Love is Progressive Part 34: How Should We Treat Schizophrenics?

I used to have a schizophrenic girlfriend. Her name was Edna, and she was a sweet and lovely gal. Her family had come from southern China where they spoke an unusual dialect, and Edna had unusually light brown eyes for a Chinese (lighter than my eyes). There was a very innocent, childlike quality about Edna which I found lovable and adorable. However, she really didn't know truth from fantasy, and her condition made bad thoughts intrude upon her mind -- for instance, thoughts of her body being invaded by parasites, thoughts of being abandoned by humanity and left without friends, thoughts of people around her being against her and not really caring, despite all evidence to the contrary. She had to carry a special water bottle because she was afraid that public water sources would be contaminated. She read the Bible, well, religiously, thinking that reading it through would solve her problems. She was kept in the dark about her schizophrenia. When Edna told me what pills she was taking, I asked my physician father, and he confirmed, as I had suspected, that they were antipsychotic medications. But they were being prescribed by an ordinary physician, not a psychiatrist, and nobody in Edna's family let on -- if indeed they knew -- that she was a paranoid schizophrenic. Edna, for her part, thought that the pills were being prescribed for the parasites that she was convinced had invaded her body.

According to Edna, things went bad for her when she was in graduate school, training to become a teacher -- so clearly she had been a fairly bright student. She was in her early 20s at the time, which would be a typical timeframe for schizohprenia to appear in those who develop it, especially among women. (Male schizophrenics tend to be somewhat younger when it develops, such as in the late teens.) Coincidentally, I also had a female graduate school classmate, Anne, who became paranoid schizophrenic in the second and third years of graduate school. Anne was recently married and had a young son at the time. It's thought that in addition to a genetic predisposition, which probably involves multiple genes, schizophrenia is catalyzed by stress in the person's life, which somehow results in dopamine activity in the brain going out of control, creating unrealistic, intrusive thoughts and perceptions. Despite the genetic connection, Edna had no other known relatives with schizophrenia. Perhaps hers was a rather idiosyncratic case. Her pitiful descriptions of her childhood made it clear that she had always been painfully shy and senstive, which is probably typical of future schizophrenics. Perhaps from the lens of the present, Edna's past seemed even more bereft of good company and friendship than it really was, but certainly she was shy and socially awkward. I do know that her family were nice people. Her parents didn't seem very well educated, but her sister was a pharmacist and her brother was college educated as well, and all of them were supportive of Edna in their own ways. There had been another older sister, but she had died of cancer, an event which I think contributed to Edna's health fears greatly, as she often talked of her departed sister.

Edna kept breaking up with me, and I would make up with her again when this happened, on several occasions. But eventually, my intuition told me that there is no way that a person such as Edna with her "broken reality checker," as Erich Fromm called it, could ever be in a healthy romantic relationship or marriage; thus, I let her break up with me permanently and let her blame it on me all she wanted to. I also avoided ever consummating our relationship, as we were both virgins and being the way that I am, I don't think psychologically I would have had it in me to break up with Edna after that point; the sense of commitment along with the potent combination I am sure, of oxytocin, norepinephrine, dopamine, serotonin, endorphins and whatever other feel-good neurotransmitters and hormones are involved in the sex act, would have been overwhelming to me. Thus, Edna and I parted ways, although I felt like a failure of sorts in doing so, having had to relinquish somewhat my belief in my ability to perform miracles of love. Instead, I wound up falling in love with and marrying Zunliang, whom I had already known for 3 years and with whom I was close friends as well as a former dating partner. Ironically, Zunliang's main career had been running a mental hospital which mostly treated schizophrenics.

Erich Fromm, however, said that "broken reality checkers" came from not receiving enough love. We know from research on schizophrenia, that this isn't true. The problem with schizophrenics isn't that they don't have enough love, but rather, their brains have a biochemical imbalance, which makes reality difficult for them to comprehend. It is not the fault of the parents or anyone else that the person is like that, although life stress plays a major role. As a matter of fact, I did some checking and found that only about 35% of schizophrenics ever get married, and most of those get divorced. Female schizophrenics are more likely to marry than males, possibly due to their later onset, but the rate is still low. My friend Simon, who did his dissertation on outpatient schizophrenics, had similarly startling marriage and divorce statistics in his sample. Schizophrenics have great trouble trusting or relating to other people normally, due to their condition, making such close relationshiips very difficult for them.

How should we treat schizophrenics, then, in a loving and helpful way? I found an article on Helpguide.org entitled "Helping a Person With Schizophrenia: Overcoming Challenges While Taking Care of Yourself" (http://www.helpguide.org/articles/schizophrenia/helping-a-person-with-schizophrenia.htm). The name of the article is telling -- the first section of the article was about avoiding being overwhelmed by the challenges of being around a schizophrenic. Schizophrenics can be very diffiicult for a person to deal with. There were no special techniques for dealing with a schizophrenic. The article basically summarizes good relationship skills for dealing with someone who is afflicted with schizophrenia. Some general advice given in the artcle was as follows:

"In order to deal successfully with schizophrenia and help your family member, it’s important to:
•accept the illness and its difficulties
•be realistic in what you expect of the person with schizophrenia and of yourself
•maintain a sense of humor

Do your best to help your family member feel better and enjoy life, pay the same attention to your own needs, and remain hopeful."

In addition to taking care of oneself, the article discusses supporting treatment, monitoring medication, watching for signs of relapse, preparing for crisis situations, and exploring housing options.

In the sad case of Edna, since her family did not inform her (if even they were fully aware of it) of her condition, only the aspect of moniotring medications was probably adequately addressed. Things might have changed since that time, but that is what I obsevered. This would not only be bad for Edna, but create more problems within her family. My graduate school friend Anne was similarly unaware of her condition at first, but I think her husband eventually told her, with my encouragement, when he realized what was happening to Anne. She was subsequently able to obtain treatment, I gather and finished her Ph.D. I now realize that I should have spoken to Edna's family members more about making her aware of her condition and treatment, but my focus was on Edna at the time.

I just looked Edna up on the internet, and was able to locate her immediately; apparently, she is still living in her parents' house. I could have found out more information about her if I had paid, but there is no need to do that.

Basically, helping a person who is schizophrenic means being compassionate and supportive, loving the person even if that person's Love-O-Meter doesn't work well, and understanding that the person will probably never be fully normal, although some function better than others. It's not other people's fault, so family members should not blame themselves or let themeselves be overwhelmed by the schizophrenic's problems, but they should endeavor to help the schizophrenic the best they can. Who knows what will happen? Some schizophrenics recover enough to lead very productive lives, especially with the proper support. How society treats those with psychopathlogy is an indication of how advanced the society is, morally. That is true of individuals as well.

Comments

Roland de Brabant's picture
Roland de Brabant 5 years 9 weeks ago
#1

Chemical imbalance is a total cop-out. Chemical imbalances cause people to feel hungry or horny. Fromm was right; in the years before WWI schizophrenia was being treated successfully in the Netherlands. But it was too labor intensive for us. And we have proven the we (in the Us) are utterly incapable of providing mental health care; our mental hospitals were uniformly factories of attrocity.

