Modern Psychoanalysis

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Tuesday, June 12, 2007

Curing Schizophrenia

Curing Schizophrenia
Views of Schizophrenia
A simple internet search for the word reveals a profusion of definitions with similar typecasting; e.g., Schizophrenia is “a chronic, severe, and disabling brain disorder...” (NIMHa, 2007), or “a severe, lifelong brain disorder,” (Medline, 2007), or a “disease.”

The reader may perceive something approaching a unanimity of opinion on the idea; i.e., that since this “disease” involves the brain and these authorities have deemed it to be “lifelong,” it must ipso facto be something strictly biological. A host of inferences follow: “it’s all in the genes,” “you’re born with it,” “there’s something wrong with their brains,” “the poor parents,” “medicine can cure them, if only we can find the right medicine,” “there’s no hope,” etc..., etc...

This writer thinks most of these views are about as useful as earlier ideas that people with schizophrenic symptoms were guilty of witchcraft. At least the same National Institute of Mental Health Report listed above candidly admitted:

“…schizophrenia is believed to result from a combination of environmental and genetic factors. All the tools of modern science are being used to search for the causes of this disorder.”
NIMHb, 2007.

Nature or Nurture?

In fact, medical science has been looking for a biological cause for schizophrenia for close to a century and has yet to find one. Over that time, many announcements of such “findings” have been made – always accompanied by the greatest publicity, but none were proved to be verifiable.

Another curious fact of this “disease” is that people who have it sometimes spontaneously recover. How then is it a disease? Or a brain disorder? Or lifelong? It is a rare disease indeed where people spontaneously recover and where there is no known physical etiology.

What about the “environmental” factors mentioned; i.e., the family backgrounds of the people who develop schizophrenic symptoms?

Peter Breggin, M.D. (p. 103, et seq.; see generally, 1994) speaks of one of the seminal reports on schizophrenia in the history of psychiatry, the study of the Genain Quadruplets (all of whom had schizophrenic symptoms). He notes that the report of the study recites the potential “biological” evidence for schizophrenia in that case in almost inexhaustible detail – but somehow neglects to consider it noteworthy that the family life of the quadruplets included such horrors as having acid poured on their genitals.

John Modrow, did not suffer the same horrors as the Genain Quadruplets; but did endure a significant amount of craziness from his parents, which he describes throughout his outstanding book “How to Become a Schizophrenic.”

Modrow notes that:

“The claim that most schizophrenics come from perfectly normal families deserves careful consideration… (regarding a case study he presented earlier)… Although the parents in this family appeared to be very ordinary and sensible people, they were later found to be playing with their daughter’s mind, subjecting her to strange ‘telepathy experiments’… it took over a year of investigation to discover those parents’ bizarre behavior.”
1995, pp. 205-206, emphasis original.

In spite of the extreme craziness of his own parents, Modrow still thinks of them as “basically decent and relatively normal” (1995, pp. 206); but also says:

“Had a psychiatrist examined my parents… he would have found… nothing strange or odd… Moreover, had that psychiatrist known my parents intimately for several years he probably would have retained his favorable opinion of them… However… there is no doubt in my mind that their behavior towards me was the major cause of my schizophrenic breakdown.”
Modern Psychoanalysis of the Schizophrenic Patient

It is no accident that the decisive text in modern psychoanalysis is entitled “Modern Psychoanalysis of the Schizophrenic Patient.” (Spotnitz, 1985). Though the theory and techniques in that book are equally applicable to all sorts of mental difficulties, Dr. Spotnitz arrived at those results through his groundbreaking work with schizophrenic patients.

Spotnitz (1985, p. 17) proceeded from the premise that “Regardless of etiology… there is no evidence that the condition is not completely reversible.”

“The operational concept follows: Schizophrenia is an organized mental situation, an intricately structured but psychologically unsuccessful defense against destructive behavior. Both aggressive and libidinal impulses figure in this organized situation… Obliteration of the object field of the mind and fragmentation of the ego are among the secondary consequences of the defense.”
Spotnitz, 1985, p. 57, emphasis original.

As to the “environmental” variables, Spotnitz says:

“It is unnecessary to postulate that a particular type of relationship produced the infantile pattern. It may be in part innate and in part learned. Even in cases where it was taught by the mother, her attitude may not have been pathological; there may simply have been a disequilibrium between her emotional training and the infant’s impulsivity. The dynamics of the mother-child relationship are not uniform in these cases. More significant than whether the parent actually loved, hated, or was indifferent to her infant is the fact that the totality of his environment failed to meet his specific maturational needs…”
1985, p. 68, emphasis original.

