What follows is an article I sent to the New Zealand Herald. It was obviously too long to publish, and made some statements that are unprintable. Readers may be familiar with much of what I say here because I have said it at some time or the other in this blog. Nevertheless, I thought I would publish it here, in full.
Six Myths about Schizophrenia
Most people entertain a number of misconceptions about psychosis and schizophrenia. In the following article, I will attempt to discredit a number of common errors people make about madness. I will draw heavily on my own life experience to prove my points, and, in many ways, this article is something of a life story. The errors I shall mention are not just entertained by the public – they are even part and parcel of psychiatric dogma. One of the purposes of this article is to show that the psychiatric profession itself can be wrong. This article may be in some ways controversial but I hope I can provoke a meaningful discussion about some important issues.
Myth 1: Schizophrenia is a life-long continuous condition.
Schizophrenia is often considered by the public and psychiatrists as being a congenital disease or disorder that first manifests in late adolescence or early adulthood. It is supposedly incurable but its symptoms can be reduced although not alleviated entirely by medication. Complete recovery, involving a discontinuation of medication, does not occur. This view seems to be the current position of the psychiatric community. People diagnosed schizophrenic are often told that they have a condition like type-1 diabetes, the grounds for this analogy being that type-1 diabetes is also congenital and incurable, and requires daily medication. This model can be referred to as the medical model of schizophrenia.
There is an alternative way of viewing schizophrenia. In the 1970s, a different model was proposed, the ‘stress-vulnerability model’. According to this model, some people are born with or incur as a result of childhood experiences a vulnerability to psychosis; psychosis itself occurs later as a result of life stressors. Mental illness is the result of nurture, not nature. According to this theory, schizophrenia is episodic rather than continuous. I believe the stress-vulnerability model to be superior to the purely medical model in some ways but, as Peter Kinderman points out in The New Laws of Psychology, the stress-vulnerability model can be used to bolster the argument that schizophrenia is a congenital disorder because it suggests that some people are born with a predisposition, vulnerability, to psychosis while others are not. I prefer to believe that anyone can suffer a psychotic episode if exposed to enough stress. In the same way that depression is a natural reaction to bereavement and PTSD is a natural reaction to the types of distressing life-events experienced by soldiers when at war, psychosis is a natural reaction to distressing circumstances.
This view is not shared by many psychiatrists. The inclination among many doctors is to regard the term ‘schizophrenic’ as denoting a category of person when it should rather be considered a temporary condition. For instance, one supposed indication of schizophrenia is a life-long difficulty forming and maintaining interpersonal relationships. What I would like to do now is give a brief history of my life prior to my first psychotic episode, which didn’t occur until the age of twenty-seven. I shall focus on my friendships to show that I didn’t have any difficulty forming interpersonal relationships. Bear with me.
The high-school I went to was Auckland Grammar. During my first years there I had one group of friends but in seventh form I fell in with a slightly different group. It was during seventh form that I met and formed a relationship with my first girlfriend, Danielle. Before I met her, I had already decided to study at the University of Otago and so, after I moved to Dunedin at the beginning of 1998, we decided to have a long-distance relationship. I formed a number of friendships in Dunedin, my best friend there being a chap called Caleb Edwards. After two years studying in Dunedin, I had a choice: I could either stay in Dunedin with the friends I had made there, or return to Auckland so that I could be in the same city as my girlfriend. I decided to come back to Auckland.
During 2000, I didn’t have any friends except Danielle and her friends (I had fallen out of contact with my schoolmates). At the beginning of 2001, she broke up with me. The next year I undertook to study a Masters in English (for which I received mostly quite good grades). I made friends with other students, including a chap called Rene Harrison who I still see occasionally today. In 2001 or 2002 I began working at Royal New Zealand Yacht Squadron and made friends there; I entered into a relationship with a girl called Maya in 2003 who I had met through the Squadron. I hesitate to call her my girlfriend because our relationship was a little complicated. In 2004, I travelled for three months by myself in Europe. That same year Maya moved into a large flat in Parnell known as the Big House, a flat with some twenty tenants, and I came to know some of the residents through her. At the beginning 2006, I moved into the Big House myself; that same year, having been pressured to do so by my father and step-mother, I undertook to study to become a secondary school english teacher.