Roland

Robindell's picture
Robindell 5 years 8 weeks ago
#2

There are psychiatrists in Europe and other continents who use the same pharmceuticals that are used in the U.S. Doctors have many years of education and training. I would trust their judgment for a serious condition such as schizophrenia over someone who is does not have the necessary training or at least first-hand experience. You (Roland) are making a false and misleading statement in saying that we are "incapable" of providing mental health care. The criticism could be made that some people unncessarily undergo treatment with medication, or seek out psychiataric care when they don't really need that level of help. (Not everyone who prefers to remain single or is unable to find a suitable partner is schizophrenic or mentally ill.) Those with a political axe to grind want reality to fit their preconceptions and version of reality. There are people who have been helped not only medically, but with housing, and, in some cases, with employment. The problem is that housing and the clubhouse model and supported employment, the latter having been designated as an evidence-based practice, are not adequately funded and are not sufficiently available to all who need these types of services. Robert Okin, M.D., a San Francisco psychiatrist and former mental health commissioner of two eastern states interviewed and also photographed homeless mentally ill people in San Francisco from whom he received permission to tell their stories. Abuse did factor into the lives of several of the people whom he interviewed. The book is called Silent Voices. Dr. Okin was interviewed (by Diane Rehm) and from what I could gather, has treated many mentally ill people as a psychiatrist. But he went the next step and talked to homeless mentally ill people not as a doctor, but as a concerned citizen who would like society to do much more to help those who are affected as Natural Lefty described above. State mental hospitals have been both closed and downsized, but community mental health centers and housing agencies never received enough state and federal funding to help the many people who have conditions such as schizophrenia. Some people confuse the kind of mental illness that Natural Lefty is talking about with the the high level of social dysfunction that exists in the U.S. I have found that members of the public often do not seem to know how to communicate effectively and appropropirate when conducting mundane, daily business. They sometimes act as if employees can read their minds, rather than finding a pleasant, business-like way to convey how they want to be served. One statistic I recently heard that is rather telling is that America has more traffic accidents than does any other country. Drivers in Italy sometimes were depicted as being rather erratic, but that seems to be something of a stereoptype compared to which country has the most accidents. America has a problem with drunk driving and with people who text while driving, but I think there are many people in this country who are angry and aggressive, impatient, and who lack a sense of being on a public street or highway, because of the individualistic, isolated nature of American culture and society. There is much rudeness, intolerance, and uncivil behavior in everyday life. Finally, we may be the leaders when it comes to multiple shootings including suicides by psychotic individuals. The individual who shot his girlfriend in Baltilmore and then wen to New York City and tragically killed two police officers was described in the news by his family as having had an undiagnosed mental illness. Mentally ill people often are not inclined to make an appointment with any kind of doctor, let alone a mental health professional. They often do not recognize their problems as stemming from an illness. I have heard of families who try and get an mentally ill person hospitalized so the person can be evaluated and stabilized, but there is a lack of inpatient beds for psychiatric patients who need to be in a protective setting. I just saw in a local paper that a county police officer was suspended for apparently using his taser on a man who was threatening to commit suicide in the basement of his house. I think Natural Lefty you would also be interested in another statistic I recently heard from a reliable news source, that 57% if I recall that exact figure of all deaths in the U.S. from gunfire are from suicides, in which the people shot themselves, fatally. More than half of all people who die from gunshot wounds took their own life. Some of these people may not have been depressed from clinical depression, but may have been facing impossible, unfair financial circumstances. Some may have had a breakup in a relationship. In downtown Chicago recently, the ex-boyfriend of a employee of Nordstrom's department store entered the store, shot the woman fatally, and then killed himself. The store was closed for a few days and then reopened. I think the man was a student at the Unversity of Chicago. He was described as suffering from some form of mental illness.

Natural Lefty's picture
Natural Lefty 5 years 8 weeks ago
#3

Robindell, thank you for your comments. I did not know that the U.S. has the highest traffic accident rate in the world. That's surprising given how people in some ohter nations drive. (I have seen it in Taiwan in particular.) I think you are probably correct about aggressive driving and indiviualism being to blame. I also didn't know that 57% of shooting deaths were suicides, but that does not surprise me, and I think I did hear something to that effect before.

I know that you are pretty knowledgeable of the mental health care system, Robindell, and I basically agree with everything that you have to say about that. I am not an advocate of psychotherapeutic drugs in general, but schizophrenia and bipolar disorder are the only 2 psychological disorders where those afflicted usually seem to need them. There may be exceptions to that, and in fact, some schizophrenics can be successfully treated without medication, but this is not the norm, as Roland implies. My wife Zunliang knows all about that too as she used to treat mostly schizophrenics in Tung Hong Hospital, which she ran in Kaohsiung City, Taiwan. No matter what psychotherapy a schizophrenic is receiving, most of them become very strange (even stranger than usual) after not taking medication for a week or two. The unsolicited thoughts start popping up in their minds, and they don't know how to distinguish them from reality or what to do about them, except in the more insightful schizophrenics who can learn to ignore them. Perhaps therapy can help schizophrenics gain such insight, but that cannot be relied upon according to what I have heard.

To make it clear, as I mentioned in a recent post, a growing percentage of the adult population has never been married. This is much more than the 1% which is the percentage of schizophrenics in the population, so clearly, most unmarried adults are not schizophrenics, never have been nor ever wil be. I know quite a few people who are single well into their adullthood who are not psychologically disordered at all, but for one reason or another have not been married. Schizohprenics, however, have a particularly difficult time being in a trusting, responsible, loving relationship. I think I handled the situation with Edna well and wisely in retrospect, except that I wish I had spoken with her family more about her situation.

DdC's picture
DdC 5 years 8 weeks ago
#4

Marijuana-Like Drugs Could Treat Schizophrenia, Study Suggests
May 20, 1999 - Irvine, CA, USA
http://norml.org/…/marijuana-like-drugs-could-treat-schizop…
Researchers at the University of California, Irvine, speculated that the body may be producing higher amounts of the chemical, called anandamide, to fight the disease, "Our findings of high levels of anandamide in these patients does indicate that [it] plays an important role in the development of the disease," Daniele Piomelli, an associate professor of pharmacology at UCI, said. He noted that "many schizophrenics smoke marijuana and claim it eases some of their symptoms.

Study: No Marijuana Link To Schizophrenia
http://www.cannabisnews.com/news/19/thread19359.shtml
There is no scientific proof that cannabis use induces schizophrenia, Dutch scientists say, questioning recent research and an argument the Dutch government uses to crack down on marijuana-selling “coffee shops.”

Are People with Schizophrenia Drawn to Smoking Pot
http://www.cannabisnews.com/news/1/thread1490.shtml

Drugwar Lies Linked to Schizophrenia
http://tinyurl.com/DrugWorrierLies-Schizophrenia

Marijuana May Prevent Memory Loss by Reducing Brain Inflammation
http://www.collective-evolution.com/…/marijuana-may-preven…/

New study shows youth-cannabis use leads to better cognition,
not Schizophrenia or defunct memory.

http://forum.grasscity.com/…/1290483-new-study-shows-youth-…

Marijuana Users Have Better Cognitive Skills, Study Finds
http://www.leafscience.com/…/marijuana-users-better-cognit…/
A new study on college students has linked marijuana use with better performance on certain brain-related tasks.

In 1974, California Governor Ronald Reagan was asked about decriminalizing marijuana.

After producing the Heath/Tulane University study, the so-called “Great Communicator” proclaimed, “The most reliable scientific sources say permanent brain damage is one of the inevitable results of the use of marijuana.” (L.A. Times)
The Hype: Brain Damage and Dead Monkeys
http://www.electricemperor.com/eecdr…/…/EMP/15/ECH15_03.HTM…

Marijuana May Live Up To Be The Elixir of Life
http://www.cannabisnews.com/news/thread21194.shtml
A study by University of Saskatchewan researchers suggests beneficial aspects of smoking marijuana at least among rats, who appear to have sprouted new brain cells and besides benefiting from reduced depression and anxiety.

"Marijuana Use and Mortality"
The Kaiser Permanente study
April 1997 American Journal of Public Health"

"Relatively few adverse clinical effects from the chronic use of marijuana have been documented in humans. However, the criminalization of marijuana use may itself be a health hazard, since it may expose the users to violence and criminal activity."