In this writer’s opinion, the techniques set forth in “Modern Psychoanalysis of the Schizophrenic Patient” work equally well with other mental difficulties because mental conditions have much in common – they are all part of the human condition.

One could even say that mental difficulties are normal; part of being human - the only question being whether we still function well in spite of our difficulties, or whether those difficulties have reached intolerable proportions, such as with the schizophrenic condition.

The Talking Cure

Many people will use Herculean efforts to appear normal, to distinguish themselves from those with problems, to split themselves off from the idea that they themselves might have any mental difficulties at all.

In spite of the efforts and protestations of these ordinary people, however, skilled observers have little difficulty seeing the underlying troubles in most of us. And, if the troubles reach a stage where they seriously interfere with the individual’s ability to love, work, or play it may be time to seek help.

When we speak of the physical illnesses we tend to think of cure as involving the complete eradication of anything relating to the condition. Not so with mental conditions – in those cases, the cure consists of placing the individual in a position where he or she can love, work and play without serious hindrance – where they can be productive and enjoy life.

The particular weakness of the individual is not likely to be completely eradicated. If a person tends to display in a phobic, or an obsessive-compulsive, or a schizophrenic, or any other way, they could have some resort to their characteristic mechanisms even after being cured. After all, we do not cure people from being human; nor do we seek to.

But, the person who has been competently treated by a modern psychoanalyst will be able to enjoy the whole range of human feelings and action available to the best of us.
References
Breggin, P. (1994). Toxic Psychiatry, New York, St. Martin's Press.

Medline. (May 24, 2007). Service of the U.S. National Library of Medicine and the National Institutes of Health, online at http://www.nlm.nih.gov/medlineplus/schizophrenia.html

Modrow, J. (1995). How to Become a Schizophrenic, Everett, Wash., Apollyon Press.

NIMHa. (March 1, 2007). “Schizophrenia,” National Institute of Mental Health, online at http://www.nimh.nih.gov/healthinformation/schizophreniamenu.cfm

NIMHb. (Jan. 24, 2007). “What Causes Schizophrenia?” National Institute of Mental Health, online at http://www.nimh.nih.gov/publicat/schizoph.cfm#symptoms

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, New York, Human Sciences Press.

© 2007, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail:
njanalyst@hotmail.com
http://modernpsychoanalysis.org
Psychoanalysis

20 comments:

Burbot said...

Anyone who knows anything about modern psychiatry knows that psychoanalysis has long been considered a pseudoscience. Sometime around 1978 psychoanalysis finally lost its credibility. Those who continue to pursue this form of quackery are obviously living in the bottom of a bucket.

Jim said...

I've been thinking that it might be useful to provide a future article on this topic, and I'd be curious to hear more about your point of view on the question.

The Encarta Dictionary (http://encarta.msn.com/dictionary_/science.html) defines science in the folowing ways:

"1. study of physical world: the study of the physical and natural world and phenomena, especially by using systematic observation and experiment (often used before a noun)

2. branch of science: a particular area of study or knowledge of the physical world the life sciences

3. systematic body of knowledge: a systematically organized body of knowledge about a particular subject the behavioral sciences

4. something studied or performed methodically: an activity that is the object of careful study or that is carried out according to a developed method the science of dressing for success

5. knowledge gained from science: the knowledge gained by the study of the physical world

[14th century. Via French < Latin scientia < scient-, present participle of scire "know, discern" < Indo-European, "cut"]>"

It is your idea that modern psychoanalysis does not fit one of these definitions?

Hugo said...

anyone who knows anything about the politics of psychiatry knows how exactly psychoanalysis fell in disgrace and understands why residents are kept away from learning psychotherapy (not just psychoanalysis); anyone who is in touch with the powers of Big Pharma (not the Hip Hop band) knows how much it has influenced the idea of a "true pseudoscience" in current medical practices, not just in psychiatry.

Jim said...

Though Dr. Spotnitz is a medical doctor, I would say that most modern psychoanalysts are not psychiatrists. In fact, a fair number of modern psychoanalysts started out as patients.

Copper Kettle said...

There is a wealth of data on changes in the brain linked to schizophrenia - decreased Reelin protein and GAD67 enzyme along with deregulation of epigenetic mechanisms (see articles by Erminio Costa); ghanges in GABAergic chandelier cells (David Lewis), glutamate receptor changes (Bita Moghaddam), in some cases - increased volume of ventricles, and more..

Jim said...

Thanks for the listing of these reputable neuroscientists and their work. The related articles should be of interest to most.

