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.