Study Turns Pot Wisdom on Head
http://www.cannabisnews.com/news/thread21191.shtml
Most "drugs of abuse" such as alcohol, heroin, cocaine and nicotine suppress growth of new brain cells. However, researchers found that cannabinoids promoted generation of new neurons in rats' hippocampuses.

Toke-A-Day May Keep Old Memory Functioning
http://endingcannabisprohibition.yuku.com/topic/1502
The more research they do, the more evidence Ohio State University scientists find that specific elements of marijuana can be good for the aging brain by reducing iNFLammation there and possibly even stimulating the formation of new brain cells.

Using Pot To Save Brains!
http://endingcannabisprohibition.yuku.com/sreply/601

"... as a multipurpose plant, ganga is used medicinally, even by nonsmokers. There were no indications of organic brain damage or chromosome damage among smokers and no significant clinical psychiatric, psychological or medical) differences between smokers and controls."

"No impairment of physiological, sensory and perceptual performance, tests of concept formation, abstracting ability, and cognitive style, and tests of memory"

"[Cannabis smoking] does not lead directly to mental or physical deterioration... Those who have consumed marijuana for a period of years showed no mental or physical deterioration which may be attributed to the drug."
~ US Jamaican Study 1974

Ganja 4 PTSD & Depression
http://endingcannabisprohibition.yuku.com/topic/1632

Researchers at the University of California (UCLA) School of Medicine have announced the results of an 8 - year study into the effects of long-term cannabis smoking on the lungs. In Volume 155 of the American Journal of Respiratory and Critical Care Medicine, Dr. D.P. Tashkin reported: "Findings from the present long-term, follow-up study of heavy, habitual marijuana smokers argue against the concept that continuing heavy use of marijuana is a significant risk factor for the development of[chronic lung disease. ..Neither the continuing nor the intermittent marijuana smokers exhibited any significantly different rates of decline in lung function" as compared with those individuals who never smoked marijuana.

Researchers added: "No differences were noted between even quite heavy marijuana smoking and non-smoking of marijuana."

Cannabis, the Importance of Forgetting
http://endingcannabisprohibition.yuku.com/topic/1620
Well, do you really want to remember all the faces you saw in the subway this morning, all the faces in the supermarket?” And I realized at that moment, well, of course, forgetting is not a defect of a mental operation, although it can certainly be that; forgetting is a mental operation. It’s almost as important as remembering.

Drug Worriers preferred methods of treatment…
http://endingcannabisprohibition.yuku.com/topic/1945
Celexa, lack of emotion, loss of memory,
Behavior change similar to drunkenness, convulsions, (seizures)

Who's Really Fighting Legal Weed
http://endingcannabisprohibition.yuku.com/topic/1974

By mining the plant’s rich pharmacopoeia, medical researchers have developed promising treatments for cancer, heart disease, Alzheimer’s, diabetes, chronic pain, and many other conditions that are beyond the reach of conventional cures.
Smoke Signals: A Social History of Marijuana
Medical, Recreational and Scientific

The government also claimed that since “THC metabolites” stay in the body’s fatty cells for up to 30 days after ingestion, just one joint was very dangerous; inferring that the long range view of what these THC metabolites eventually could do to the human race could not even be guessed and other pseudo-scientific double-talk (e.g., phrases like: “might be,” “could mean,” “possibly,” “perhaps,” etc.)*
The Facts: Government’s Own Experts Say
That Metabolites Are Non-Toxic, Harmless Residue
http://www.electricemperor.com/eecdr…/…/EMP/15/ECH15_05.HTM…
* “May, might, could, and possibly are not scientific conclusions.” Dr. Fred Oerther, M.D., September 1986.

No Physiological Deterioration
http://www.electricemperor.com/eecdr…/…/EMP/15/ECH15_13.HTM…
Marilyn Bowman, in a battery of psychological tests on chronic cannabis users in Jamaica in 1972, found "no impairment of physiological, sensory and perceptual-motor performance, tests of concept formation, abstracting ability and cognitive style and tests of memory."

These Jamaicans had smoked anywhere from six to 31 years (16.6 mean average) and the average age at the first puff was at 12 years and six months.

Marijuana Ingredient May Help Alzheimer's
By Miranda Hitti Feb. 23, 2005 From WebMD
http://www.foxnews.com/…/marijuana-ingredient-may-help-alz…/
Chemical Counters Brain Problems in Alzheimer's Disease,
New clues about Alzheimer's disease have emerged from a Spanish study of marijuana. The drug's active ingredients -- cannabinoids -- help prevent brain problems seen in Alzheimer's, say the scientists.

Cannabis May Help Prevent Alzheimer's Memory Loss
http://www.cannabisnews.com/news/20/thread20277.shtml
Marijuana Ingredient May Help Alzheimer's
http://www.cannabisnews.com/news/20/thread20276.shtml
Marijuana May Block Alzheimer's
http://www.cannabisnews.com/news/20/thread20269.shtml
Alzheimer's Disease Covered Under Medical Marijuana Act
http://www.cannabisnews.com/news/6/thread6073.shtml

"Users in our matched-pair sample smoked marijuana in addition to as many tobacco cigarettes as did their matched non-using pairs. Yet their small airways were, if anything, a bit healthier than their matches. We must tentatively conclude either that marijuana has no harmful effect on such passages or that it actually offers some slight protection against harmful effects of tobacco smoke"
Cannabis in Costa Rica:
A Study of Chronic Marijuana Use;
Institute of Human Issues.

Robindell's picture
Robindell 5 years 8 weeks ago
#5

Diane Rehm had a program with psychiatrists who are doing experiments on the use of psychodelic drugs such as Ecstasy to treat Post Traumatic Stress Disorder. These clinical trials have to be approved by the FDA. There was once a program on T.V. about a teenage girl who lived in Michigan who had severe clinical depression. She had been prescribed different antidepressants, none of which worked, so her mother ended up having to take her to the University of Michigan hospital for electroshock therapy. A series of treatments are administered over time. This seemed to be the only treatment that helped her overcome her depression.

Since you commented on one of the statistics I mentioned above, I wanted to verify this. I found a Web site called, "10 Countries With Most Car Accidents" by Chris Pengago (open post). It states, "The United States has the dubious distinction of having the highest number of traffic accidents in the world. The U.S. is also the third most populated country and is among the most developed nations. The country's wealth means that most people of driving age have at least one car. The high volume of traffic translates into more people getting into accidents." The article also mentions that Sweden has among the lowest rates of car accidents.

The following "story" I think is relevant to your topic and may be of interest:

Chestnut Lodge was a private, relatively small psychiatric hospital started by a psychiatrist many years ago outside of Washington, D.C. in Rockville, MD. In the early days of psychiatry, anti-psychotic drugs had not yet been developed. Being a private institution, Chestnut Lodge was known for its innovative efforts to treat patients. Psychiatrists at the time were interested what was going on there and sometimes visited the facility, as it were known for trying to help people who others would have given up on. One well-known psychiatrist from the Washington/Baltimore area who was not on staff at Chestnut Lodge but who sometimes visited and talked to patients and doctors there was Harry Stack Sullivan, who is remembered today as a personality theorist. As you know, Psychiatry then had been influenced to a considerable extent by Freud and psychoanalysis. Chestnut Lodge was known to have specialized with some of the more severe cases, and they tried to help the patients with a humane approach using intensive psychotherapy along with recreational type of activities. The person who wrote the novel, I Never Promised You A Rose Garden had been a patient there and based the book on her experiences in that psychiatric facility. Even today, there is stigma in American society against mentally ill people, as Dr. Okin has pointed out, but back in the 1930s, 40s, and 50s, it was even more pronounced than it is today. Some people had to be permanently hospitalized and lived in hospitals such as Chestnut Lodge as their permanent or at least long-term place of residence. Well-to-do people sent mentally ill family members to Chestnut Lodge and counted on the hospital's discretion so that no one would know that their relatives were mentally ill and had to be institutionalized.