What's your idea on the significance of this wealth of data?

Anonymous said...

I can't believe that anyone is this day and age would deny that schizophrenia is a biological disorder. Please tell me what legitimate clinician thinks psychoanalysis is a legit enterprise anymore. Didn't psychoanalysis do enough harm in the past when schizophrenia was blamed upon the mother?

Jim said...

Re: your first question, there are over 1,200 legitimate clinicians listed at the National Association for the Advancement of Psychoanalysis (www.naap.org); I assume most of those think psychoanalysis is a legit enterprise.

I am curious about the answer to your second question, but not certain I know enough about it; what types of harm were done in the past?

Mark said...

" Anonymous said...

I can't believe that anyone is this day and age would deny that schizophrenia is a biological disorder."

I deny it easily, 99.9999% of diagnosis of schizophrenia is done through observation/interview with a psychiatrist.NOT a biological laboratory test.
If no laboratory tests exist, how can you in this day and age continue to believe in biological psychiatry?

There is proof psychology may work to reduce mental illness.
http://www.apa.org/monitor/feb00/schizophrenia.html
or
http://tinyurl.com/3dyw2n

"At the most optimistic of times, the traditional treatment paradigm conceded that perhaps 10 percent to 20 percent of those with schizophrenia might achieve recovery. But proponents of the recovery movement point to data that shows as high as 68 percent rate of recovery and significant improvement."

Anamaria Ivan said...

Hello,

I noticed that some people that deny psychoanalysis bring the "no-science" argument all the time... but, in my humble oppinion, this argument is at least fallacious. What if we assume that psychoanalysis is indeed a non-scientific domain? What then? Should we reject something that has souch an enormous therapeutical impact only because it does not comply to the constraints of an exact science such as physisc or mathematics? And of so... what should we do with the arts, the literature or... let's say phylosophy? Why should the word science be the supreme truth-guarantee?
And... another quetion for the "science" lovers and "non-science" haters: have you heard of the "Godel-Turing" scientific prooved statement? Just tell me what do you think about that, and then, let't have a nice chat about being human.

Best regards!

Mel Avila Alarilla said...

Hi Dr. James,
I'm new at your blog. I hope you don't mind if I give my own comment on your post.

Marvelous. Simply fantastic. I should have known and read your blog earlier. That was a very authoritative, informative and thorough medical post. I have always been fascinated with medical journals that are presented for laymen's consumption. They help eradicate misconceptions of various illnesses.

Thanks for the very wonderful post. I enjoyed it to the max. May I invite you to visit my own blog as I link your blog with mine so that I can always have an update of your informative posts on psychoanalysis.

God bless you with all the wisdom and wit in the world.

Anonymous said...

Hi Salty Davis from Belfast, I have been in three secure units and had schizophrenia for 10 years I always rubbish the idea that talking therapy could help, but I found that off loading all your bad experiences onto a stranger ie a therapist is a liberating experience and helps towards recovery I don't know about psycho analysts but I recommend anyone with schizophrenia to get some talking therapy

geo said...

Hi, I just found this blog today.

I really enjoyed this post.

Personally I think that this whole "it is proven that schizophrenia is a biological illness", "all one can do it take neuroleptics and maybe have some supportive therapy" is one of the biggest lies that exist at the moment.

I am not saying the opposit, that "schizophrenia is just a psychological problem", but when I go through articles or books that seem to be reliable, they say something like: "We do not know". And just because there are some changes in people`s brains who have schizophrenia doesn`t decide the question: "Have the thoughts changed the brain or have the brain changes affected the thoughts".

So to me it looks like the most honest way to talk about it, is to say that "we don`t know".

But as long as we don`t know it seems worthwhile to take all our strenghts to find out whether maybe there is a "talking cure" to schizophrenia. It might not be psychoanalysis, but maybe CBT, or a future mixture of both or something that isn`t invented, yet. But I think we should try.

FM said...

