross
the medicated and unmedicated florid schizophrenic. The common themes,
though, of the unmedicated and medicated schizophrenic have always provided
for me rich content from a PCP perspective in understanding the coping
mechanisms, stressors, and patterns of the medicated person. Discussing those
leads to plans to develop new theories for our collaborative endeavor.

John Fallon