In more recent times, I think sometime in the 1990s, a severely depressed patient was taken to Chestnut Lodge. This man was a physician, a nephrologist, whose marriage if I recall broke up because of his depressed state. A friend drove him to the hospital, where he was admitted. A week or so later, the friend returned to see how the kidney specialist was doing, and was shocked to discover that instead of improving, his condition had deteriorated. After making a few inquiries, the friend removed the doctor from Chestnut Lodge, and drove him to Sheppard Pratt, another well-known private psychiatric hospital, located in nearby Baltimore. Unlike Chestnut Lodge, whose doctors prescribed no medication for the depressed doctor, Sheppard Pratt prescribed anti-depressant medication, and he was up and about and ready to leave the hospital within days. The doctor sued Chestnut Lodge for malpractice. The Washington Post wrote an article which I read about the incident, and it was also discussed in an article in The Annals of Psychiatry. The staff at Chestnut Lodge, the lawsuit alleged, had addressed the doctor not as "doctor," but only by his first name, which was Ray. The writer of the newspaper article interviewed a psychiatrist who remembered what it was like at Chestnut Lodge back in the early days, and he said that while their attempts to treat people, such as schizophrenics, with severe mental illness with psychotherapy created much hope and excitment, looking back on that time, the doctor said that they really didn't make much if any progress with most of their patients. This was someone who was right there, at a facility that was considered to be cutting edge for its time. The treatment didn't work. That is one reason why I feel that there are too many misinformed, overly-opinionated, overly emotional people who are completely against psychiatric medical treatment on political grounds who only add to the neglect of mentally ill people in this country. Some schizophrenics supposedly get over their condition without having any treatment, but I am not sure that this is adequately understood or documented. It would be more helpful to point out that there is a denial of job loss, unemployment, and poverty in this country, and that neither psychiatrists or talk threrapists can help those who have little or no income, and no friends or family to help them, by only treated their emotional symptoms. Social Darwinsim is a kind of social sickness that we have had in our past history, as Professor Richard Hofstader has written about, and has come back with the financial and economic problems that the country has experienced more recently. Also, I do not agree that past rejection, abuse, and disappointment can ever be completely gotten over. All one can do is to learn to live with these things. By the way, there is such a thing as music therapy, and I have found that music, if it is weighty and meaningful enough, and aesthetically profound, can be of some consolation, as can the visual arts, and according to one Ph.D. student in social psychology who did a research project toward his doctorate, those who read so-called literary fiction are likely to be more empathetic toward others than those who read only popular novels or do not ready any fiction.

The story of Chestnut Lodge has sort of a sad ending. The family that owned the hospital, headed by a psychiatrist who was the offspring of the fouder, sold it to a non-profit mental health provider. They were unsuccessful in generating enough revenue, largely from insurance payments, to make a go of it, so the hospital closed. The main building was originally a lodge that was converted into a mental hospital, hence the word "lodge" in the title. It was an older multi-story brick building, and after the hospital went out-of-business was slated to be converted into condos. Unfortuntately, a fire started by arson burned the building into a useless hull. I found a video of the fire, I think on YouTube.

P.S.,

Since my early post from above, I read in the newspaper and also saw on the local T.V.news that within a few days, Chicago had three incidents of fights breaking out, involving a large number of teenagers, in three different public places. One was at Navy Pier, which is the city's most visited tourist attraction. It is located in Lake Michigan. One of the functions is that it serves as a boarding location for boats where people can take rides in the lake, overlooking the city's skyline. The fight it was reported involved some 30 young people. It took place after 7 p.m. The second place where fighting occurred was at a large McDonald's located in downtown in what is known as the River North area of the city. This McDonald's is larger than most. Although the original McDonalds was in California, the company as it is known today was started by Ray Kroc, who was from Chicago. and the company is headquarted in suburban Oak Brook. I might have been at the McDonald's where these teenagers became rather violent in that they threw chairs at other people. The third location where a fight broke out within this same period was at the food court in a suburban mall, called the Chicago Ridge Mall, in Chicago Ridge. Also, as usual, there were several shootings in Chicago, one of which it was reported took place over two city blocks. I don't recall how many victims or fatalities exactly there were, but this was not the only shooting in the city on that one day alone. Through my own work, combined with various crime stories from across the country, combined with the political and ecomomic problems that have been discussed on this Web site ad nauseam, there is a psychopathic tendency among Americans, inclusive of rich, poor, and middle class individuals.

Natural Lefty's picture
Natural Lefty 5 years 7 weeks ago
#6

Okey dokey, DdC.

it has been found that schizophrenics have a high rate of marijuana use as well as the use of other drugs. But schizophrenics are generally not very healthy. Their life expectancy is considerably less than average, and I certainly don't think they can be trusted to be good at self-medication.

Robindell, I went to a McDonald's in Chicago. I doubt it was the one that you mentioned, but it was pretty large. The area it was in seemed economically depressed, however.

Harry Stack Sullivan was known for his success in treating schizophrenics, but again, I don't think his techniques would work for everyone.

Yes, I agree that past rejection, abuse and disappointment cannot be gotten over completely. I think schizophrenics deal with these experiences more dysfunctionally than most people, though.

Regarding the use of hallucinogens to treat psychopathology, I remain skeptical and suspect that this research is being driven by the pharmaceutical industry. Some people could improve after taking hallucinogens, but that could happen with appropriate experiences that avoid hallucinogens too, i think

Robindell's picture
Robindell 5 years 7 weeks ago
#7

Yesterday, now that it is January, we had our first big snowstorm of the winter, and I had to go to work so I had to drive while it was taking place. And unlike California, the weather forecast for the forseeable future calls for below-zero temperatures and more snow, which makes both the road conditions and the visibility ahead hazardous. It takes a while for the state to clear the roads of ice and snow. There are sometimes multiple snow plows or salt trucks, one right after the other, because they have to keep at it to make any headway. I just pretend that I am in International Falls, MN, which seems to be the coldest city in the country outside of Alaska.

I did some reseach last week and earlier today on the Internet on the subject of Chestnut Lodge, and I wanted to report back one more time with my findings, as I have a few corrections for the sake of accuracy and different clarifications that I think would be helpful, because this seemingly obscure psychiatric hospital played a significant role in the history of both psychoanalysis and psychiatry, and would be of interest to all psychologists, especially academics who are interested in the history of these matters.

