Being Brained About Schizophrenia

Being Brained About Schizophrenia

Since the 1990s, epidemiologists, psychiatrists, historians, and journalists have questioned the extent to which schizophrenia has disappeared as a medical diagnosis. An article in The Lancet entitled “Does Schizophrenia Go Away?” suggested a significant decrease in reported turbulence incidents since the mid-1960s; Posted 2012, Schizophrenia is a misdiagnosis, They criticized the validity of the diagnosis and openly announced its demise. Articles with similar titles, such as “Schizophrenia does not exist” and “The concept of schizophrenia is coming to an end”, appeared in British Medical Journal And the independent in 2016 and 2017, respectively. Industry leading magazine editor, Schizophrenia Bulletinand discussed whether the magazine should be re-baptized and the word “schizophrenia” removed from its name. In the end, he decided to keep “schizophrenia” in the magazine’s title while adding an explanatory subtitle as a kind of disavowal. With the addition of the Journal of Psychosis and Related Disorders, the editor seemed to anticipate where the field would soon be headed. Finally, a 2017 article in this particular journal claimed that the word schizophrenia may eventually be relegated to the trash of history, as was previously the case with the medical use of the term “dropsy.”

As we still lack a laboratory test to diagnose schizophrenia and have not found accurate biomarkers for this group of symptoms, we are now being asked to re-imagine schizophrenia as revealing not a different class of mental illness but rather a group of disorders whose specific characteristics are part of a continuum. connected instead. A token of a basic or natural species. History teaches us that distortions in thoughts, emotions, and behaviors have always been viewed as either categorically different (in the same way that plants differ from animals and minerals, and different trees differ from each other) or as a difference in spectrum (in the same way we measure height or weight, or high or low blood pressure).

But the decline in diagnosis was not only driven by general shifts in psychological classification as it shifted from qualitative categories and methods to quantitative spectra and models. In addition, psychiatrists, psychologists, social activists, survivors, ex-patients, and others have argued that the stigma of “schizophrenia” should be de-stigmatized precisely because it carries connotations of hopelessness, chronicity, and even seriousness that cannot help but lead to therapeutic nihilism and Unexplained “despair advice”.

Physicians and patients advocating a name change are seeking and advocating less discriminatory and more attractive diagnoses, with “extreme mental states”, “auditory states”, “unusual states” or “diverse identities” only a few of the suggestions made. In addition, some have urged the American Psychiatric Association to follow the example of Asian countries such as Japan, where psychiatrists have replaced the term and diagnosis of “schizophrenia,” which implies “split mentality,” with “integration disorder,” opening the dramatic change that has proven, with all Scales, it is useful for both patients and clinicians.

However, while the lineage of madness since its first appearance in the Bible offers us two ways of conceiving the difference between sanity and madness, i.e., as one categorical difference or one degree—in other words, as one of qualitative difference or one that can establish a quantitative measure—we may seek also to reimagine the kind of hopeful future that may remain in store for us through this alternation of models. This means imagining the picture that emerges once one considers a diagnosis of schizophrenia to be a stable identity per se, but also potentially marked by an astonishing and sometimes changing shift in perspective.

This double vision of the same complex phenomenon is reminiscent of the optical illusion, which Thomas Kuhn, following Ludwig Wittgenstein, borrowed from psychologist Joseph Jastrow to prove the “structure of scientific revolutions”. According to Kuhn, even when nothing changes in the environment, a shift in the attention of the scientific community simultaneously changes its concept of the phenomenon under study. In Kun’s words:[w]The hat was a duck in the scientist’s world before the revolution rabbits were then.” As can be deduced from Jastrow’s famous drawings and later interpretations of the duck-rabbit image, these ambiguous figures show that the above alternative perceptions and theoretical or clinical models are not merely a product of how the stimuli recorded in the Our visual field (that is, data in the so-called sense). Instead, it shows that what we see is, first and foremost, perceived by the eye of the mind. In other words, expectations, knowledge, and the direction of our attention are all involved in what we can not only see, but desire Also in seeing it.Just as at Easter children tend to recognize a rabbit while they see ducks more easily on the average Sunday, scholars and practitioners in their respective fields tend to see one or the other of the available viewpoints on the matter in question depending on the context. In doing so, they seem to follow the zeitgeist, the zeitgeist, the mores (habits and habits), and perhaps even the prejudices of their age.

During their extensive hands-on training, clinicians (myself included) who work with individuals who suffer from what is perhaps too obvious to call and identify as “schizophrenia” learn that “if he looks like a duck, swims like a duck, and fights like a duck, then, In all likelihood, she is a duck.” But watching the emergence of more general spectral presentations and models, alongside more pervasive generations’ resistance to labels and classifications (remember the analogous case of gender and gender), while also listening to the perspective of advocacy groups and hearing testimonies from patient-led movements, gives one pause: rather than preferring One paradigm over the other, not to mention slipping into pure and simple relativism, those who diagnose and treat mental disorders must accept and live or work with the undeniable paradox of having two seemingly exclusive paradigms of accounts of severe mental states operating concurrently or alternately . Being ‘of two minds’, they may see either a rabbit or a duck, fully aware that both images and visuals are a state of ‘now you see, now you can’t see’. After all, whether we diagnose patients as categorically different or on a spectrum with the normal, this diagnosis is nothing more than an incomplete schematic diagram of what is, in essence, a much more complex and intractable phenomenon.

Adapted from Schizophrenia: an incomplete history (Poletti, 2022).

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