In a flat with twenty flatmates, one shouldn’t expect to be friends with everyone, but I did have some friends there, my best friends being a chap called Simeon and a chap called Harry. Maya had moved out of Auckland to teach art in Katikati. I found it difficult to juggle the social life of the flat with the intense workload of Teachers Training College and in September dropped out. I hadn’t really wanted to become a teacher but even so being forced to drop out severely knocked my self-confidence. A month or two later, I rocked up to the radio station bFM, on a whim, partly to resuscitate an old friendship and partly because helping out there seemed like something fun to do. I was engaged to write news stories a couple of mornings a week on Mikey Havoc’s breakfast show.
I have written about my experiences at bFM in a blog I keep and, even today, am still piecing together what happened in 2007, at bFM and at the Big House. It is difficult to know when a psychotic episode begins but I believe I began to go a little crazy shortly after the Big Day Out held 19 January 2007. I started to become delusional a couple of weeks later, and a couple of weeks after that stopped working at bFM entirely. For a period, I was more or less well, although I struggled with some depression, and then, shortly after watching the Red Hot Chilli Peppers perform at the Vector Arena with some family members, I became psychotic. I started to believe that the flat was bugged and that I was under surveillance, that my flatmates were divided into angels and demons, that the horoscope was referring to me. I formed a paranoid delusion that I’ll describe later in this article. Things reached a crisis point and I considered drowning myself; my flatmates called my mother and I was removed from the flat. The next day I was taken to the Taylor Centre, the public mental health facility in Ponsonby.
What I attempting to show here is that the idea that ‘schizophrenic’ denotes a category of person is problematic in my case because I didn’t experience a psychotic episode until the age of twenty-seven. Before then I had had a life; although I occasionally experienced a little anxiety and a little depression on occasion, as most people do, I had never experienced real psychotic symptoms. I wish now to show that the ‘illness’ I have suffered since was episodic rather than persistent.
Shortly after my first appointment with a psychiatrist, Antony Fernando, I was prescribed 2.5mgs of Rispiridone daily. I continued to experience psychosis for the remainder of that year. Although the Big House kept aside my room for me in the early days, I only returned there once for a visit. It felt like returning to the scene of a crime. In the early days, I did want to move back into the flat but in reality was too ill to cope effectively there. In 2008, I was very close to totally well, although the drug I was taking produced odd cognitive side-effects. Sometime in the second half of 2008 I broke up conclusively with Maya. A couple of weeks later, an old friend who had been living in the Czech Republic phoned me up and asked if he could stay in my house for a week or two. Later in the year, he moved to Piha and I would occasionally visit him there. I made the mistake of telling a nurse treating me that I had a male friend. He wasn’t even a particularly good friend. But I think the people treating me got the wrong idea.
In January 2009 I became psychotic again. For the first time I started hearing voices. I remained psychotic until August and on August 6 experienced some suicidal ideation. When I told the psychiatrist this a couple of days later, he panicked a little and allowed me to discontinue Rispiridone. Being permitted to stop taking antipsychotics cured my psychosis and I was close to well for the next two months. Then I suffered a sudden relapse. I ended up back in the psychiatrist’s office and was prescribed Olanzapine, the dosage I think being gradually increased over a couple of weeks to 10mgs daily.
I experienced my most intense period of voice-hearing in December 2009 and January 2010. The voices faded away in the first couple of months of 2010. In the second half of the year, I undertook some training at Youthline and also began going to a weekly Pub Quiz that I still attend; although I didn’t make friends through Youthline, I have formed enduring friendships with my Pub Quiz team-mates. In 2011, I unsuccessfully pursued a relationship with a girl I had met at a Hearing Voices group at the end of 2009. Although this part of the essay is concerned with interpersonal relationships rather than work history, I still wish to add that from 2005 until 2013 I worked part-time for the TAB as a call centre operator.
Around 29 January 2012, I asked my psychiatrist if I could be discharged from the Taylor Centre to a GP’s care, and also if I could lower my dosage from 10mgs, the dosage I had been on since late 2009, to 7.5mgs. He agreed. I remember my key worker at the time saying, “It’s okay to hear voices!” – I thought this an odd thing to say because I hadn’t heard voices at all for over a year and a half, but it was easiest not to correct her. I felt so well that I reduced my dosage myself to 5mgs. For all of 2012 I was totally well. During this year, I started and completed a degree, a Masters in Creative Writing through AUT. For this degree, I wrote a film about schizophrenia inspired by the girl I had met at the end of 2009. I was on 5mgs the whole year – in fact, when I travelled to Christchurch to carry out some research for my film, I took the opportunity to go off my medication entirely for a brief period.
