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

Thomas N. Elliott, Ph.D (
Wed, 06 Jan 1999 11:33:17 -0600

Please post a reference to Richard Warner's article.


Tom Elliott
-----Original Message-----
From: Barbara Tooth <>
To: <>
Date: Tuesday, January 05, 1999 7:36 PM
Subject: Re: [Fwd: A Neuroscientists Says No to Drugs]

>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