But first, I wanted to respond to your comment about McDonald's and Chicago. The McDonald's I was referring to is not the same one that you described. I don't know what neighborhood you visited, but the one where the fighting broke out recently is in River North, which is the northwest part of downtown. To get there, you have to cross one of several bridges over the Chicago River. It is an exclusive area with expensive hotels, high rise condo buildings, and different office buildings, businesses, and restaurants. I haven't been there for a while, so I don't remember the intersecting streets, east to west and north to south, but the McDonald's in question is near Grand Ave. and may be next to Clark St. Across the street is a Portillo's. That is a local hot dog and Italian fast food chain. We have one of those in Indiana. There are some Chicago pizza chains not far away. Also, to the north of there is the downtown campus of Loyola University of Chicago, and futher north and slightly west, the Moody Bible Institute. If you ever visited downtown, I could take you on a tour of the different colleges and universities located there. Most of them are in the South Loop. East-West University, Columbia College, which is known for things like commercial art, photography, journalism, and broadcasting, Roosevelt University, National Lewis University, which is known for teacher training, DePaul University whose main campus is in Lincoln Park but has its information/computer science school, law school, and I think business school downtown in several buildings, the School of the Art Institute of Chicago, the Adler Institute of Professional Psychology, which mostly awards the Psych.D. degree, the Chicago School of Professional Psychology, which I think has a branch in California someplace, Robert Morris University which is a career type of university, and Harold Washington College, which is one of the city colleges which are all just like your place of employment, two-year community colleges. They have a program now so that all Chicago high school graduates with adequate or maybe at least above-average grade point averages are guaranteed two years of college at the city colleges without having to take out student loans, or in other words, at an affordable cost, if not completely free of charge. The area north of the river is also known as the near north side. My mother lived up there before getting married in a residetial buidling for women which once existed. The Poetry Foundation and American Medical Association are two organizations that are nearby. When I said that this McDonald's is big, what I meant is that it is a two-story building with a glassed-in front, and the trademark Gold Arches go all the way up to the top, even maybe taller than the roof. In recent years, teenagers went to another nearby near north area called Streetorville, named after an early squater who I think lived on a boat, like Thom, and was eventually kicked out by the city, and assulted people on the street and took their cell phone and maybe in some cases their wallets. They arrived via a certain subway station and communicating through text messaging. They also shoplifted from a few stores. The area were they attacked people is right by Nothwestern Memorial Hospital, the teaching hospital of Northwestern medical school. I happened to see "Jeopardy" the other day, and one question on the show was, "What is Northwestern Memorial Hospital?" The statement was the street that the main entrance is on. Northwestern's law school is right near the medical school. The University of Chicago has one building which serves as its downtown facility, just north of the river. All of downtown Chicago historically has been very safe, but in recent years, there have been some occasional robberies and several shootings. An executive in a company over on LaSalle St. just last year brought a gun to the office and shot the CEO, who demoted the man, and then took his own life. Both men lived in different suburbs. The CEO survived. It was a business computer software firm, and the man who did the shooting had two master's degrees from the University of Dayton, one in computer science, and one in psychology. I remember hearing about a robbery that took place on the riverwalk along the Chicago river. A mentally ill man started shooting in a subway station in the west Loop. And there have been other sporadic and relatively infrequent acts of violence downtown, which overall encumpasses a fairly large area, especially beyond the traditional "Loop." Chicago wants to attract as many tourists as possible. I think the main two attractions of the city are the lakefront and the architecture, Chicago being the city where the skyscraper was invented. Chicago is also known for its many restaurants, hotels, and theaters, as well as several museums and other cultural offerings. If dangerous teenage thugs in the heart of the city or other violent activity becomes a problem, this will cetainly discourage people from visiting, when they may have many other alternative places they could visit. Chicago has more moveable bridges than any other city in the world. While I am on the subject of cities, and since you knew someone from nearby Gary, I would mention that it has been reported that Gary has some 7500 abandoned houses. The city is receiving some federal funding to tear some of them down, but has only gotten rid of a fraction of them so far. If the house is in usable condition, they certainly would like to see people take over the home, and the mayor was on talking about the $1 home program, where if you agree to repair, restore, and maintain the abandoned home, you can have it for $1. That's less than a Big Mac!

Cities grew with industriaiization. Detroit and Chicago are two cities in particular which have been called "working class." Don't confuse an old neighborhood with a poor neighborhood. The neighborhoods in Chicago are all pretty old, but the city has had more new houses built than is the case in many other cities which have also had their share of economic decline. There are older homes in the city that are very expensive, even $1 million or more in some cases. Also, I believe Chicago probably has more high-rise condo and apartment buildings, over 700 I think, than any other U.S. city other than New York. Los Angeles may have more, but I have never been there. Other large cities I have been have nothing like the high-rise residential buildings found in Chicago. Chicago and suburbs has the most diverse housing types that I know of. A Chinese developer plans on building a new 88-story hotel and condo building in downtown Chicago, near Lake Michigan. That is not what is needed, but that is what a foreigner is willing to invest in.

In Rockville, MD, the Woodlawn Hotel opend in 1889. It was a four-story building with 40 luxury rooms. Semi-permanent residents moved to new houses in Rockville, and within a decade or so, the hotel was bankrupt and closed. Dr. Ernest Bullard was the superintendant of the Wisconsin State Hospital for the Insane just outside of Madison. Gov. LaFollette wanted to use the hospital grounds for political functions, but Dr. Bullard said that would be disruptive to the patients, so the governor fired him. He headed for Rockville and for $6000 bought the old Woodlawn Hotel which had been empty for 10 years. He renovated it and re-opened it as Chestnut Lodge. He named it after the 125 chestnut trees that were on the property. It was a sanatorium for the care of nervous and mental diseases. For the first two years of more, Dr. Bullard was the only doctor, but he eventually started to hire other psychiatrists. In 1927, his son Dexter, also a psychiatrist, got married, and Ernest built a family home for them on the grounds, only a hundred feet from the main building. It was in the Tudor Revival style. It became known as the Little Lodge. After Ernest's death, Dexter took over as director. He needed someone with experience to help him. He hired Freida Fromm-Reichmann. She had been married to Erich Fromm, who you mentioned. Fromm-Reicmann had already run her own sanatorim in Heidelberg. Her background included her Orthodox Jewish upbringing and he training as a major in the Prussian Army. Dexter and Fromm-Reichmann put the Lodge on the world map. Dexter eventually built her her own home on the grounds, which was called the "Freida Cottage. " Her association with Chestnut Lodge lasted for 22 years. Other nationally renowned therapists worked at the hospital including Wayne Fenton, Dr. Harold Searles, and Otto Allen Will. The hospital soon adopted a psychdynamic approach to the treament of pschosis. By 1937, the Bullards were operataing the only psychiatric hospital in the world that specialized in psychoanalysis for psychotic patients. During this time, Freud was expressing pessimistic views with regard to the suitability of psychoanalysis for psychotic patients. He did not believe that their weak egos could withstand the intense responses and emotions evoked by the analytic situation. Fromm-Reichman believed that early childhood traumas were behind schizophrenia. Dance, music therapy, psychodrama, and rehabilitative endeavors were carried out by specialized professionals. As psychotropic drugs became available, there was an ongoing debate within the hospital about their use. Some believed that drugs reduced anxiety, regression and cognitive disorganization. Others felt that medication would blunt feelings and conflicts which would become inaccessible through psychoanalytic therapy. My information on this comes from a paper I found called, "Intensive Psychotherapy with In-Patients at Chestnut Lodge Hospital, by Marco C. Chiesa, Joint Snior Registrar in Pschotherapy, St. Bernard's Wing, Ealing Hospital and the Cassel Hospital, Richmond, Surrey.

Chestnut Lodge's research institute did a long-term follow-up study of patients, averagely 15 years after discharge, between 1950 and 1975. With schizophrenics, only 1 in 3 patients had a moderate to good outcomee, while the rest remained chronically ill or "marginally functional." The Chestnut Lodge patients did better than did schizophrenic samples in the Boston State Hospital study. Patients of Chestnut Lodge with borderline personality disorder showed 80% improvement. Overall, the hospital had patients who were chronically ill and established themselves as treatment failures in previous institutions. Chestnut Lodge was a tertiary care hospital which treated patients in the poor prognosis spectrum.

Harry Stack Sullivan had not been on the staff, but gave 246 lecture-discussions in the Bullard residence and those formed the basis for his posthumously published (1956) Clinical Studies in Psychiatry. Also, Joanne Greenberg, Fromm-Reichmann's daugher as "Hannah Green" wrote the autobiographical novel, I Never Promised You A Rose Garden.