In January 2013 I approached my GP (who I saw I think about once every three months) and asked her if I could reduce my dosage from 5mgs to 2.5mgs. I still felt totally well. She advised me to alternate between the two dosages. A couple of weeks later, I became psychotic again and voluntarily reentered the Taylor Centre. During the year, although I was seeing a psychiatrist monthly, I was unwilling to increase my dosage back to 10mgs. The reason I refused to increase my dosage is simply that, by 2013, I no longer believed medication to be the solution to the problem of mental illness. I wanted ‘talking therapy’– I wanted to talk about my family and the reasons I had become ill in the first place. I wanted the truth to be on the record. I wanted the psychiatrists to do their job. This aim has never been successfully realised. Around October or November, the psychiatrist I was seeing, Jennifer Murphy, bullied me into increasing my dosage to 12.5mgs, the highest dosage I had ever been on. Although my mother ensured I took the medication every night, I began trying to vomit it up. My next appointment with Murphy went well – until I honestly told her that I was throwing up my pills. She reacted badly but allowed me to discontinue my medication entirely.
Around February of 2014, I ended up back in the Taylor Centre. I was bullied into signing a form that I didn’t even read by about half a dozen mental health workers. This occurred while my Key Worker was away on holiday. I was sent to a Respite Facility in Point Chevalier for a couple of days and put under observation. I was indeed ‘ill’ at the time but I had good reasons – the memory of a delusion or hallucination that I had experienced in early 2010 had resurfaced, and, furthermore, I knew that regardless of anything I said or did, I was going to be put under the Mental Health Act. Shortly after I was put under a Compulsory Treatment Order. I am still under it today.
Despite receiving 300mgs of Olanzapine delivered monthly via injection, I remained psychotic, although the psychosis didn’t take the form of either delusions or voice-hearing. The worst period occurred at the end of 2014 and beginning of 2015 – it was a reaction to some eight months of seeing weekly an incompetent Clinical Psychologist. The period during which I experienced the most intense voice-hearing (usually while I was lying in bed trying to go to sleep) was 2016. Last year I lodged a complaint against Jennifer Murphy and Antony Fernando with the Health and Disabilities Commissioner; Murphy reacted by doubling my dosage. She did this despite the fact that I wasn’t psychotic at all.
What I am endeavouring to show is that the idea that schizophrenia is a persistent life-long condition is incorrect. I did not experience psychosis at all until 2007 when I was twenty-seven years old; I experienced it again in 2009 and 2013 and continued to experience psychosis after I was put under the Compulsory Treatment order. I have been quite well since the beginning of last year and completely well for the last several months. Aside from my Pub Quiz friends, I have four or five other friends that I see infrequently. Although I only see them infrequently, this should not be taken as evidence of a disorder but rather as a simple side-effect of being thirty-nine. It is the universal problem of someone staring into the abyss of middle age.
Myth 2: The voices a psychotic hears are auditory hallucinations.
Voice-hearing is one of the first-tier symptoms of psychosis – it is difficult to make a diagnosis of schizophrenia if the patient doesn’t hear voices. There is widespread awareness among the public that voice-hearing is the most characteristic feature of schizophrenia; however, many people also completely fail to understand the nature of voice-hearing. In fact, the psychiatric profession itself completely fails to understand it. To explain voice-hearing, one needs to understand the nature of consciousness.
People think. If a person is walking around the streets, or lying in bed, or doing anything at all, he or she maintains a kind of running commentary in his or her mind, an internal monologue. It can take the form of memories, of rehearsing or recollecting conversations, of writing essays in one’s head, of imagining possible future scenarios, and so on and so forth. This is sometimes referred to as ‘self-talk’. Many people have had the experience of getting a song stuck in their heads, a phenomenon known as an ‘earworm’. The verbal nature of consciousness is displayed through the literary technique known as ‘stream-of-consciousness’, a technique employed sometimes by Tolstoy, by Joyce in Ulysses, by Virginia Woolf, and more recently by Will Self in Umbrella. When we recognise the verbal nature of consciousness, it becomes easier to understand the phenomenon of voice hearing. The voices a psychotic hears are not literally auditory hallucinations; rather they could be better described as thoughts that the sufferer attributes to outside agents. The defining feature of psychosis is the feeling that one’s thoughts are not one’s own.
