Orna Ophir

Schizophrenia


Скачать книгу

R. Kotov, R. F. Krueger, D. Watson, et al., “The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies.” Journal of Abnormal Psychology 126, 4 (2007): 454–77.

      37 37. Nikolas Rose, Our Psychiatric Future (Cambridge: Polity Press, 2019), 92.

      38 38. Hacking, Mad Travelers, 87.

      39 39. Norman Sartorius, Helen Chiu, Kua Ee Heok, et al., “Name change for schizophrenia,” Schizophrenia Bulletin 40, 2 (2014): 255–8.

      40 40. Tanya M. Luhrmann, Of Two Minds: The Growing Disorder in American Psychiatry (London: Picador, 2000).

      When reconstructing the history of schizophrenia as a diagnosis, a medical concept, and a condition that requires clinical treatment, it is important to keep the patient’s view in mind.1 As Roy Porter aptly instructed us, we ought to write the people’s history of suffering as we try to understand what “schizophrenia” was for the person who was ill, diagnosed, and treated.2 Here is one such narration, to begin with:

      I was diagnosed with schizophrenia on February 21, 1995, I was 22 years old, and my reaction was initially shock … the word “mad” surfaced in my mind. It was not just the word; my mind actually did a complete reversion to my childhood, particularly 2 stories: Alice in Wonderland and Dr Jekyll and Mr Hyde … The images of the [Mad] hatter, Mr Hyde, and those other famous characters made by the media … reinforce the notion of madness as something to instill comic relief or as fascinatingly dangerous: How can something that destroys families, relationships, and friendships be considered “funny.” There is nothing laughable about losing one’s direction in life. There is no joke in one’s brain playing such vile tricks to take you to an anxiety point that may result in suicide. (Mark Ellerby, 2018)3

      The term schizophrenia emerged in twentieth-century Germany, when modern attempts to scientifically classify madness borrowed heavily from Greek dictionaries and created a series of neologisms (such as “phobia,” “manic-depressive psychosis,” or “paranoia”) to add to ancient concepts defining abnormal mental states and unusual behavior (such as “melancholia” or “mania”) the more generic notion of “madness.” The schism or split, inevitably suggested by the modern name schizophrenia, meant not to denote a split in two, but rather to express the tearing apart of the psychological functioning, a peculiar destruction of the cohesiveness of the self, a dissociation of the unity of the personality to a point of complete disintegration of one’s thoughts, emotions, and behavior.

      Today, schizophrenia is a psychiatric diagnosis that is assigned mostly to individuals who suffer delusions, hallucinations, disorganized speech, and chaotic behavior, as well as diminished emotional expression, resulting in severe dysfunction in work, inter-personal relationships, and self-care. While naming the different symptomatic manifestations of what we call schizophrenia, we will refer to examples from experts by experience, such as Susan Weiner, whose first-person account conveys the experience of going mad.5

      All of these latter mental phenomena are likewise seen as possible symptoms that call for a consideration of the schizophrenia diagnosis. Moreover, hallucinations that are typical of schizophrenia include the reported presence of negative and derogatory voices, as in “you are evil, you are a whore,” “you are the reason your brother is dead, you should die” or, for that matter, voices that command the individual to act in certain ways: “you should burn this house,” “you should jump off this bridge.” Lastly, they consist in hearing voices that presumably converse about the individual in question, so that the voice of X would say: “he is going to take the knife now,” followed by voice Y: “no, he isn’t, he is a coward.”

      But beyond this list of symptoms, the most defining characteristic of an individual that would most likely be diagnosed as suffering from schizophrenia is the feeling that they provoke in the observer, of being incomprehensible and inaccessible.

      In this chapter, we will see how texts written long before the term appeared can teach us about how extreme forms of “madness” were viewed throughout history, both by those who experienced it firsthand and those who observed it in others. Although writers of every epoch insist on the uniqueness of their interpretation of the phenomenon, two trends can be identified across this history: one that places madness at the extreme end of a spectrum that includes the norm, and another that views it as a distinct and categorical