Re: [Fwd: A Neuroscientists Says No to Drugs]

Barbara Tooth (
Wed, 6 Jan 1999 11:19:21 +1000

John you have raised some interesting points and I hope you will ask some
of those questions you feel unable to ask at present.

I worked for quite a few years with people experiencing florid psychotic
symptoms and I agree with you about the devastion a SMI can have on a
person's life. However the issue of taking medication or not is complex. I
have a lot of empathy for the posting Jim forwarded, because this has been
a part of my professional life, but I appreciate the usefullness of
medication. For me, the decision to take medication is a personal one and
professionals' knowledge is best used in helping a person experiment with
their decision. Unfortunately many people with chronic illnesses have not
had the opportunity to experiment in a way that has been either respectful
or usefull. Also the effects of medication are often blurred by a persons
environment. Richard Warner found in his review of 85 studies on recovery
from schizophrenia that drugs really only impacted on recovery if the
person's living conditions were poor. It has been my experience that in a
service that focuses on medication, people do not do as well as they do in
services that focus on the impact of the disorder on the person's life,
their strengths and where the person wants to go.

I could say much more about this, but will leave this for now.

> From:
> To: PCP Net <>
> Subject: Re: [Fwd: A Neuroscientists Says No to Drugs]
> Date: Saturday, 5 December 1998 16:11
> 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
> There is much that is misunderstood about schizophrenia. It is an awful
> disease. I work with those with very chronic schizophrenia every day.
> stigma is horrible. Many people do not believe it is a disease and
> many people are faking the illness. Clients are afraid of the medication
> because if it is discovered (unlike other medications like insulin, which
> alters behaviors) they will be fired and they will be shunned. While I
> participated in the academic argument of whether a delusional person had
> 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
> experience the world with severe symptoms of schizophrenia." While some
> appreciated my defense of their freeedom, many patients were glad someone
> 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
> glad that someone helped them. I no longer believe that chronic
> is something that is the result of poor parenting, toileting, overly
> 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
> and do not understand people with a chronic mental illness. There are
> multiple causes of schizophrenia and the exact mechanism is not
> The diagnosis is used too often and imprecisely.
> Most people do not see a schizophrenic with florid symptoms and then the
> person with medication. While the causal mechanism can be debated, the
> 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
> a PCP framework. I think "as if I am a doctor using the medical model"
> this case as it helps me to anticipate the events best. I have and do
> 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
> psychiatric illnesses from medication. Questioning the usefulness of many
> other diagnostic categories would get less argument from me.
> 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
> 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.
> are are other pathways and variances. Medication for schizophrenia is
> imprecise and medicines have not been found to be effective for all
> 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
> the use of the correct medication. Overall, the concept of background
> thematics is an interesting one still though. The problem is that I find
> only broad themes of content and strands of thoughts are consistent
> the medicated and unmedicated florid schizophrenic. The common themes,
> though, of the unmedicated and medicated schizophrenic have always
> for me rich content from a PCP perspective in understanding the coping
> mechanisms, stressors, and patterns of the medicated person. Discussing
> leads to plans to develop new theories for our collaborative endeavor.
> John Fallon