Raphael Osheroff, or Ray, was the kidney specialist who was hospitalized in Chestnut Lodge for 7 months in 1979. He was given no medication there, and although they did diagnosis him with pschotic depression, they also said that he had narcissistic personality disorder, and treated that with talk therapy. My recollection from the Washginton Post whose article must have been published back in 1979 or 1980, a long time ago, was faulty. It was his parents who took him out of Chestnut Lodge, and he was taken to Silver Hill Hospital in Connecticut, a private psychiatric hospital affliated with Yale University. He was treated with medication there and was much improved in10 days. In his lawsuit, Dr. Osheroff said that he was kept in a locked ward with schizophrenics in Chestnut Lodge. One commentator on the lawsuite wrote, "As a reseacher in personality disorders, I agree that personality characteristics sometimes explain why people get depressed. But once depression begins, it takes on a life of its own." The hospital's defense was that Osheroff improved not because of the antidepressants he was given at Silver Hill, but because he had a better relationship with the doctors and therapists there than at Chestnut Lodge, so that their failure to give him drugs had nothing to do with his lack of improvement or his improvement at the other facility. I also read that psychoanalysts such as those at Chesnut Lodge were trained in a rather dogmatic way, that they were right in their opinions. So the couldn't objectively see or admit that the therapy was not working.

In the 1960s, Dr.Dexter Bullard Jr., or "Rusty," took over from his father, who retired. Dexter Jr. modernized Chestnut Lodge. He oversaw the design and construction of the new adult buildings. He feltsrongly that they should medicate their patients. He hated cold wet sheet packs. He wanted a hospital where poor as well as rich could be helped, and wanted an ethnically, racially, economicall diverse patient and staff population.

The fire that destroyed the main building years later, after the hospital was closed, had undeterminate cause.

TheEvangelicalBuster's picture
TheEvangelicalBuster 5 years 7 weeks ago
#8

Great topic. I am a MISA professional but haven't been working in the field for about 5 years now. Schizophrenia was always one of the most heartbreaking diseases for me to witness. At least from what I experienced, it was such a pervasive diagnosis that unlike depressive or anxiety disorders, the prognosis was not near as well. You are most likely to find an individual with schizophrenia on the streets, in homeless shelters, or in and out of mental health facilities their entire lives. Family members are generally unable or unwilling to take care of them. Some of the insensitivity that I have experienced from family members and personal hatred towards patients literally left me in tears. They think their loved one chooses to act this way deliberately. It is those left to fend for themselves, and therein lies a big part of the problem. While I think we have made progress, we still are not a society that wants to really tackle the issue of emotional wellness and mental health parity. Only the worst of the worst are given priority treatment. Furthermore, those who cannot regulate their behavior often end up in the legal system, where they are left to essentially rot.

Another issue I see is that the general public doesn't understand schizophrenia. If most people see someone walking down the street talking to themselves or acting irrationally, they will likely make fun of them. That's the truth. They would not be willing to help. If the general public at least could understand what schizophrenia really is, they might be at least willing to pick up the phone and say that they have a friend/loved one who is exhibiting symptoms and needs help. i am also a big proponent of every county or geographical region having a mental health hotline. I would like to see a hotline where if someone was exhibiting some symptoms of a mental health problem or crisis that it would be followed up on by a qualified mental health professional. If your neighbor is talking like he or she wants to commit suicide, if a classmate is saying things about violence, etc. I think we would help ourselves in the long run by such a program.

From what I read about Edna, it sounds like she had the paranoid version of schizophrenia, which was brilliantly portrayed in A Beautiful Mind. As you see from that movie, and people such as Darrell Hammond, individuals with schizophrenia can lead fully functioning lives where they can take care of themselves. They might have issues along the way, but overall, they can lead a fully functioning life. What makes the difference? A good support team is first and foremost. If you are left to fend for yourself, your prognosis is often poor. Also, no matter what, people with schizophrenia need to adhere to their medication. When they go off is when the problems happen. I hope that the Ednas of the world can live in a world one day where they are all living like John Nash--in a home with a loving family, employed, not living in poverty.

Natural Lefty's picture
Natural Lefty 5 years 6 weeks ago
#9

Sorry for the late reply, Robindell and EvangelicalBuster.

Robindell, the studies you cited are indicative of the poor prognosis with schizophrenia. EvengelicalBuster mentioned that too. Schizophrenia is very pervasive. However, with a supportive environment, many schizophrenics can do okay.

I concluded on my own that Edna was a paranoid schizophrenic, EvangelicalBuster. I am glad to have that notion seconded. I am not aware of any official diagnosis of her condition. One of the problems in dealing with her is that nobody seemed willing to tell her that she was schizophrenic. In my situation, I think that would have been very difficult and made her extremely upset.

Her family wasn't too poor, and they were nice people, but they didn't know much about schizophrenia or how to deal with it, much as you said. I am sure that I know far more about it than the average person -- enough to make my own informal diagnoses and efforts to properly relate to the schizophrenic. The article that I cited does a good job of explaining how to help a schizpophrenic family member, but as you say, most families in fact do not.

The Reagan administration forced many schizophrenics out of mental hospitals, many of whom wound up homeless. These are the people that most citizens see and make fun of, but it's pretty easy for a well-informed person to recognize when a person's behavior is a result of scihzophrenia

Robindell's picture
Robindell 5 years 6 weeks ago
#10

States on their own continued to close or at least downsize state mental hospitals. Where it gets a bit complicated is that these institutions did not always provide the best care for patients. Their history sometimes included the warehousing of patients who were often put in restraints and received little treatment. In the more intractable cases of schizophrenia, medication may sedate the person, but does not always do that much to return them to "normal." I think it works better for some people than it does for others who are more severe. Dr. Okin made an important point when he was interviewed about his book. He said that it is a "misconception" held by many people who have never met a schizophrenic that they cannot talk about their own lives in a realistic, understandable way. He was able to learn about the lives of mentally ill people who were living on the streets, not receiving any treatment. In the book The Soloist, the subject of the book who has schizophrenia told the author that he studied the bass violin at the aclaimed Julliard School. When Steve Lopez called New York, he was skeptical if Mr. Ayres was telling the truth, but the school called back and confirmed that he had indeed been a student there. Of course, the late Robin Williams studied acting at Julliard. He also had mental health as well as substance abuse issues. The Republicans in the U.S. House, rather predictably, are trying to financially harm many disabled people right now.

I am not sure if psychiatrists all agree, but it is believed that psychotic individuals often or usually do not know that there is anything wrong with them. They believe the voices and delusions they have to be real. If you suggest to them that they are mentally ill, they seem to deny it rather vehemently, although there may be some who on their own go to mental health agencies for at least some help.

In my state, Indiana, there are various non-profit community mental health centers, which, like hospitals, charge fees for their services. But if someone does not have health insurance, they still are seen and are charged either nothing or a sliding fee based on ability to pay and income. Also, an interesting aspect of Indiana's mental health centers is that some of them, not all, but some, have their own, local inpatient hospital unit. Depending on the community, they probably don't have enough beds to take every person in need of a hospital stay, but at least there are some units available. Central State Hospital in Indianapolis had a patient death and a history of some other mishaps, and so then-Democratic governor Evan Bayh ordered the hospital to be closed. The mental health centers around the state are only given so many beds they can send patients to who need more extensive hospitalization that might otherwise be available.

Right near Western Michigan University in Kalamazoo, there is a huge red brick building which is called the Kalamazoo Psychiatric Hospital, formerly known as Kalamazoo State Hospital. It is old, having been built in the 1950s. An historical marker is in front of the building, stating that America's first nurse, supposedly, worked there. There was a huge state hospital in Yipsilanti, Michigan, Yipsilanti State Hospital, which was closed. It had large, very scary-looking instutitional buildings, almost like a prison. I saw some videos of the place on YouTube. Since then, I read that it was torn down. In the book mentioned above, A Beautiful Mind, mention was made of Michigan's mental health system as having been involved at the time with innovative treatment for schziophrenia. The author might have specifically mentioned the hospital in Yipsilanti, and they were thinking of sending the professor there. Michigan has a pretty good system of community mental health centers, but there are homeless people in Michigan like there are everywhere else, and I am sure that they have insufficient funding for housing for mentally ill people who may be homeless. Yipsilanti is the home of Eastern Michigan University and is just east of Ann Arbor, home to the main campus of the U. of Michigan. Detroit is not far from there.

