Schizophrenia and the mind

25 August 2011

Schizophrenia affects about one out of two hundred people.  It’s a serious mental disorder that typically involves distortions in perception, especially vivid auditory hallucinations, and bizarre and usually paranoid delusion.  Imagine trying to carry on a conversation with while at the same time you're surrounded by four other people, talking loudly to you, often about thoughts you might have considered to be private.  That’s an exercise support groups often use to suggest to family what it's like to be a schizophrenic.

The best-known portrayal of a schizophrenic is probably the movie `A Beautiful Mind’.  Russell Crowe plays John Nash, a mathematician who won a Nobel Prize in Economics.  In the movie, Nash’s hallucinations are portrayed as both auditory, visual and tactile.  But that’s really not at all common, and wasn’t truly the case with Nash.  Like most schizophrenics, his hallucinations were purely auditory.

There is some debate whether schizophrenia is just a label for a bundle of commonly co-occurring symptoms, or a single underlying disease.  There are no laboratory tests for schizophrenia.  However, it is frequently associated with excess dopamine --- a neuro-transmitter in the brain.  On the basis of this, there are some pretty good medications.

John Nash in real life, and in the movie, preferred not to take medication.  That’s very common.  There are side-effects, and the schizophrenic also often sees the medications as part of a conspiracy.

Schizophrenia is interesting to philosophers for several reasons.  Schizophrenics often think the thoughts they're directly aware of in their own minds belong to someone else.  Sometimes they just mean that the thoughts come from the outside --- perhaps in radio transmission through their fillings, or some other bizarre way --- and they can’t control them.  But sometimes they insist that the thoughts actually and literally belong to someone else.

That challenges a very fundamental view in the philosophy of mind, that when you are aware of a thought, you know it’s your own; it makes no sense to be introspectively aware of the thoughts of another.

Schizophrenics also challenge a picture of thoughts that many philosophers find attractive.   Many philosophers feel thoughts are beliefs gained through perception, desires, and thought-processes.  In this view, to attribute thoughts to a person presupposes a certain modicum of rationality.  The thoughts you pick up from perception should be related to what you perceive in some rational ways.  Schizophrenics seem to challenge that picture.

Schizophrenia also poses ethical problems that have to do with this irrationality.  For example: we think it's OK, in the case of children, or old folks with dementia, to violate their autonomy --- the right to make their own decisions -- in various ways, including forced medication.  The schizophrenic may be motivated by extremely bizarre beliefs.  But, given those beliefs, their reluctance to take medication, or leave the house, may make perfect sense, and indeed be articulately defended.  Is forced medication a violation of autonomy, or something required to give them meaningful autonomy and a hope for a normal life?

 We’ll talk with John Campbell from the philosophy department at Berkeley, who has thought and written deeply about schizophrenia.

Comments (14)


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Guest

Thursday, August 25, 2011 -- 5:00 PM

In terms of the "debate [about] whether schizophre

In terms of the "debate [about] whether schizophrenia is just a label for a bundle of commonly co-occurring symptoms, or a single underlying disease", it seems to me almost certain that what we describe as schizophrenia will, in the future, be described as several different disorders, with distinct causes and overlapping effects. While diseases like diabetes can be diagnosed on the basis of measurable factors (blood insulin levels), no physiological measure is currently used to diagnose schizophrenia. Of course, as mentioned above, there are brain and neurochemical abnormalities associated with schizophrenia (positive symptoms like delusions and hallucinations are believed to be related to hyperdopamine function; negative symptoms like social withdrawal and flat affect are strongly associated with enlargement of brain ventricles reflecting brain tissue loss). However, these are examined in individuals already diagnosed with schizophrenia, they're not a diagnostic tool. The DSM manual that describes the symptoms necessary in order to be diagnosed with schizophrenia should, I think, be thought of as 'the best we can do' at the moment in order to make some sense out of these abnormalities in thought, attention, sense of self ... There are lots of brain abnormalities that have been associated with schizophrenia (in addition to those just mentioned). Some with schizophrenia have abnormalities in the frontal lobe, and abnormalities in the hippocampus. I used to teach a seminar on schizophrenia at Columbia University, and the research literature was so complex and varied, that it was too difficult to give a cogent seminar on the subject --- I no longer give the seminar. I'm pretty sure it will turn out to be a constellation of disorders. I'll bet you a dollar.