I first started hearing voices in late January 2009 (after I had been taking antipsychotics for over a year and a half). I had spent much of 2008 trying to derive the Special Theory of Relativity from first-principles and had eventually succeeded; lying in the bath one night, I decided to try to do it again in my head. I ran into difficulties. Then I heard a voice say, in a Texan accent, “Do you want George W. Bush to help you?” Deciding that the former president would by of little assistance, I changed the subject. We talked. I asked him, “Are you straight?” He said, “I think so.” I asked him if he believed in God and he said, “No.” I asked him how then we could be communicating and he replied, “Midi-chlorlans”. After I got out of the bath, we talked a little more – I asked him what the real reason was for the war in Iraq and he replied with some bosh about “the clash of civilisations”. I said to him, “You do believe in God, don’t you?” He said, “So you do know a joke when you hear one.”
From the beginning, my experience of voice hearing was always accompanied by the delusion that I could communicate telepathically with other people. Starting in 2008, I had been a regular viewer of The Daily Show with Jon Stewart; partway through 2009 when I was lying in bed, I heard Jon in my head. He said, “Who the hell are you, anyway?” I said, “Just a poor little schizophrenic living in New Zealand.” He said, “Are you straight?” I said, “I think so.” He said, “What’s the time difference?” I said, “About eight hours.” We talked for a bit. The next day, on his show, he seemed to refer to the conversation we’d had the previous night. After this, and because of this, I adopted Jon Stewart as an imaginary friend.
My most intense experience of voice-hearing occurred in December 2009 and January 2010. I imagined I was talking to Jon and the girl I’d met at a Voice Hearing support group, a girl I call Jess, from the moment I woke up until the moment I went to sleep. They used to tell me jokes all the time. I was continually giggling to myself. Memorably, there was a night when I was explaining to Jess that many African-Americans think milk in schools is a honky conspiracy because so many African-Americans are lactose intolerant. Jon, who in real life is lactose intolerant, broke in to say, “Lots of us feel that way.” To which John Oliver said, “Jon Stewart - are you black?”
I’ll provide one last example from my own experiences of voice-hearing. In around 2014, I was lying in bed and I heard Jess in my head. She said, “I have the perfect word to describe you – sesquipedalian.” I thought to myself, “What the hell does sesquipedalian mean?” I climbed out of bed and went and Googled it. I found it meant, “Lover of big words.”
The reason I have included these examples of voice-hearing from my own life is to show that my experience of voice-hearing was always one of conversation, dialogue, with others. Obviously this means that my experiences can’t be described as auditory hallucinations. Other people have different experiences. Probably the most common form of this symptom of psychosis is that a person hears an unidentified voice that tells the person what others think of him or her. Some overhear conversations between two or more other people. Sometimes psychotics give their voices names as I did. I know a woman who talks, or used to talk, to pop stars like Rihanna and Beyonce; this woman told me that she believed the voices to be guardian angels simply pretending to be celebrities. Another woman I spoke to recently, a woman I think in her late thirties, described a little her own experience of voice-hearing. She had suffered “adverse life experiences” when a teenager (although she didn’t elucidate what these life experiences were and I didn’t press her to explain). Since then, she had heard the voices of two men, aged in their mid thirties, who would either talk with each other or talk with her. She had noticed that neither man grew any older. The two men were often verbally abusive. The woman told me she thought the men blamed her for not protecting them when she was young. After she told me this, I commented, “That’s an odd thing to say. Perhaps you should blame them for not protecting you.”
Some psychotics do indeed experience occasional auditory hallucinations but I believe the reason why voice-hearing is thought to be so common is because psychotics often misdescribe their experiences. It is easer to tell doctors and mental health workers that they hear voices rather than explain what is more likely true, that what they are doing is misattributing thoughts to outside agents. The voices I used to hear were always imaginary friends and were never abusive, but many psychotics hear abusive voices. I don’t know why some psychotics hear friendly voices (as John Nash for instance did) and others hear abusive voices. I wish I did know why.
3. Myth 3: Delusions are Permanent
Early in my treatment, I was told by my psychiatrist that “delusions are fixed, by definition”. He told me this even though he didn’t know what my delusions were. In the same way that the public and mental health workers don’t recognise that psychosis comes and goes, so also do they fail to appreciate that a delusion can be transient. Once again I’ll draw from my own life experience to prove this point.