Aliceinwonderland's picture
Aliceinwonderland 5 years 6 weeks ago
#11

A few years ago I read this great book called "Mad In America" (I wish I could remember the author and publisher). It was loaded with information about mental health treatment in this country, in a historical context as well as the present. The gist of it is that mental health care in this country sucks, that it has always been full of quackery and cruelty.

You guys might want to look this one up sometime; it's a real eye opener. - AIW

Natural Lefty's picture
Natural Lefty 5 years 5 weeks ago
#12

Hello Robindell. You bring up a couple of important points.

First, schizophrenics can talk about their lives and other things, and seem very rational about it at times. They are often very intelligent, too. I would liken their condition more to people who believe in wild conspiracy theories, that they might not be willing to share at first, but as time goes on, they bring out stranger and stranger ideas that seem less and less tenable -- at least in the higher functioning people. In more severe cases, they might show obvious signs of delusions and hallucinations immediately. Frankly, I suspect that some of the people who originate these conspiracy theories are, in fact, schizophrenic.

Second, you are correct that schizophrenics usually are relatively unaware of their condition, as with Edna. They blame their problems on the "crazy" world around them, typically, not realizing their own role in the problems that they perceive. Many schizophrenics are nonetheless distressed, depressed, etc. and some recognize that there is something seriously wrong with them, but the recognition is muted compared to what it should be typically, due to the nature of schizophrenia attributing the internal to the external world.

Alice in Wonderland, it's difficult to comment on that book without more details. I am reminded that books are published to make money, and a book about mental health care that says that mental health care is going well in the U.S., is not likely to sell many copies. The information also might or might not be up to date. The situation might be different for mental hospitals as well, which are usually filled with schizophrenics, from outpatient treatment, which is primarily for other disorders. I do know that there have been hundreds of studies on the effectiveness of psychotherapy in the U.S., resulting in several meta-analyses which summarize large numbers of studies, and these show that psychotherapy works better than a placebo around 75% of the time, I think it is. Compared to no treatment, psychotherapy works better over 80% of the time. So I am not sure what to think of the book without more details, but there is clear evidence that psychotherapy is usually better than a placebo (sympathetic listener who is not a psychotherapist) or no treatment.

Robindell's picture
Robindell 5 years 5 weeks ago
#13

A professor of (clinical) psychology I once emailed at Ball State University agreed with me in my comments that for people with severe forms of mental illness, with a psychotic type of condition such as schizophrenia -- your original topic -- psychotherapy generally does not do that much good, for the reasons that you already described with Edna and with your reponse above, that they often tend to be irrational, like the insane Republicans, but because of brain dysfunction which they cannot help. I recently saw and was examined by a cardiologist, and had some tests done, which found some deterioration, but not anything that seems to be serious or life-threatening, as long as I don't eat too much fat and sugar and excercise to some extent. The doctor happened to mention when I brought up the subject of mental health, depression, etc. that in addition to being trained in internal medicine and cardiology, he also had a year's training in psychiatry. Clearly, he decided not to go into that speciality and chose cardiology instead. He said that therapists "talk to you a little." I don't believe that in serious cases, such as the type you describe, that an occasional, brief talk with a stranger, no matter how calm, objective, and understanding, can accomplish very much. You may be interested to know about a certain comment that I read years ago from a college in Illinois which offered a master's program in counseling psychology, which as you know is basically the same thing as clinical psychology, but without as much emphasis probably on some of the more technical aspects and procedures, like psych testing. The story has an interesting twist to it. At one time, the YMCA, which has its world headquarters in a skyscraper somewhere in downtown Chicago (I once knew a fellow who worked in the headquarters before retiring) owned and operated a college which was located in suburban Downers Grove, IL. They had some programs that were designed to prepare people on a professional level to work at YMCAs, in physical fitness and recreation. They may have had an administrative training program of some kind for non-profits, but I didn't pay that much attention to it, and the reason I was slightly interested in the school, which was called George Williams College, was because they had master's programs in the mental health as well as the social service fields. They had an M.A. in counseling, and also the M.S.W. (social work) degree, if I recall. I convinced a friend of mine to take a drive out there from Indiana, and upon arriving at admissions, a young women who I believe was a student was brought forward to give us a tour of the campus. Being a private liberal arts type of institution, it was relatively compact in size. My contact who was retired from the YMCA's headquaters orginally was from Michigan and was a graduate of the University of Michigan. When I mentioned to him that I had once visited the YMCA college, George Williams College, he said that was his alternative prospective school to the University of Michigan, which won out in the end. His goal all along, even before he started college, seemed to be to work for the YMCA. Anyway, a number of years after visiting this school, it was reported that it had gone into bankruptcy and then was closed. The campus today has been transformed into a medical university which offers graduate and professional degrees, the highest of which is Doctor of Osteopathy (D.O.). As an aside, a second medical school recently opened in Indiana, at a small Catholic university in Indianapolis, called Marian University, and they are the only Catholic university in the country to offer the Doctor of Osteopathy degree. The Indiana University school of medicine, whose main campus is in Indianapolis, is the nation's second largest medical school, after the University of Illinois at Chicago College of Medicine, which has the largest enrollment. And now, finally, is the point to my story. After this George Williams College went out-of-business, another nearby suburban college, which today is called Illinois Benedictine University, took over the closed school's mater's of counseling psychology program. I wrote to them for information, and when they sent me a brochure on the program, they stated that counseling (or, in other words, psychotherapy) is a "very limited" field in what it entails. The practioner listens and sometimes says nothing, sometimes gives specific advice or assigns psychological or social excercises, or just rephrases what the client just said, like Carl Rogers talked about with "non-directive" therapy and "unconditional positive regard." It is a limited kind of service that cannot address serious cases of different psychiatric conditions. That is why many seriously mentally ill people do not see a therapist, but instead deal with a mental health facility employee known as a case manager. A case manager usually only has a bachelor's degree in a field such as psyhology, social work, or even nursing. Finally, one author, a psychologist (in Michigan), cites a study which found that professors with no background or graduate degrees in counseling, psychology, or social work did just as well as counselors, as rated by "clients" in a study, than did actual licensed, trained therapists. The non-professional counselors were given some brief, basic instructions on how to proceed. He says that the training is not the important thing. It is setting up a positive relationship with the client. Of course, at places like the closed Chestnut Lodge, where psychoanalytical ideas were used, transference was the most important aspect of therapy.

There have been different kinds of problems in the mental health field. Most but not all people are professional in their approach and try and show at least some understanding. Like all of health care, cost is an issue. Sending people to college for even four years, let alone to become a physician, is not inexpensive. The stigma against the mentally ill has never been addressed adequately through our educational system, and today, conservatives are looking for new outlets for hatred, when in fact they are the ones who are mentally unbalanced and are abnormal in their maladjustment to life.

Natural Lefty's picture
Natural Lefty 5 years 5 weeks ago
#14

Good point about the difference between schizophrenia and non-psychotic conditions, Robindell. When I said that meta-analysese show that psychotherapy is usually effective, these are not studies on schizophrenics, for whom psychotherapy alone is usually not very helpful. Once a schizophrenic's symptoms are minimized, psychotherapy can help, I gather.

However, schizoprhenics are usually given antipsychotic medications by psychiatrists, and receive little psychotherapy. Clinical psychologists usually treat most other disorders, and they do not prescribe medications. (They are not allowed to). But their clients may receive medications from medical doctors.

But the book described by Alice in Wonderland, referrred to "mental health care" as she said it, which includes treatment for all manner of psychological problems. In any case, I really would not recommend sending people to a psychiatrist for counseling, but I would send a schizophrenic to one for treatment, and send people to clinical psychologists for counseling.

