“An enormous amount of research has examined possible physical causes of psychotic experiences. This research has yielded some interesting findings, but no definitive conclusions can yet be drawn. Work in understanding biological influences on psychotic experiences may have been hampered by a number of problems:
The use of unreliable and invalid diagnoses. If diagnoses are misleading, real physical processes that are related to only some of the psychotic experiences might be hidden.
The fact that two things happen together does not mean that one has caused the other. Few studies have made this distinction.
The effects of complicating factors (such as medication) have not always been taken into account.
It has often been assumed from the outset that the reason for these experiences is likely to be a biological one and so other possible reasons have not been investigated.
It has often been assumed that there is likely to be just one cause. It is of course possible (indeed likely) that a number of things need to come together for someone to have these kinds of experiences.
For example, someone may have an inherited sensitive temperament but only have psychotic experiences if at some point in their life they experience extreme stress.
There are, of course, biological and brain events that correlate with all aspects of our mental functioning. This is equally true for ‘normal’ and ‘abnormal’ experiences. However, it is incorrect therefore to conclude that biological abnormalities are the primary causes of a complex range of experiences. The undoubted existence of biological aspects to our experiences does not in itself justify categorising them as medical illnesses.”
British Psychological Association (2000)
Recent advances in understandingmental illness and psychotic experiences
British Psychological Society, Leicester. P.24, p.25, p.29,
“The overarching message of ISoS is that schizophrenia and related psychoses are best seen developmentally as episodic disorders with a rather favourable outcome for a significant proportion of patients. Because expectation can be so powerful a factor in recovery, patients, families and clinicians need to hear this.”
“Despite these notes of caution, the ISoS findings join others in relieving patients, carers and clinicians of the chronicity paradigm which dominated thinking throughout much of the twentieth century.”
Harrison G. et al (2001)
Recovery from psychotic illness: a 15 and 25 year international follow up study
British Journal of Psychiatry: Number 178, pp.506-517
“The only well-established structural abnormality in schizophrenia is lateral ventricular enlargement; this is modest and there is a large overlap with the normal population.”
Chua S.E. & Mckenna P.J. (1995)
Schizophrenia – a brain disease? A critical review of
structural and functional cerebral abnormality in the disorder.
The British Journal of Psychiatry: Number 166, pp. 563-582
“…the notion of schizophrenia is unsupported by scientific evidence and is unsustainable. Maintaining that schizophrenia exists is dishonest. It would be of more help to those in distress, and move forward the research effort to understand madness, if we stopped trying to fit their symptoms into a bogus diagnostic category.”
King J, (2000)
What in fact is schizophrenia?
British Medical journal
Volume 320: p.800
David Whitwell challenges the Kraepelinian dogma of inevitable decline and cites the ‘plateau’ effect of deterioration levelling out after 2 – 5 years followed by stability or improvement. He argues that early intervention is the key to positive outcomes and recovery. This is the ‘critical period’ hypothesis.
Whitwell D. (2001)
Service innovations: early intervention in psychosis as a core task for general psychiatry
Vol. 25, pp.146-148
“(People with schizophrenia) improve without fanfare and frequently without much help from the mental health system. Many recover because of sheer persistence at fighting to get better, combined with family or community support. Though some shake off the illness in two to five years, others improve much more slowly. Yet people have recovered even after 30 or 40 years with schizophrenia.”
Froggatt, D. 2007
Recovery Part 2: Concept of Recovery
WFSAD Newsletter: 2007, 3, P1.
For an overview of the research and theory concerning High Expressed Emotion in serious and enduring mental illness read:
Leff J. (1998)
Needs of the Families of People with Schizophrenia
Advances in Psychiatric treatment
Vol. 4 pp. 277-284
Hooley J.M. (1998)
Expressed Emotion and the Locus of Control
The Journal of Nervous and Mental Diseases
Vol. 186, No. 6, pp.374-378
We’ve now reached the end of the ‘Emotional Management’ blog series. I hope it’s been useful and perhaps even entertaining to read.
Feel free to print this stuff and distribute it either physically or electronically to anyone who may find it interesting. All I ask is that you that you don’t edit or alter my words and that you keep my contact details and copyright intact.
I’d also be very keen to receive any feedback about this. You can get in touch with me through the address at the top of every page or via the blog at www.thecareguy.com/blog
Thankyou for reading.
The ‘Emotional Management’ blog series first appeared during 2010 on Stuart’s personal blog. It is reproduced here as part of an ongoing process of ‘rationalisation’ to compress the contents of 5 blogs into just 2. You can download a PDF of the entire series (along with much more free stuff) from www.stuartsorensen.wordpress.com