Around March 2007, when I first became psychotic, I formed the delusion that the world was ruled by a conspiracy of closet homosexuals. I even went so far as to decide that George W. Bush was a closet homosexual. I never spoke of this to anyone because I thought that if I exposed this conspiracy, I would be killed. My situation wasn’t improved by the fact that, at my first appointment with a psychiatrist, I decided that he was a member of the homosexual conspiracy. This delusion was extraordinarily involved: I believed that the Nazis were all closet homosexuals and that the Jews were all straight, I believed that Whanganui was a small enclave of enlightened heterosexuals who had fled there to escape all the closet homosexuals who made up the bulk of the rest of the population, I believed that this social stratification was the subject of the song Working Class Hero by John Lennon. I strongly suspect, now, and have for some time, that the writer of the film The Departed, William Monahan, must have had a similar paranoid delusion sometime in his life.
This delusion had disappeared by the beginning of 2008. Certainly, after I spoke with George W. Bush in January 2009, the delusion that he was a closet homosexual never came back and perhaps had disappeared long before that. Although I experienced psychosis again for much of that year, 2009, a psychosis characterised by the delusion that I could communicate telepathically with others, the homosexual conspiracy delusion never returned.
Another delusion I held in those early years was that there was a listening device in my glasses and that everything I said was being relayed to third parties, perhaps the media. This delusion greatly restricted my ability to talk with others about the things that I believed. This delusion took hold shortly after I became a patient of the Mental Health Services and was prescribed antipsychotics; it also went away at the beginning of 2008, returned very intermittently in 2009, and vanished for good in January 2010.
Commonly people don’t ascribe meanings to delusions but in truth every delusion has in fact a secret meaning. I believed that the world was ruled by closet homosexuals – gay men who married gay women and bore children by them. In other words, I believed that the world was ruled by liars and sociopaths, by people with no love in their hearts. The delusion that there was a bug in my glasses came to me because I sensed that if I talked about the things I believed that I would get into trouble; it was a delusion elicited by the culture of the Mental Health Services, a culture in which nothing is discussed openly.
I was not psychotic or delusional against until early 2013. When I became psychotic again, that year, my madness was very much motivated by a fear that my friend Jess was going to turn into a lesbian. This cannot, however, be regarded as a delusion because, in a way, it actually occurred – she did turn into a lesbian. A second belief I formed at the beginning of the year was that there was doubt about my sexuality in the public arena, particularly in the media; later in the year I even became afraid that I had been publicly outed as gay even though I’m not. I thought, stupidly, that if approached the Mental Health System again, sought treatment from a different psychiatrist, and told him or her that I was straight, that this fact would filter out into the collective consciousness. I still don’t know if this belief, that I had been mistakenly outed as gay in 2013, was delusional or not.
I might finish this section by saying a little about the psychiatric attitude towards homosexuality. I think most psychiatrists seem to have ridiculous views about this topic. The only logical conclusion I can draw from my interactions with them is that most psychiatrists are queer and project their own sexual confusion onto their patients. By ‘queer’, I mean that a lot of male psychiatrists secretly frequent gay brothels and fantasise, when they masturbate, about sticking their dicks in the mouths of their heterosexual male patients. I should say that I don’t have conclusive evidence for this belief. However, my interactions with psychiatrists over the last twelve years, and the attitude of the clinical psychologist I saw in 2014, suggest strongly to me that many people working in the Mental Health System don’t seem to believe that heterosexuality exists, and seem to believe that everyone is bisexual.
Myth 4: The mentally ill are stupid.
The psychiatric profession continually seeks to describe the ‘typical schizophrenic’. Some ten years ago, and perhaps still today, it was believed that schizophrenics lack verbal fluency and have problems with abstract thinking. At my first appointment with a psychiatrist he said, “Well, you’re certainly verbally fluent!” although this assessment didn’t prevent him from leaning towards me and telling me that his sister was schizophrenic, encouraging me to believe that I had been diagnosed schizophrenic myself.
