August 26, 2011
Today: Schizophrenia and the mind.
Posted by JP
Schizophrenia affects about one out of two hundred people. It’s a serious mental disorder that typically involves distortions in perception, especially vivid auditory hallucinations, and bizarre and usually paranoid delusion. Imagine trying to carry on a conversation with while at the same time you're surrounded by four other people, talking loudly to you, often about thoughts you might have considered to be private. That’s an exercise support groups often use to suggest to family what it's like to be a schizophrenic.
The best-known portrayal of a schizophrenic is probably the movie `A Beautiful Mind’. Russell Crowe plays John Nash, a mathematician who won a Nobel Prize in Economics. In the movie, Nash’s hallucinations are portrayed as both auditory, visual and tactile. But that’s really not at all common, and wasn’t truly the case with Nash. Like most schizophrenics, his hallucinations were purely auditory.
There is some debate whether schizophrenia is just a label for a bundle of commonly co-occurring symptoms, or a single underlying disease. There are no laboratory tests for schizophrenia. However, it is frequently associated with excess dopamine --- a neuro-transmitter in the brain. On the basis of this, there are some pretty good medications.
John Nash in real life, and in the movie, preferred not to take medication. That’s very common. There are side-effects, and the schizophrenic also often sees the medications as part of a conspiracy.
Schizophrenia is interesting to philosophers for several reasons. Schizophrenics often think the thoughts they're directly aware of in their own minds belong to someone else. Sometimes they just mean that the thoughts come from the outside --- perhaps in radio transmission through their fillings, or some other bizarre way --- and they can’t control them. But sometimes they insist that the thoughts actually and literally belong to someone else.
That challenges a very fundamental view in the philosophy of mind, that when you are aware of a thought, you know it’s your own; it makes no sense to be introspectively aware of the thoughts of another.
Schizophrenics also challenge a picture of thoughts that many philosophers find attractive. Many philosophers feel thoughts are beliefs gained through perception, desires, and thought-processes. In this view, to attribute thoughts to a person presupposes a certain modicum of rationality. The thoughts you pick up from perception should be related to what you perceive in some rational ways. Schizophrenics seem to challenge that picture.
Schizophrenia also poses ethical problems that have to do with this irrationality. For example: we think it's OK, in the case of children, or old folks with dementia, to violate their autonomy --- the right to make their own decisions -- in various ways, including forced medication. The schizophrenic may be motivated by extremely bizarre beliefs. But, given those beliefs, their reluctance to take medication, or leave the house, may make perfect sense, and indeed be articulately defended. Is forced medication a violation of autonomy, or something required to give them meaningful autonomy and a hope for a normal life?
We’ll talk with John Campbell from the philosophy department at Berkeley, who has thought and written deeply about schizophrenia.
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In terms of the "debate [about] whether schizophrenia is just a label for a bundle of commonly co-occurring symptoms, or a single underlying disease", it seems to me almost certain that what we describe as schizophrenia will, in the future, be described as several different disorders, with distinct causes and overlapping effects. While diseases like diabetes can be diagnosed on the basis of measurable factors (blood insulin levels), no physiological measure is currently used to diagnose schizophrenia. Of course, as mentioned above, there are brain and neurochemical abnormalities associated with schizophrenia (positive symptoms like delusions and hallucinations are believed to be related to hyperdopamine function; negative symptoms like social withdrawal and flat affect are strongly associated with enlargement of brain ventricles reflecting brain tissue loss). However, these are examined in individuals already diagnosed with schizophrenia, they're not a diagnostic tool. The DSM manual that describes the symptoms necessary in order to be diagnosed with schizophrenia should, I think, be thought of as 'the best we can do' at the moment in order to make some sense out of these abnormalities in thought, attention, sense of self ... There are lots of brain abnormalities that have been associated with schizophrenia (in addition to those just mentioned). Some with schizophrenia have abnormalities in the frontal lobe, and abnormalities in the hippocampus. I used to teach a seminar on schizophrenia at Columbia University, and the research literature was so complex and varied, that it was too difficult to give a cogent seminar on the subject --- I no longer give the seminar. I'm pretty sure it will turn out to be a constellation of disorders. I'll bet you a dollar.