Robindell's picture
Robindell 5 years 5 weeks ago
#15

Yes, as usually, you accurately grasped the gist of what I said. But that is why I wrote about Chestnut Lodge psychiatric hospital, because they did attempt to use not only psychotherapy, but neopsychoanalysis on patients with serious cases of schizophrenia, and had some staff members who at the time were well-known, as I mentioned. They did follow-up research as I described and were less successful with those with schiophrenia than with those with borderline personality disorder. I believe in some large cities, such as New York, Chicago, Los Angeles, and perhaps in some European countries, a patient could receive one hour, or at least 50-minute psychoanalysis or psychotherapy, with a psychiatrist, an M.D. (or maybe a D.O.). But certainly, because of the cost of medical school training and the number of people who are seeking psychiatric treatment as opposed to talk therapy, the vast majority of psychiatrists around the world, I'm sure, mostly evaluate and prescribe medicines. As you already know, there are a few states that allow clinical psychologists to go back to school and take an advanced training program on pharmacology so they can become certified to prescribe psychotropic only medications. This has not been accepted by most states, and I am sure that most psychiatrists and other physicians are opposed to allow psychologists to receive this kind of training and authorization. They would say that it is insufficient training to do it safely, but the psychologists who either want this privilege or live in one of these states that offers to certification would say that the training on biochemistry and drugs they would receive is equivalent to the training given to physicians, and that there is a shortage of psychiatrists. I once read an article I think you would find both a bit interesting and even amusing in the South Bend Tribune. The article said that the local community mental health center couldn't attract enough psychiatrists to move to South Bend, because these doctors, sort of like T.V.'s Frazier, were so cultural-minded and wanted to live the urbane "high-class" life that they declined to take a job and move to South Bend. A few comments about South Bend. I would compare it slightly to Riverside, CA in that the St. Joseph River runs through South Bend, so it actually has a river in it. I know that Riverside has a branch of the University of California, and every so often, I see experts being interviewed on PBS that are from the U. of C. Riverside. South Bend has a branch campus of Indiana University, but more famously is the home of the "Fighting Irish," at the University of Notre Dame, which has quite a beautiful campus which I have visited. The university has a two-story art musuem which, while not home to famous artists, at least that I have heard of, or famous paintings of sculptures that you might see in books, it is a very nice collection. I once took a friend there, and he agreed it was an enjoyable way to spend 50 minutes or so. Downtown South Bend has a convention center called the Century Center, where they have different meetings and events, and that facility has a small non-profit art gallery, not much of a museum. But the psychiatrists could attend occasional concerts by the South Bend Symphony, which has some concerts with the full-sized orchestra, and some with a smaller number of the musicians, which are known as chamber concerts. Their music director who has been with them now for many years is Chinese and was trained in music at Yale University. I liked to sit up in the upper part of the balcony as the sound there in the Morris Center for the Performing Arts, also known as the Morris Civic Auditorium, was excellent. For some reason, they stopped offering tickets to that section of the hall, and some of the the other locations were more expensive or did not have as good accoustics. One of the main criticisms of South Bend by psychiatrists who didn't want to move there to practice medicine was that there weren't enough find dining restaurants. I myself, when I used to go there sometimes, was more than satisfied dining at Perkins Pancake House, which is a reasonably priced restaurant chain, or a buffet place. I didn't want or need anything fancy, like these psychiatrists must have. There are some upscale restaurants in South Bend. Notre Dame has its own inn which has a restaurant in it. But not anything like exists in a major metropolis. So what the article revealed is that the mental health center has a closed-circuit television hookup with Chicago, where some consulting psychiatrists they use live, and the patient is brought into a room and sees and talks to the doctor over the T.V. If the doctor writes a prescription, it is written at the center by a practicing nurse, who is licensed to write prescriptions. They may have at least one psychiatrist on staff in South Bend, but it seems that many of the patients use this telemedicine approach at this facility. The doctors just needs to know what the problem is, what the symptoms are, and if the patient is allergic to any medication and what medications he or she may already be taking. Apparently, this can all be communicated via T.V. Speaking of the show Frazier, i once attended an all-day free program of classical piano music with many different pianists coming on stage, playing, and then existing. The program had two hosts who knew each other. The first was pianist Emmanuel Ax who is an exceptionally nice person, and the second was actor David Hyde Pierce, Niles Crane from the show. Before he went into acting, he wanted to be a professional painist, but wasn't good enough. He and Emmanuel Ax played a duo piano work together. They took turns introducing the various pianists who performed, all of whom are very famous in the world of classical music and piano. The event lasted all day, and at the end, they filled the stage with something like 10 or 15 pianos, and the artists all came back and played at the same time, like an orchestra of pianos. Educated people who are interested in the arts could never get to see an event such as this in a lesser city like South Bend or even Fort Wayne, which also has an orchestra. The I event I just described was in Chicago. I think there may be more counselors in this country who have a Master's in Social Work than there are psychologists, who have a doctorate and more training.

Natural Lefty's picture
Natural Lefty 5 years 4 weeks ago
#16

Yes, Robindell, I have actually seen at least two U.C. Riverside professors in the media within the past year or so. One was Sonya Lyubomirski, a psychology professor (although I never met her) who was interviewed by Thom Hartmann. The other was a political science professor who was interviewed and made the interviewers look ignorant regarding the middle east.

U.C. Riverside is actually among the leaders in several categories of research and research awards, I think, and its psychology department was ranked 10th in the nation for research psychology when I was a graduate student there.

Robindell's picture
Robindell 5 years 3 weeks ago
#17

On T.V., I see many more academics from Ivy League universities and from Stanford. There is an expert on the Middle East from Indiana U. who I saw twice on the PBS Newshour. I also have heard guests on non-commercial radio from Georgetown U., the University of Maryland, and the University of Virginia, among other universities.

The sister of Warren Buffett recently donated a huge amount, maybe over $100 million or some similar figure, to Northwestern U. to fund international studies. It is the largest single gift ever given to the school.

LysanderSpooner's picture
LysanderSpooner 5 years 3 weeks ago
#18

I disagree with the whole premise. There is no such disease as schizophrenia. You should treat so-called "schizophrenics" the same way you should treat everyone else. Respect their rights. You don't have to like them or agree with them. But don't put them in prison(mental hospitals) and don't drug them against their will.

Robindell's picture
Robindell 5 years 3 weeks ago
#19

Why would I be naive enough to go along with the opinion of a radical extremist who has no medical training or degree and who doesn't know anything about science, unless it is a matter of going back to the 18th or 19th century? Generally, however, mentally ill people should not be forced into treatment. When they get arrested, and there are probably thousands of schziophrenics in jails and prisons, their legal violation in most cases are relatively minor. There are some violence-prone, physically threatening people in society. In some cases, they have symptoms of psychosis. Some people with these kind of problems and condition seek treatment on their own; in other cases, they may be brought in to a see a doctor by a relative or friend. The newer approach is called housing first, in which homeless people such as schizophrenics are helped in getting off the street without requiring that they accept any medical treatment. They may be seen by a social worker who would let them know that certain services are available. People with physical illnesses who are hospitalized are given medication in the hospital which they didn't specifically request. That is just how health care works in certain circumstances when someone needs medical attention.

Natural Lefty's picture
Natural Lefty 5 years 2 weeks ago
#20

Yes, Lysander, people who are called schizophrenics are perfectly normal I guess except that they have unreal thoughts and perceptions that pop up in their brains. But never mind that they don't know reality from their own delusions. Have you been around any schizophrenics?

Yes, the new approach is to try outpatient treatment first, and medications with fewer side effects so they can live relatively normal lives.

I certainly agree with you, Robindell, about certain elite universities being overrepresented in both politics and the media. This is wrong, and nonsensical. These schools are mostly private, too, lending to a system of privilege.

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