Of course, the idea that the mentally ill are stupid is just another bogus idea invented by the psychiatric profession. As someone who has been a student of English literature, I am and have always been aware that there is a strong link between intelligent creativity and mental illness. Ernest Hemingway, Virginia Woolf, and David Foster Wallace all killed themselves. A case could be made that Woolf was schizophrenic. In Mrs Dalloway she presents a character, Septimus, who has suffered shell-shock during the First World War – her descriptions of his psychosis could only have been written by someone who had experienced psychosis herself. Although it isn’t mentioned in his wikipedia page, there is internal evidence in the short stories of the famous writer Donald Bathelme that he experienced mental illness, possibly schizophrenia. When one reads his stories, it is difficult to know if they are works of genius or works of madness.
I believe that in terms of intelligence Mental Health patients lie on a bell curve, a bell curve that pretty much corresponds with the bell curve of intelligence in society as a whole. Some schizophrenics are very smart indeed (an obvious example being John Nash). I myself am highly verbally fluent and possessed of a strong capacity for abstract thought, although it is possible that many years of antipsychotic medication have reduced my IQ somewhat. There is some research that suggests that a sense of humour correlates with abstract thinking ability, and I certainly used to have a sense of humour. My friend Jess, also diagnosed schizophrenic, is an accomplished poet and short story writer, proving once more, if we need further proof, that schizophrenics can be verbally fluent. This same woman received an A+ in a paper on logic through Auckland University. It is another hardship borne by the mentally ill is that they are often treated as stupid by those tasked with caring for them, when sometimes they are cleverer than the people treating them.
Myth 5: Antipsychotic medication helps
Because mental illnesses such as schizophrenia are literally considered illnesses, it seems that medication is the appropriate form of treatment. Kinderman puts it in the following way:
"Too much of our language, even the use of the term ‘mental illness’, implies that people in emotional distress have medical or biological problems. Since medical terminology and procedures are used, professionals and the public alike tend to assume incorrectly that people are ‘suffering’ from ‘illnesses’, rather than recognising that problems represent a meaningful human reaction to difficult circumstances. The hugely impressive scientific insights of neuroscience can sometimes be misused. People are damaged by the continued and continuous medicalisation of their natural and normal responses to their experiences. People are often very distressed and should be helped, but this does not need to be described as ‘illnesses’ or ‘disorders’. If we regard these experiences as ‘disorders’, it implies they are abnormal. In what sense is it a ‘disorder’ if we remain distressed by bereavement after three months or ‘pathological’ if we are traumatised by the experience of industrialised military conflict?" (p. 29)
Within the New Zealand Mental Health Service, there is considerable medicalisation of mental illness. An assumption exists that patients must be suffering from something like a congenital disease to be diagnosed mentally ill and that the best and often the only form of treatment is medication. To make matters worse, if a patient refuses to accept the idea that medication is the right answer, this refusal is itself seen as evidence of illness, of a lack of ‘insight’. This puts patients in a Catch 22 situation. If a patient wishes to discontinue medication, this can often be used as a justification to keep a patient on it (or increase it or switch the patient to another medication).
From my own experience and from my observations of other patients, I do not believe that medication is at all effective. At best, it treats the symptoms rather than the causes of mental illness. My own recovery in early 2010 had little to do with medication, and my current wellness has everything to do with a blog I have been writing since 2015 and nothing to do with the drugs I am forced to take. This might seem an outrageous claim – I know that there is some research out there suggesting that medication works. But much of this research is paid for by pharmaceutical companies who have a vested interest in selling antipsychotics, antidepressants, anti-anxiety medication, and sleeping pills. There are also some powerful voices on the other side, speaking out against the prevailing medical orthodoxy that antipsychotics are the appropriate treatment for madness. An example of such an apostate is British psychiatrist Joanna Moncrieff (who wrote a book called The Myth of the Antipsychotic). Another is Pulitzer-prize winning journalist Robert Whitaker.
One theory of schizophrenia is the so-called ‘dopamine hypothesis’. According to this theory, the brains of schizophrenics produce too much dopamine, and antipsychotic medication is the appropriate form of treatment because it dampens down the dopaminergic system. Patients are often told this, that their problem is an excess of dopamine – for instance, at my first or second appointment with a psychiatrist, I was told that I had suffered a “dopamine explosion”. However, as Whitaker points out (the clip of his presentation is on Youtube), although psychiatrists often tell patients that they have a dopamine imbalance, the psychiatric profession itself hasn’t believed this hypothesis since at least the ‘nineties. Is it any wonder that mental health patients suffer paranoia, when the psychiatric profession itself lies to them all the time?
