We who do not believe in mental illness as pathological disease continue to have our work cut out for us. In a blog with the tantalizing title Family Dysfunction and Mental Illness, psychiatrist Dr. David Allen believes that there is something called "true bipolar" which does not arise from childhood trauma because it is "genetic." Dr. Allen also asserts that "psychosis is never a normal variant of anything."
Note: Since no gene has been discovered for schizophrenia or bipolar we can take any "proof" of a genetic link as hearsay. Epigenetics, on the other hand, is the study of inherited changes in gene appearance that do not change the underlying DNA sequence. These changes can come from the environment, can last for the life of the cell and express themselves over generations. So, if one of your grandparents went on wild spending sprees, had multiple sexual partners and/or was down in the dumps a lot, there is a chance that this behavior is established currency in the generations that followed whether you like it or not. Your genetic coding looks like the culprit, but so far it it not.
Dr. Allen writes: We know that true bipolar disorder is a real brain disease that has a significant genetic component. Earlier studies indicated that if you have a bipolar parent, your odds of developing the disorder are 5 to 10 times higher than the general population. Since the prevalence in the general population is about 1 percent, that means you have a five to ten percent chance of developing the disorder yourself. True bipolar disorder usually manifests itself in the late teens or early 20’s, most frequently with a depressive rather than a manic episode.
Further on in the same blog he writes: "Some 12 year olds actually do have mania and are psychotic, but they are extremely rare" and in the comments to one of his earlier posts, "With schizophrenia, however, I do not think that the evidence that the condition is due to to trauma or abuse is particularly strong. There is a lot of evidence now being developed that there are marked changes in the neural networks of the frontal lobes in schizophenia that are well outside the bounds of normal neural plasticity.
Admittedly, we still have not pinpointed the exact nature of the brain pathology in schizophrenia, nor have we found out what causes it. In the past, patients with true bipolar were often misdiagnosed as schizophrenic, so some of the people who "got better" may have been misdiagnosed in the first place.
Dr. Allen believes that family trauma does not contribute to schizophrenia or true bipolar. These are always "special cases." Dr. Allen is expressing opinion, not hard science, because science isn't there yet. Patients operating under a doctor's belief system are probably under the impression that his advice is science. They are doomed from a treatment point of view because their doctor believes that they are intrinsically a separate species. The rest of you might be helped, but, despite the fact that the blog links family problems to mental illness, "schizophrenia and true bipolar" mysteriously are not the results of your birth environment. Psychiatrists who believe that schizophrenia and bipolar are true brain diseases will not give their clients the kind of help they deserve. I'll let Dr. Allen have the final word here.
After dealing for over 30 years with what I consider to be the extreme case of normal reactions to abnormal situations - borderline personality disorder - and with schizophrenia, I remain convinced that schizophrenia is a true brain disease.. . . Just for other readers, claims of 75-85% recovery rates for schizophrenia from non-traditional medicine are pure snake oil. I hate to see people given false help through outrageous claims. True psychosis is never a normal variant of anything. And I never tell people that they have a chemical imbalance, because that is truly a meaningless phrase.
Posts
In a culture that only values the individual member in as far as s/he unconditionally supports the established norms and values - as opposed to a culture that regards the purpose of its societal structures to be the support of the individual member - reactions that indicate discontent with the established norms and values are perceived as a threat. The more extreme the reactions, the more of a threat they represent. "Psychosis" is the most extreme and terrifying expression of discontent human beings are capable of. *) At the same time though, the trauma that caused the individual to react usually is not recognized as trauma by the "psychotic" individual him-/herself, because that which renders an event traumatic is not the event itself, but the emotions connected to it, while people who become "psychotic" were denied their emotions. Just because emotions are denied, that doesn't mean they don't exist. In fact, it is vital for us to have emotions so as to be able to react to our environment. "Psychosis" is the result of nature winning over culture. Eventually, with years, sometimes decades, of delay, the emotions we should have had when the event occurred, but which we were denied then, surface and overwhelm us. The suffering this causes can be overcome by drawing the connection between the emotions and the event they are a natural response to. But in order to do so it must be acknowledged that the event in itself has an extremely traumatizing potential. It must be acknowledged that the cultural context in which the event occurred, the culture's norms and values, indeed have the potential to traumatize in such an extreme way that an extreme reaction like "psychosis" becomes possible. Such an acknowledgement represents the most extreme threat imaginable to the culture, its norms and values, as it acknowledges their destructiveness, and thus the culture in question's destructiveness.
ReplyDeleteAs soon as the connection between a traumatic event and the emotional reaction to it is disrupted, our culture, as one that clearly only values society's individual members in as far as they support its norms and values, therefor defends itself by denying the traumatizing potential of the event, and defining the "psychotic" individual him-/herself as the source of his/her own trauma (= brain diseased), so to speak. The threat is neutralized.
It was never, and is not psychiatry's purpose to help the individual. It was and is its purpose to defend the at any given time prevailing cultural norms and values. This is why psychiatry - with a few individual exceptions such as Laing - always has made, and still actually increasingly today, makes use of hypotheses that define the individual as diseased/defective (and indeed destructive, cf. the concept of "the dangerous mentally ill"), and not society, its cultural norms and values. This is also why there is no such institution as psychiatry in cultures where the purpose of institutions is to support the individual (and by supporting the individual to support the community; for instance the Maoris' and other "primitive" cultures).
Dr. Allen's task - and that of his colleagues - is to serve the ego, not the individual/community.
*)Even more extreme and terrifying than suicide, because in "psychosis" it is the ego that is deconstructed, in suicide it is "only" the body, while our culture stands or falls by the survival of the ego.
P.S.: Dr. Allen does quite a good job. But he also is the victim of an unfortunate conflict of interest. His own ego isn't quite satisfied with just being one ordinary shrink (he's a potential candidate for the "helper syndrome", maybe it's genetic? :D). He wants to be special, a "better" person. So he thought, if he can't stand out as a researcher for instance, he could take these "borderliners" into his special consideration, and get some ego-satisfaction from treating them a little better than his colleagues... There's so much critique of psychiatry these days, you see. People complain about that their traumas aren't acknowledged, and stuff. So, hey, why not try and stand out by acknowledging some trauma? Well well, at least he still toes the line when it comes to those "true loonies", the "schizophrenics". - Which renders him even more of a fake.
ReplyDelete