Posted by: Jon Horvitz | Aug 26, 2011 11:30:43 AM
Inasmuch as I am not a doctor (of any sort),I'll await observations, experiences and opinions from the pros who provide commentaries on such things. I may have some opinions about the topic-but those matter little to anyone but me. Greetings to all...
Posted by: Dave the Carpenter | Aug 26, 2011 4:58:57 PM
Looking for ways to measure mentalities?
I can tell you truth is measureless,
And that's about All!
Posted by: Michael J Ahles | Aug 27, 2011 8:42:18 AM
Listened to this rebroadcast with interest, but somewhat dismayed to see the shallowness of experience with the topic by the professional academic. How can one be a philosopher without having altered-state experiences either via meditation or entheogens to see the plasticity and arbitrariness of consciousness, and the world of synchronicity that schizophrenics live in. Interestingly, heard another podcast describing that schizophrenics have much better outcomes in traditional witch-doctor cultures due to the acceptance of spirits. Also, an interesting piece of evidence supporting the risk of schizophrenia with cannabis is the biography of Kurt vonnegut's son 'Eden Express' where his schizophrenia was provoked by extreme cannabis use. From my own experience with schizophrenics, it is therapeutic to live in a rural low stress setting with lots of nature, and to have a religious outlook where angels and the saints have power to heal are believed in and the belief is supported.
Posted by: a1b5jj | Aug 28, 2011 10:50:09 AM
Hello, I am Philip Randolf,
At various times I have experienced an arising thought and then a subsequent thought saying something like "what a weird thought that was; it's a thought I don't subscribe to at all" or "Yow where did that thought come from?"
In other words, in effect the sentiment is that I disown the thought; it is not "my" thought, but something a bit alien.
I think many people have this experience without any indication of pathology.
So what are we talking about here, a matter of degree?
And thoughts "coming from outside" doesn't seem so odd to me; after all, most thoughts arise without our willing them or without a process of consciously generating them. If "I" didn't generate the thought, then, in a sense they do come from "outside" an "I"
-----apart from a "me".
So, again, a matter of degree? If other people are bugged by your behavior or thoughts, or you can't concentrate on the business you were hired for or some such---then, society must step in?
Electro-shock for you?
But apparently, Nash was operating brilliantly as a mathematician (Nobel prize), and he was not violent or destructive.
So,seems to me value judgements operated here to some extent --to condemn him for not thinking as otheres do, as some others thought he should.
My understanding is that Nash stopped taking any medication (who can blame him with the horrific side-effects) and gradually he detached himself from unusual thoughts by his own efforts and they diminished. But, interestingly, he also felt that subsequently he was not as inspired a mathematician after he did this.
Paranoia and out of the ordinary connections made between events, entities posited that some people think don't exist, indicates schizophrenia and a danger? On that basis, then, I must insist that some fundamentalists be immediately subject to heavy medication along with a few Physicists who believe we live on a Brane.
Really, is there not a lot of value judgement going on here?
This whole thing puts me in mind of the current rumble about Autism. People once had to exhibit behavior that was quite extreme to be diagnosed as Autistic. Now, millions of school kids who fidgit in their seats or can't keep their voices down or who are very shy or who are smart as hell but uncommunicative or some such-----are Autistic! And, of course need professional consultations and medications and long term expert supervision and so on. Those professional folks make out well what with the rather sudden burgeoning of this terrible condition into the general population and all.
I just read a short biography of Dirac, the brilliant English Quantum Mathematician (Nobel prize),
and gee, who coulda guessed it? According to the bio he suffered from Autism too! (but apparently a mild case—so mild it was almost non-existent---almost!) Golly, if only those psychiatrists then had had the knowledge they have now--why we'd have had old Dirac fixed and on meds in no time! The wonders of modern medicine! Yes, a medicated stupor surely is much more normal than weird thoughts and being socially ill at ease.
Better that Mr. Dirac did not produce his brilliant
maths and instead was rid of his terrible condition, right?
Finally, I must say that at times it has occurred to me that the notion of a self, an I, a me, could be just another thought, and the universe is really without the personal---no entity to correspond to the "Me" anywhere.