FM In Ireland
New to your blog as a commenter but have been reading it for a while. Iam doing a MA in Psychoanalysis and find these discussions interesting and partly frustrating! It would be easy to postulate that people with such a strong denial of psychoanalysis appear to be exhibiting a ignorant fear of some sort. Most reasonable people will at least hear both sides of an argument, state them and interrogate the points they have problems with. Not just come out with pseudoscience jargon. I can understand how PA can appear unsavory to some people, especially if they have not read up that much on it. There seems to be alot of misconceptions in particular to do with the language used and its context. I would encourage anyone to read it with an open mind and in the context it is implied, bearing in mind Freuds era of 18th C Austria. Freud gets a lot of stick. I have never come across a 'creator or inventor' of any other discipline who is attacked so frequently. The first try at things wont always be right, and (by definition of a science) the point is to move forward and alter your hypothesis accordingly.
With regards to Schizophrenia. It has not been proven either direction yet to be a biological illness or environmental reaction strictly but it appears to be a combination of the 2. This appears so far to be the most reasonable answer. Medications do work for most people but not all and not for all symptoms. I dont see why the lay persons opinion is for PA and Psychiatry always to be at odds. The most valuable way to cure anyone with any disease or condition is to value and treat them as a WHOLE person. Body mind and soul. If medication eases some of the more positive symptoms and someone feels relieved then great. Equally if exploring their feelings and thought encourages progress and relieve then equally as great. Both can and do work together well. Schizophrenia is a very unique disease and so the ideal for an individual has to be tailored to them. who is to say that some cases may be purely biological and others may be more environmental but present similarly??

Additionally, if anyone has any interesting ideas that would be worthy of an MA thesis im open to suggestions and inspiration.

Bloggerhead said...

Modrow doesn't want to take responsibility for himself and his own peculiar mind traits. "However… there is no doubt in my mind that their behavior towards me was the major cause of my schizophrenic breakdown.” What hardly anybody talks about in schizophrenic treatment is personal choice. How you choose to react is based on your own internal mindset to which others (even parents) have no access. Yet, we are supposed to endlessly coddle the patient and unquestioningly accept his or her verdict of parental failure. If a person with a more garden variety mental health concern went to a therapist with his complaints, would not the therapist try to get that person to stop assigning blame? Paranoid schizophrenics also believe they are being watched. Everybody rubbishes that one, yet when they say the parents are to blame that is accepted as truth.

Anonymous said...

There's a reason that "Biopsychosocial" formulations of mental disorders exist, and to say that Schizophrenias or Psychosis is the same as, say, Parkinson's or Alzheimer's Disease just doesn't fit with my understanding of these things.

I'd suggest everyone who is solidly convinced that Schizophrenias/Psychoses are diseases or disorders OF the brain read George Graham's "The Disordered Mind." Philosophy has a good middle grounded perspective that can provide a lot to this discussion.

Also, for those who poo-poo psychoanalysis (of any variety), ask someone whose had it how effective it is before you write it off. Anecdotal evidence is just as scientific (if not more so than) as any randomized clinical trial. Read "Cultures of Healing" about that idea.

Anonymous said...

In response to Burbot, in the United States the preferred training of modern psychiatrists who wish to become therapists is still psychoanalysis. The preferred method of psychotherapy for the enemies of psychoanalysis is Dr. Phil, or Dear Abby.

Anonymous said...

Copper Kettle said...
"There is a wealth of data on changes in the brain linked to schizophrenia - decreased Reelin protein and GAD67 enzyme along with deregulation of epigenetic mechanisms (see articles by Erminio Costa); ghanges in GABAergic chandelier cells (David Lewis), glutamate receptor changes (Bita Moghaddam), in some cases - increased volume of ventricles, and more.. "

-----
Whose to say the peculiar physiology was not preceded by psychosis? Simple sexual arousal triggers all sorts chemical and physical changes in the entire body. To assume that internal conflict would have no effect of brain physiology requires a total absence of imagination.

Anonymous said...

Schizophrenia is likely to be a combination of many factors, biological and cognitive.

It could even perhaps rely on a conditional gene which becomes active depending on the conditions.
Though you may have taken some select definitions from a select website, a key feature of science is falsifiable theories, you can not prove psychoanalysis right any more than you can wrong, this discredits it as a science.

"I deny it easily, 99.9999% of diagnosis of schizophrenia is done through observation/interview with a psychiatrist.NOT a biological laboratory test." Someone once told me that this same number of statistics was made up... There have been studies which show that schizophrenia is linked with a dopamine imbalance, and the medication that rectifies this helps with the symptoms, apparently there is no biological element?

Also, how do you explain the conordance rate in families? Even separately adopted twins have a heightened concordance rate, so this points towards genetic as well as environmental.

You see, what this article has done is called a straw man fallacy, the author has taken select points of evidence against psychoanalysis and put them out of context so they can be considered to be weak, and easily broken down, making no point to deal with other evidence, or even the evidence as a whole.

nezza said...

what's wrong with having it. Words and voices are just that, don't need to do what they say or pay them any mind. Perhaps they are making us think...as long as others are not ignorant towards mental illness then it will have a positive effect upon society since accepting different view points makes us grow