Re: Schizophrenia

Barbara Tooth (
Sun, 6 Dec 1998 12:58:51 +1000

Tim I haven't read many of the posts about schizophrenia as yet, but your
first observation has stirred me to a quick reply whilst I remember.

I think people who have a diagnosis of schizophrenia CAN and DO routinely
check their constructions against social consensus and modify them
accordingly. Lets consider the following scenario. A person has the
symptoms of schizophrenia, they come into contact with well meaning health
professionals (many of whom have very clinical and poor prognostic views
about such things) and they effectively check their constructions against
the social consensus and modify their behaviour accordingly. They are
advised to avoid stress, stop studying, stop working, take medications
that produce side effects that are often worse than the symptoms and often
produce symptoms that are then interpreted as symptoms of the disorder.
Many people are told they need to be cared for, many scheduled and
sometimes held down and sedated and put in seclusion rooms. It is easy to
begin to construct a world with little hope for the future, a world
dominated by what a person can not do rather than a world dominated by what
they can, a world where they need "help" etc etc.

>From the research I have undertaken looking at what people who have a
diagnosis of schizophrenia (and consider themselves to be "in recovery")
have found to be the most important factors in their recovery it seems that
many people do effectively construe others constructions of their
constructions and modify their behaviour accordingly and that this is one
of the major things they have to recover from. For a majority of people we
spoke to, they accepted the "system" for many years but it wasn't until
they became determined to overcome the impact of the disorder on their
lives that they began to recover.

Of couse there were many findings from the research, but the one thing that
never ceases to amaze me is that whenever I present the findings at
conferences there are always some (many) health professionals who get
upset, whilst consumers say "yes, that is what it is like". Health
professionals are invalidated, consumers validated. Sounds a bit like where
you started your first observation. Some health professionals have an
inability to check their constructions against the social consensus and
modify them accordingly.

If anyone wants a copy of the report I would be happy to email it.

Barbara Tooth
> From: Tim A. Connor <>
> To:
> Subject: Re: Schizophrenia
> Date: Monday, 30 November 1998 16:30
> In working with "schizophrenics" (Kelly always put that in scare quotes,
> so I'll follow him), I've struggled to understand and find ways to help
> them with their difficulties that are consistent with constructivist
> principles. A few things stand out:
> 1) It seems to me that the core of "schizophrenia" is not the content of
> their constructions, but their inability to do what most of us do
> routinely--to check our constructions against social consensus and modify
> them accordingly (or not modify them, but to effectively construe others'
> constructions of our constructions, and temper our social behavior
> accordingly). In other words, an impairment of sociality and
> There are lots of people who have unusual, even seriously annoying,
> systems and yet manage to avoid getting diagnosed. They must be able to
> do something that "schizophrenics" can't.
> 2) Even if, as I think we must, we concede that "schizophrenia" (or at
> least some "schizophrenias") has its roots in some dysfunction of the
> brain chemistry, we still need to take into account the effect on
> personality development of having such a condition. Not only the
> difficulty of construing and anticipating our own experiences, but the
> constant invalidation of our constructions by others. ( I have worked,
> I'm sorry to say, in places where clients were all but forbidden to talk
> about their "delusions" or "hallucinations" and staff were told to simply
> change the subject if the client tried to talk about his or her bizarre
> experiences or fears. I can't think of many situations less conducive to
> mental health than being unable to communicate one's experience to
> anyone.) Normalizing the brain chemistry does not "cure"
> though it may be a necessary precondition for such a "cure."
> 3) To have a relationship with someone, I need to construe his/her
> constructions, including constructions of self, but I don't need to take
> them at face value. I don't assume that either I or the client
> necessarily have the "correct" construction of the situation, but that we
> can benefit from each others' perspectives. So I have no hesitation
> saying, "I know that you believe you are not ill, and that (elaborate
> system involving the US Govt., the Marines, almost all psychiatrists, and
> a special research project dealing with ESP) is true; well it doesn't
> sense to me, and frankly I think it's a symptom of your problem and that
> you might well change your mind if you agreed to take the recommended
> of Zyprexa. But that's your choice to make...what are you willing to
> experiment with to make your life a little better today?" The "credulous
> approach" doesn't mean I have to share the client's world view, only to
> assume that it makes sense to him/her and try to understand how.
> I think the constructivist/biological dichotomy is a rather unproductive
> one (on both sides), hopefully one to be transcended someday. I do find
> that the more we learn about neurobiology, the more support there is for
> constructivist psychology, but most of the people on the biomedical side
> don't seem to have noticed yet.
> Tim

> Tim Connor, M.S. "Psychotherapy is not
> Pacific University an applied science, it
> School of Professional Psychology is a basic science in
> 2004 Pacific Avenue which the scientists
> Forest Grove, OR 97116 USA are the client and his
> <> therapist"
> --George Kelly