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Guest

Thursday, August 25, 2011 -- 5:00 PM

Inasmuch as I am not a doctor (of any sort),I'll a

Inasmuch as I am not a doctor (of any sort),I'll await observations, experiences and opinions from the pros who provide commentaries on such things. I may have some opinions about the topic-but those matter little to anyone but me. Greetings to all...

Guest's picture

Guest

Friday, August 26, 2011 -- 5:00 PM

Looking for ways to measure mentalities? I can tel

Looking for ways to measure mentalities?
I can tell you truth is measureless,
And that's about All!
Be True,
=
MJA

Guest's picture

Guest

Saturday, August 27, 2011 -- 5:00 PM

Listened to this rebroadcast with interest, but so

Listened to this rebroadcast with interest, but somewhat dismayed to see the shallowness of experience with the topic by the professional academic. How can one be a philosopher without having altered-state experiences either via meditation or entheogens to see the plasticity and arbitrariness of consciousness, and the world of synchronicity that schizophrenics live in. Interestingly, heard another podcast describing that schizophrenics have much better outcomes in traditional witch-doctor cultures due to the acceptance of spirits. Also, an interesting piece of evidence supporting the risk of schizophrenia with cannabis is the biography of Kurt vonnegut's son 'Eden Express' where his schizophrenia was provoked by extreme cannabis use. From my own experience with schizophrenics, it is therapeutic to live in a rural low stress setting with lots of nature, and to have a religious outlook where angels and the saints have power to heal are believed in and the belief is supported.

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Guest

Sunday, August 28, 2011 -- 5:00 PM

Hello, I am Philip Randolf, At vario

Hello, I am Philip Randolf,
At various times I have experienced an arising thought and then a subsequent thought saying something like "what a weird thought that was; it's a thought I don't subscribe to at all" or "Yow where did that thought come from?"
In other words, in effect the sentiment is that I disown the thought; it is not "my" thought, but something a bit alien.
I think many people have this experience without any indication of pathology.
So what are we talking about here, a matter of degree?
And thoughts "coming from outside" doesn't seem so odd to me; after all, most thoughts arise without our willing them or without a process of consciously generating them. If "I" didn't generate the thought, then, in a sense they do come from "outside" an "I"
-----apart from a "me".
So, again, a matter of degree? If other people are bugged by your behavior or thoughts, or you can't concentrate on the business you were hired for or some such---then, society must step in?
Electro-shock for you?
But apparently, Nash was operating brilliantly as a mathematician (Nobel prize), and he was not violent or destructive.
So,seems to me value judgements operated here to some extent --to condemn him for not thinking as otheres do, as some others thought he should.
My understanding is that Nash stopped taking any medication (who can blame him with the horrific side-effects) and gradually he detached himself from unusual thoughts by his own efforts and they diminished. But, interestingly, he also felt that subsequently he was not as inspired a mathematician after he did this.
Paranoia and out of the ordinary connections made between events, entities posited that some people think don't exist, indicates schizophrenia and a danger? On that basis, then, I must insist that some fundamentalists be immediately subject to heavy medication along with a few Physicists who believe we live on a Brane.
Really, is there not a lot of value judgement going on here?
This whole thing puts me in mind of the current rumble about Autism. People once had to exhibit behavior that was quite extreme to be diagnosed as Autistic. Now, millions of school kids who fidgit in their seats or can't keep their voices down or who are very shy or who are smart as hell but uncommunicative or some such-----are Autistic! And, of course need professional consultations and medications and long term expert supervision and so on. Those professional folks make out well what with the rather sudden burgeoning of this terrible condition into the general population and all.
I just read a short biography of Dirac, the brilliant English Quantum Mathematician (Nobel prize),
and gee, who coulda guessed it? According to the bio he suffered from Autism too! (but apparently a mild case?so mild it was almost non-existent---almost!) Golly, if only those psychiatrists then had had the knowledge they have now--why we'd have had old Dirac fixed and on meds in no time! The wonders of modern medicine! Yes, a medicated stupor surely is much more normal than weird thoughts and being socially ill at ease.
Better that Mr. Dirac did not produce his brilliant
maths and instead was rid of his terrible condition, right?
Finally, I must say that at times it has occurred to me that the notion of a self, an I, a me, could be just another thought, and the universe is really without the personal---no entity to correspond to the "Me" anywhere.
Kind of an unusual thought compared to most folk, eh?
I was thinking that gee, perhaps I am Autistic or Schizophrenic too and need to go on disability or have the government pay to send me to a place where I might recover, say to live in a quiet grass hut by a tropical sea and self-medicate, say with a nice pina colada or two in the afternoon. Now that is what I would call recovery!

