Monday, July 6, 2009

Psychological Causes of Schizophrenia (MacPherson, 2009)

MacPherson, M. (2009). Psychological Causes of Schizophrenia. Schizophrenia Bulletin, 35(2), 284-286.

As I try to look for articles concerning the assessment tools used to evaluate pain in patients with psychosis, I came across this article based on the first person account of a schizophrenic patient in the academic journal titled "Schizophrenia Bulletin."

In this article, the author shares with us the lessons he or she learned for the past 32 years. Through his accounts, the author provides us with a positive example about how patients actually could lead an independent and eventful life through consciously and constantly working on developing coping skills in general as well as in managing additional demands imposed by being a schizophrenic.

It was stated in this article: "In the discharge planning process, I made a conscious decision to return to work." In addition, "One needs to grow in life's experience and cognitive functioning. The help and support of a specialized vocational program…" I cannot agree more.

Ever since the onset of my psychosis about 10 years ago, my psychiatrist and I have been working on keeping me "vocationally functional" if possible. One thing people might not understand is that, the impacts of all health conditions are generally two-folded. One the one hand, you deal with the symptoms associated with the disorders; on the other hand, you also have to deal with the side effects of the treatment such as medication. Interestingly, over two years ago, I would have told you that the above is applicable to mental health condition. It was not until I became a handicapped in chronic pain did I realized that such is applicable to all health conditions.

I have been very lucky in this perspective because my employers have been very accommodating and I have always been able to return or remain at work even when I just got discharged from the psychiatric ward… sustaining high level of psychotic symptoms such as hallucination and delusions as well as having limited cognitive capacity due to both the symptoms and the side effects of the high-dose medications.

However, I do not quite agree with the author concerning the role of parents in the development or maintenance of schizophrenia. Personally, this sounds a bit too much like the classical attachment theory to me… What I believe, instead, is that the development and maintenance of our symptoms are very much dependent on our modus operandi in dealing with all relationships including those with our parents.

I also do not really agree with the statement that "Paranoia and paranoid states and reactions are simply child-like sates similar to a child's temper tantrum." While it is true that some parts of our delusions and hallucinations might have a more childish presence, others do take on a more adult presence. At the same time, some part of the interactions in our delusional worlds might simulate the characteristics of adult-child relationship. However, I don't feel that "a child's temper tantrum could sufficiently explain all symptoms.

I do agree with the notion that "delusions are also based in fear and paranoia and represent a false belief but have a basis in reality." I would also add "guilt" as well. Such opinion is based on my personal experiences. Coincidentally, I have come to this conclusion myself earlier this year or late last year after realizing the "horror" components of my visions, hallucinations and delusions. I have been since pondering about where to start from to resolve issues in me which might have contributed to the manifestation of my psychotic symptoms. Unfortunately, I have yet to find out how to go about doing it.

One thing I cannot stress enough is that… the psychotic symptoms we experience are or could be idiosyncratic to us. For instance, my immigration status to remain in the United States has been an issue for me for a long time, and, the immigration status has also been a major theme in my psychotic symptom. Apparently, such might not be one of the themes for those who are American or who are not aliens wishing to stay in the US.

Most importantly, I am only a fledgling psychotic in that I have only spent about 10 years of experiences dealing with psychotic symptoms etc. There is a high possibility that, as the time goes on and as the learning progress, I might eventually come to fully appreciate what the author tries to convey.

In addition, I am mostly appreciative to both the author and the editors of the journal Schizophrenia Bulletin in the efforts they put forth to publish a case study base the personal account of a Schizophrenic patient. So has it been one of my most deep-seated bias… at point, patients might have something to offer…. at least for the fellow patients...

This writing is cross-posted in my Disability in Ratology blog.

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