Schizophrenia: a challenge to our culture?

The Schizophrenia Commission has just published a report on schizophrenia in this country.1  The findings highlight many of the problems surrounding people with a diagnosis of schizophrenia, or as the Commission prefers to call it, psychosis.2  These problems include a lack of proper care in acute settings, a lack of access to talking therapies, and the fact that, on average, people with schizophrenia die 15 to 20 years earlier than the rest of the population.

One of the reasons that many sufferers do not seek help early on is because of the stigma that is still attached to mental illness in general, and psychosis in particular.  This is in spite of the fact that early intervention can produces very positive outcomes.

One of the problems with schizophrenia is that in many ways it appears to epitomise everyone’s worst fears and prejudices regarding serious mental illness.  This is especially when the individual sufferer is in the middle of a crisis and may be having bizarre thoughts, hearing voices, and experiencing very strange bodily sensations.   Schizophrenia, more than any other mental illness, challenges and subverts everything that most people cherish in our culture, including ‘rational’ thinking, material success, and being able to ‘play the game’ in terms of social relations.

This is not to deny that people with schizophrenia do not suffer: they often do and sometimes unbearably.  However, at least some of this suffering relates to their position in society, i.e. the stigma of being radically different and not ‘fitting in’ with the ‘norms’ of our culture.  The way that many people with schizophrenia would prefer to live their lives is very much at odds with what is demanded by the society they live in.

As the report acknowledges, the causes of schizophrenia are complex and include a mixture of genetic and psycho-social factors.  However, what the report does not acknowledge, and perhaps to be fair this was never within its remit, is that this complex mixture of the biological and psycho-social produces an individual who simple does not ‘fit in’ with how most people think people ought to be and ought to behave.  Ultimately this has nothing to do with biology or psychology, but a great deal to do with social values.

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  2. Clinically, schizophrenia is one four psychotic illnesses:  the other three are paranoia, manic-depression (bi-polar disorder) and autism. []

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