Guest's picture

Guest

Sunday, August 28, 2011 -- 5:00 PM

Thanks for the post. Honestly this post will clear

Thanks for the post. Honestly this post will clear Clouds of myth surrounding schizophrenia.

Guest's picture

Guest

Tuesday, August 30, 2011 -- 5:00 PM

The Source If you?re looking for the source of

The Source
If you?re looking for the source of a thought my friends it is the same as the source of a river.
Come this Way: Follow a river upstream sometime and you'll find the source to be a creek. And beyond the creek the source is a trickle of water, formed from melting snow. Beyond the snow the snowflakes, from the clouds that formed over the evaporating source the sea. Then back or forward to the delta One will find, the source, the truth, Oneself, the beautiful river Equality.
=
MJA

Guest's picture

Guest

Tuesday, August 30, 2011 -- 5:00 PM

Once again, the djinn is out of the bottle. Or is

Once again, the djinn is out of the bottle. Or is that the gin is out of the bottle? Randolf has made an interesting point---one that many of us have been ruminating over for lo these many years now (though I exagerate for effect): If there are so many mentally unbalanced people in this world, how on earth are we to distinguish who among us are sane? Moreover, perhaps, is it not better to be a few sandwiches shy of a picnic and to fit in with others than to be left on that postage-stamp island with a coconut tree for company?
Certainly, there are extremes in every realm and we shall never have all the answers to any one question. It is good fun to speculate, though. Your blog just keeps getting more interesting and diverse. Thanks for all of that and keep it rolling,please,
PDV.

Guest's picture

Guest

Tuesday, August 30, 2011 -- 5:00 PM

As the sad sister of a lovely brother who was schi

As the sad sister of a lovely brother who was schizophrenic I find myself on both sides. The drugs my brother was given caused his premature death, but gave him a few years outside an institution. One of the things that helped him was walking around with musical tapes or radio and earplugs. This allowed him to escape the voices. Why this worked is not the question. The question is: if it works, why not?

Harold G. Neuman's picture

Harold G. Neuman

Tuesday, August 30, 2011 -- 5:00 PM

"In 1947, a man bought a new Plymouth, put it up o

"In 1947, a man bought a new Plymouth, put it up on blocks and covered it with cosmolene. Today, it it worthless."
---Kehlog Allbran, THE PROFIT, circa 1970

Guest's picture

Guest

Wednesday, August 31, 2011 -- 5:00 PM

Just like with the sandwich generation (silent, bo

Just like with the sandwich generation (silent, boomer, x/y), there are children of Schizophrenics who are confused. We don't know how to care for our parents and we don't know if we are going to pass it on to our children. We also wonder: what is the problem with some of the thoughts our parents have? Sometimes my mother and father make sense. My mother has the diagnosis of Schizophrenia, while my father has been diagnosed with early onset dementia. I always thought they were still experiencing an acid trip from the 60s. Then as I grew up and started experiencing more fantasy influenced books, TVs, and movies, I started thinking maybe my parents aren't crazy. This could be wishful thinking. This could be a desire to be special or supernatural. But I have to tell you that Hollywood sensationalized Schizophrenia. It is television and movies that confuse us more than we already are. There are times that I think I have crossed to my mother's realm just because of something I have seen on TV. Yes, I know the difference between fantasy and reality, but it is a fine line. There are coincidences. There is irony. And there is wishful thinking. But at the same time, I think no one has ever really asked my mother if she knows the difference between the life she leads out and the boon docks and what is going on in the city (reality). I think she does. I just think she can't control her thoughts and reactions. I think she prefers to live in her world because our world is cruel and misleading.