Whitaker in fact goes even further than saying that antipsychotics are unhelpful. He argues that antipsychotic medication itself causes schizophrenia. The argument is so simple that it must be true. Antipsychotics work by blocking dopamine receptors on neurones; if a person takes antipsychotics for any extended period of time, the brain attempts to restore homeostasis by growing additional dopamine receptors. This means that over time patients become neurologically dependent on antipsychotics and suffer withdrawal effects if they attempt to go off them. The psychiatric profession and public alike believe that if a patient becomes ‘ill’ as the result of discontinuing medication, this is proof of an underlying condition that the medication controls. The idea that people may well suffer withdrawal effects, probably temporary, if they discontinue medication, although obviously true, is deliberately discounted, because it threatens the whole system, the myth that ‘schizophrenic’ denotes a category of person rather than a temporary condition.
Yes, the urban myth of the schizophrenic who secretly goes off his or her medication and becomes ill as a result is true. I have seen it myself. However the full truth is probably more complicated. If a patient secretly discontinues his or her medication, the patient may well suffer withdrawal symptoms as I pointed out above; an additional stress in the person’s life is that he or she has to try to keep these symptoms secret from those around him or her. I knew a patient who secretly went off his medication and, during this period, felt well and was even told by others how well he was doing; one day, a smell of cannabis was noticed around the complex in which he was living and all the rooms were searched. When they searched Robert’s room, they found all the medication he had been spitting out. Robert told me that he did become sick again – but only after those treating him had discovered that he had stopped taking his medication. Obviously this complicates any simplistic notion of a direct link between medication and mental health. I wish now to make a strange claim. I believe that one cause of mental illness is having others around the person believing that person to be mentally ill.
I have also known people who have suffered psychotic episodes, weren’t put on drugs, recovered and went on to have fulfilling lives, involving productive work and real relationships.
It might yet be argued that antipsychotics, even if they do no good, do no harm. However this proposition is also difficult to maintain. Some decades ago, a post-mortem examination of the brains of schizophrenics found that the schizophrenics had reduced brain volumes compared to the rest of the population. The psychiatric profession reacted to this study by resurrecting an old idea that schizophrenia is a neurodegenerative condition; they concluded consequently that antipsychotics must prevent brain-shrinkage. I was even told explicitly by my psychiatrist, I think in 2007, that schizophrenia causes people’s brains to shrink. It was his way of compelling me to take medication. There is however a significant problem with the study. All of the schizophrenics examined in it had been taking antipsychotics all their lives. This raises a basic question: is it the ‘condition’ or the drugs that cause the brain shrinkage? In 2005, a study was conducted on macaque monkeys in which some were put on olanzapine and haloperidol and other were ‘prescribed’ a sham drug. The monkeys put on antipsychotics ended up with reduced brain volumes. This study proved conclusively that it was the drugs, rather than the condition, that caused the brain shrinkage.
Psychiatrists are quite prepared to lie to protect each other and their precious medical model. I’ll cite some examples from my own life to show this. A legal right I have as someone under a Compulsory Treatment Order is that I can request an Independent Review. At this review, which lasts maybe an hour, the patient sits with his lawyer, psychiatrist, key worker, and family members across the room from a review board consisting of a psychiatrist, lay-person, and solicitor. It is illegal to talk about what goes on during these reviews but, as the subject of the reviews, I believe I myself am legally entitled to talk about it. At my first Independent Review in 2015 (I have had about four) it was asserted that I was taking 12.5mgs of Olanzapine daily in 2012 and that I became ill again in 2013 because I had reduced it, myself, without consultation, from 12.5 to 2.5mgs. Of course, in 2012 I was actually only on 5mgs of Olanzapine. I told the panel this and even quoted from my medical notes to prove it. In the decision, they ignored my testimony and the doctor’s own notes, and said that I had become ill as a result of reducing my dosage, myself, from 12.5mgs to 2.5.
I’ll tell another true story about another review I had, I think in 2016. At this review, the psychiatrist on the panel wouldn’t even look at me. He piped up I think only once, asking, “How often do you see your mother? Once a week?” My mother replied, “Try every other day!” During the hearing, I asked him, “What do you think the cause of schizophrenia is?” I knew more or less why I had first become ill but it was too complicated to explain to the panel at that time in that place; my question was an act of aggression. I knew but he didn’t. He wrote in my decision, “He said rather poignantly that if he knew the cause of his illness, he would argue his case better” – another barefaced lie by another fraud.