Kind of an unusual thought compared to most folk, eh?
I was thinking that gee, perhaps I am Autistic or Schizophrenic too and need to go on disability or have the government pay to send me to a place where I might recover, say to live in a quiet grass hut by a tropical sea and self-medicate, say with a nice pina colada or two in the afternoon. Now that is what I would call recovery!
Posted by: Philip Randolf | Aug 29, 2011 9:46:10 AM
Thanks for the post. Honestly this post will clear Clouds of myth surrounding schizophrenia.
Posted by: samar | Aug 30, 2011 12:23:55 AM
If you’re looking for the source of a thought my friends it is the same as the source of a river.
Come this Way: Follow a river upstream sometime and you'll find the source to be a creek. And beyond the creek the source is a trickle of water, formed from melting snow. Beyond the snow the snowflakes, from the clouds that formed over the evaporating source the sea. Then back or forward to the delta One will find, the source, the truth, Oneself, the beautiful river Equality.
Posted by: Michael J Ahles | Aug 31, 2011 10:13:10 AM
Once again, the djinn is out of the bottle. Or is that the gin is out of the bottle? Randolf has made an interesting point---one that many of us have been ruminating over for lo these many years now (though I exagerate for effect): If there are so many mentally unbalanced people in this world, how on earth are we to distinguish who among us are sane? Moreover, perhaps, is it not better to be a few sandwiches shy of a picnic and to fit in with others than to be left on that postage-stamp island with a coconut tree for company?
Certainly, there are extremes in every realm and we shall never have all the answers to any one question. It is good fun to speculate, though. Your blog just keeps getting more interesting and diverse. Thanks for all of that and keep it rolling,please,
Posted by: Paul D. Van Pelt | Aug 31, 2011 3:33:10 PM
As the sad sister of a lovely brother who was schizophrenic I find myself on both sides. The drugs my brother was given caused his premature death, but gave him a few years outside an institution. One of the things that helped him was walking around with musical tapes or radio and earplugs. This allowed him to escape the voices. Why this worked is not the question. The question is: if it works, why not?
Posted by: Janga | Aug 31, 2011 4:04:25 PM
"In 1947, a man bought a new Plymouth, put it up on blocks and covered it with cosmolene. Today, it it worthless."
---Kehlog Allbran, THE PROFIT, circa 1970
Posted by: Harold G. Neuman | Sep 1, 2011 5:24:56 AM
Just like with the sandwich generation (silent, boomer, x/y), there are children of Schizophrenics who are confused. We don't know how to care for our parents and we don't know if we are going to pass it on to our children. We also wonder: what is the problem with some of the thoughts our parents have? Sometimes my mother and father make sense. My mother has the diagnosis of Schizophrenia, while my father has been diagnosed with early onset dementia. I always thought they were still experiencing an acid trip from the 60s. Then as I grew up and started experiencing more fantasy influenced books, TVs, and movies, I started thinking maybe my parents aren't crazy. This could be wishful thinking. This could be a desire to be special or supernatural. But I have to tell you that Hollywood sensationalized Schizophrenia. It is television and movies that confuse us more than we already are. There are times that I think I have crossed to my mother's realm just because of something I have seen on TV. Yes, I know the difference between fantasy and reality, but it is a fine line. There are coincidences. There is irony. And there is wishful thinking. But at the same time, I think no one has ever really asked my mother if she knows the difference between the life she leads out and the boon docks and what is going on in the city (reality). I think she does. I just think she can't control her thoughts and reactions. I think she prefers to live in her world because our world is cruel and misleading.
Posted by: lolarain | Sep 1, 2011 9:09:15 PM
An interesting writer who explores philosophy and mental illness is Louis Sass. One of his books is "Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind". In this one he makes connections between solipsism and mental illness.
I wish the program could have addressed how philosophy can contribute to how we think about and treat mental illness.
Posted by: John O Smeltzer | Sep 7, 2011 9:31:30 AM
Well. I'll wait a bit. Perhaps there are Kinds of Minds. As Dennett has suggested. Hmmm.
Posted by: Frank, and Ernest... | Sep 7, 2011 4:24:01 PM
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