Guest's picture

Guest

Tuesday, September 6, 2011 -- 5:00 PM

An interesting writer who explores philosophy and

An interesting writer who explores philosophy and mental illness is Louis Sass. One of his books is "Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind". In this one he makes connections between solipsism and mental illness.
I wish the program could have addressed how philosophy can contribute to how we think about and treat mental illness.
~John

Guest's picture

Guest

Tuesday, September 6, 2011 -- 5:00 PM

Well. I'll wait a bit. Perhaps there are Kinds of

Well. I'll wait a bit. Perhaps there are Kinds of Minds. As Dennett has suggested. Hmmm.

Guest's picture

Guest

Thursday, January 12, 2012 -- 4:00 PM

First of all I want to

First of all I want to disagree that humans are predominantly rational. For most humans reason is at the service of emotions. It is easy to dismiss the schizophrenics as holding irrational beliefs without analyzing why they formed those beliefs. I believe that some of their distorted and unreal perceptions leads them to form beliefs that seem irrational to us. Some of our beliefs are models formed by our brains out of our experiences including reading, listening and other modes of input. It makes sense that when our experiences are based on unreal stimuli, our models are not going to be anywhere near real as defined by inter-subjectivity. I think schizophrenics develop their seemingly irrational beliefs over time trying to make sense of the erroneous perceptual input that comes out of their own minds. I'm basing this based on my own experience. A few years back, I was diagnosed with referential delusions. Over a period of time I started believing that my thoughts and actions were being broadcast and
I'm being spied upon. These beliefs didn't come spontaneously. It gradually developed over a period of years based on auditory hallucinations and distortions of auditory stimuli. The hallucinations are not just random voices. These are the voices of people I knew. Like my friends, relatives, colleagues and some strange voices. And at least in my case, the voices were not random. When a particular friend is near me, I often heard comments in his voice. For example I may hear comments from my Boss's room in his voice when he is there. But only that he didn't actually make that comment. So most of the times the hallucinations are not just random voices, it is the voices of people we know.
Since the comments those voices carry arise out our own minds, the content of those voices carry a lot of personal details. Things only you know and are thinking. For example, let us say you are thinking about some personal topic and you hear a comment about what you are thinking in your boss's voice. What would you think? You may think he eavesdropped on your thoughts and commenting. If this happens once we may dismiss it as some random stupid notion of ours. But imagine if this happens everyday for a year, in the voices of so many people you know and don't know. You will seriously start looking for explanations.
As someone with a background in biomedical science, I started searching for the availability of technologies that allows one to eavesdrop on your thoughts. I know that such a technology doesn't exist. And I very well know that it takes very large machines like fMRI to even detect brain patterns and hence not possible. Nobody can do it remotely. I came upon this technology called sub-vocal speech detector that comes closest to a cheapest technology that can detect what we are thinking. However It is obvious that no such machine is attached to my throat. While you are logically striking off these possibilities, you are actually experiencing things to the contrary. So you come to the conclusion your thoughts are not being tracked, may be your activities are being monitored. There is cheap technology available to monitor your every view.
Once you start believing this based on your distorted experiences and perceptions, you start wondering why anybody would do this. And you start coming up with conspiracies, reality shows to other weird explanations and schemes to explain what you are experiencing. And your judgements are being clouded by very real fear and anxiety about the situation.
So looking at this sequence of events, the seemingly irrational beliefs of mine were actually rational attempts to explain perceptual abnormalities. I'm not saying this is exactly what happens in all schizophrenics. But I'm able to sympathize with them. Someone who is very religious may interpret the voices in different ways and may come up with different beliefs. The content of the voices, very much based on the individual personalities, is sure to lead to different beliefs.
Would love to discuss more on this issue. Thank you.