An indication of the moral and intellectual bankruptcy of the psychiatric profession is the way that they routinely lie about their patients.
Myth 6: Schizophrenia is causeless
Last year, I had a key worker, a nurse, who asked me on one occasion if I thought schizophrenia was caused by a kind of magic. When I brought this up with her a little later with others around, she said I had misremembered what she had said and that she believed schizophrenia to be hereditary. I got rid of this key worker shortly after because I felt I couldn’t trust her to tell the truth about me. Her attitude however indicates the general attitude of the Mental Health Service to mental illness, that it is somehow causeless. Also sometime last year, I heard a little voice that said, “The way out is the same as the way in.” I’ll conclude this article by giving some small idea of the cause of my ‘mental illness’.
When I first made contact with the Taylor Centre in 2007 I found myself in a room with the woman who was to become my Key Worker and another psychiatrist, Trish Van der Krellen. I told them, “My father’s gay, he divorced my mother when I was seven because he didn’t want me to be gay, and I want to come out as straight!” At this first contact, I wasn’t really psychotic although I became psychotic again shortly after. A proper understanding of this statement is essential to understanding my illness. The important part of it was the wanting to “come out as straight” – essentially I believed, I think correctly, that a rumour that I was gay had got out among some of my acquaintances, that this was the root cause of my paranoia, and I simply wanted to be recognised by others around me as heterosexual. The belief that my father was gay was a delusion. As best as I can reconstruct my thought processes at the time, there were three reasons why I decided that my father was gay. First, it would explain why I was friends with so many closet homosexuals and so strongly supported gay rights. Second, the contrast between myself and my father was necessary to make my justify my desire to “come out as straight”. Third, I think I decided to out my father as gay because he was the straightest man I knew.
Kinderman says that episodes like psychosis are natural responses to distressing circumstances. To think one has been outed as gay when one isn’t can be a highly distressing situation in which to find oneself. In the real world, heterosexual people never need to tell others that they are heterosexual – yet this is precisely the situation Mental Health patients often find themselves in. We could term it the Tom Cruise Syndrome. I have seen it over and over again among patients diagnosed schizophrenic. A part of the problem is that for reasons of privacy, patients are never asked how they identify in terms of sexuality, creating a culture of suspicion within the Mental Health Service. It is possible that in the same way schizophrenics are supposed to have difficulty forming interpersonal relationships, and are supposed to lack verbal fluency and abstract thinking ability, the psychiatric profession may believe that all schizophrenics are bisexual. During the years I was treated by Fernando, he never asked me if I was gay or straight. But on one occasion, in 2009 before I went off the Rispiridone, he asked me in a deliberately off-hand manner, with my parents in the room, “Do you stand up for yourself or are you a people pleaser?” I had no idea what he was talking about but plumped for “people pleaser” because I was afraid of him. When I said this, the psychopath smirked.
It is tempting to say that the psychiatrists will all burn in hell after they die – but we should try to be more forgiving. Fernando, in his public statements, says that compassion is like a muscle that can be strengthened through practice – so perhaps we should try to feel compassion for the psychiatric profession. Psychiatrists are products of their genetics, upbringing, and eduation, as much as anyone else, and shouldn’t be held responsible for the crimes they commit daily and have committed for well over a hundred years. It is not their fault that they tend to be incompetent, dishonest, and sadistic.
Really the causes of my ‘illness’ are simple. I incurred a vulnerability to psychosis as a result of my parents’ divorce when I was seven, a childhood trauma that made me very sensitive to how others perceived me. My first psychotic episode was caused by my experiences at bFM and the Big House. Every subsequent episode was caused either directly or indirectly by the Mental Health Service itself. In order to completely recover, I needed to work out the cause of homosexuality – in short, I now believe, like Ian Wishart, that homosexuality is a choice but, unlike Ian Wishart, I do not believe it to be immoral. If, however, I had been recognised as genuinely heterosexual by the people treating me, if I hadn’t been put on medication, if the people treating me had made the slightest effort to find out the real reasons I had become ill, I believe I wouldn’t have needed to take this path to recovery and would have recovered in a year. Is it any wonder I hold a grudge against the psychiatric profession?
