Schismatic Mind:
Controversies over the cause of the symptoms of schizophrenia


by Richard Gosden

THESIS FOR
DOCTOR OF PHILOSOPHY
UNIVERSITY OF WOLLONGONG, AUSTRALIA

2000


Abstract

Doubts about the real nature of schizophrenia are long-standing. There are no laboratory tests to confirm diagnoses and  it is not certain whether there is consistency in the diagnostic process. Various models have been developed to explain the cause of the symptoms. The dominant explanatory model is based on  medical assumptions that the symptoms are pathological and are caused by an illness of the mind or brain. The medical model embraces a wide variety of psychological and biological theories of aetiology but there is no scientific/medical consensus  and all the evidence supporting medical theories is equivocal.  This apparent confusion gives rise to questions concerning the validity of a medical interpretation. Alternative, non-medical models explain the cause of the symptoms as being either a mystical/spiritual emergency (mystical model)  or as social alienation (myth-of-mental-illness model).

When a comparative analysis of the medical, mystical and myth-mental-illness models is undertaken in the light of interest group theory it is apparent that competing interest groups are promoting different explanatory models to achieve political ends. A key determinant of this political struggle involves the selection and emphasis of conflicting human rights imperatives. Human rights are central to the issue of schizophrenia because people who display the symptoms tend to be socially disruptive and, as a result, are frequently hospitalised involuntarily and forcibly treated with  drugs that are mentally and physically debilitating.


Table of Contents


1. INTRODUCTION (pdf-330 kb)
  • Objectives of the Thesis
  • Methodology and Underlying Theoretical Perspective of the Thesis
  • A Brief Description of Schizophrenia
  • Schizophrenia Controversies
  • Expanding the Diagnostic Net
  • The DSM Diagnostic System
  • Growth of the Mental Health Industry
  • Social Control, Youth and Unemployment

2. INTEREST GROUPS AND HUMAN RIGHTS (pdf - 340 kb)
  • Interest Group Theory
  • Human Rights and Activism
  • Background to Human Rights
  • Human Rights, Science and Technology
  • Human Rights and Psychiatry
  • Soviet Psychiatry
  • UN Principles on Mental Illness
  • The Burdekin Inquiry

3. THE MEDICAL MODEL: SCHIZOPHRENIC SYMPTOMS AS PATHOLOGY (pdf - 370 kb)
  • Regression Theories
  • Current Diagnostic Criteria
  • ICD-10 Diagnostic Criteria for Schizophrenia
  • DSM IV Diagnostic Criteria for Schizophreni
  • Origins of descriptive psychopathology for Schizophrenia
  • Kraepelin and Bleuler

4. THE PSYCHIATRIC DICHOTOMY AND THE PROLIFERATION OF MODELS (pdf - 520 kb)
  • Biochemical Hypotheses — and Associated Drug Treatments
  • Atypical Neuroleptics
  • Other Biochemical Theories
  • Uncertainties in Schizophrenia Research
  • Brain Imaging
  • Scanning For Causes
  • Infection Theories
  • Nutrition
  • Genetic Theories
  • Theories of an Environmental/Experiential Aetiology
  • Developmental Theories
  • Family Environment
  • Double Bind Theory
  • Family Stress
  • Social Stress

5. THE MEDICAL MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES (pdf - 300 kb)
  • Interest Groups
  • Campaign to Extend Involuntary Treatment in NSW
  • Human Rights Imperatives
  • Right to Treatment
  • Informed Consent

6. THE MYSTICAL MODEL: SCHIZOPHRENIC SYMPTOMS AS A NATURAL EXTENSION OF CONSCIOUSNESS (pdf - 450 KB)
  • Background to the Mystical Tradition
  • Dealing With the Knowledge of Mortality
  • Attaining Mystical Experience
  • Mysticism and Psychiatry
  • Anti-Psychiatry, Laing and the Mystical Model
  • Jung
  • John Weir Perry — a Jungian
  • Mythological Heroes and Schizophrenia
  • Summary of the Mystical Model

7. THE MYSTICAL MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES (pdf - 340 kb)
  • Interest Groups
  • Human Rights Imperatives
  • The Spirit of Article 18
  • The Technical Requirements of Article 18
  • Involuntary Treatment Provisions in New South Wales (NSW), Australia
  • Incarceration of Alleged Schizophrenics
  • Hypothetical Mental Patient
  • Neuroleptic Treatment
  • Human Rights Report on Freedom of Religion and Belief

8. THE MYTH-OF-MENTAL-ILLNESS MODEL: SCHIZOPHRENIC SYMPTOMS AS MANUFACTURED ARTIFACTS (pdf - 490 kb)
  • Sub-Type 1: Schizophrenic-as-Cultural-Outsider
  • Negative Symptoms
  • Outsider Case Studies
  • Sub-type 2: Schizophrenic-as-Scapegoat
  • Sub-Type 3: Schizophrenia-as-Role-Play

9. THE MYTH-OF-MENTAL-ILLNESS MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES (pdf - 380 kb)
  • Interest Groups
  • Human Rights Imperatives
  • Background to the Insanity Plea
  • Relevant Human Rights
  • Torture and Cruel Treatment
  • Neuroleptics, the M-M-I Model and Human Rights
  • Treatment or Torture

10. EARLY PSYCHOSIS: PREVENTIVE MEDICINE, SCIENTIFC ASSAULT ON MYSTICAL TENDENCIES, OR AN EXTENSION OF SOCIAL CONTROL? (pdf - 520 kb)
  • Early Psychosis as Preventive Medicine
  • Early Psychosis Programmes
  • Case Study — The EPPIC Programme
  • Critical Analysis of Early Psychosis
  • Drug Company Influence

CONCLUSION (pdf - 170kb)

BIBLIOGRAPHY (pdf - 480kb)