Thursday, April 22, 2010

Al Siebert's double binds

Al Siebert, who passed away last year, has a website called "Successful Schizophrenia." Here is an excerpt from Psychiatry's Lack of Insight: Four Double-Binds That Place Patients in a Living Nightmare. The third double-bind below demonstrates the reason I have always had trouble with Dr. E. Fuller Torrey. I don't think he sees people with a diagnosis of schizophrenia as fully human. He's not alone, however. Family members often demonstrate the same lack of insight.

The third double-bind is to perceive someone as being "a schizophrenic" and then express humanitarian love and compassion for them.

The activity of allowing one's mind to engage in "negative nouning" is similar to swearing. Perceiving someone as mentally ill is a stress reaction in the mind of the beholder. It constricts and reduces the person into something not fully human. When the viewer sees a person as a defective or sick it prevents the viewer from experiencing the diagnosed person as unique in a special way (the basis for love.)

The authors of DSM-III recognized diagnostic labeling as a problem and took the following position: "A common misconception is that the classification of mental disorders classifies individuals, when actually what are being classified are disorders that individuals have. For this reason, the text of DSM-III avoids the use of such phrases as "a schizophrenic" or "an alcoholic," and instead uses the more accurate, but admittedly more wordy "an individual with Schizophrenia" or "an individual with Alcohol Dependence."

Yet, even with the adoption of this position by the American Psychiatric Association in 1980, statements about "schizophrenics" abound in modern psychiatry. Psychiatrist E. Fuller Torrey, for example, tours the country telling audiences "there are over 100,000 active schizophrenics roaming the streets of our cities."

An example of the "Love for Schizophrenics" double-bind can be found in Torrey's recommendations on "How to Behave Toward a Schizophrenic." He states, "In general, the people who get along best with schizophrenics are those who treat them most naturally as people."

Silvano Arieti is a leading authority on schizophrenia. In concluding his award winning book Understanding and Helping the Schizophrenic: A Guidebook for Family and Friends, he states: "...where modern psychiatric science and our hearts meet, is the place in which help for the schizophrenic is to be found..."

The experience of people viewed as schizophrenic is something like being told by a smiling, powerful authority "I have only love and compassion for rotten assholes like you."


  1. "active schizophrenics" - OMG! Sounds like "active criminals" to me (which probably is what is intended).

    Taken into account modern biological psychiatry's definition of "schizophrenia", and "mental illness" in general, it seems to me that it doesn't make any difference whether someone is referred to as "a schizophrenic" or as "an individual with schizophrenia". To the extent that both expressions define the individual's thoughts, emotions, her being in this world as diseased, they're both equally dehumanizing and discriminatory.

  2. Agreed. So people may then wonder why I use the word "schizophrenia" at all in my blog. The reason is because people need access to information and "schizophrenia" unfortunately says something. It's like looking trying to look for shoes in a store that sells hats. You need to use the word "schizophrenia" to see whether this store or another establishment will meet your needs. You can choose to reject the word later, but first you got to determine what's going on. Dr. E. Fuller Torrey "active schizophrenics" sounds like criminals or a pack of dogs and you never know when there will be a sighting.

  3. That's exactly why I use the word, as well as other psychiatric terminology, too. Guess which word I myself (!) typed into the search box at my very first Google search concerning, yeah, well, "schizophrenia" :D Although I think, it doesn't really say something, but people believe it says something - so they google it, and, of course, an entry about "existential crisis" for instance won't be among the search results, no matter how relevant for their search it actually might be.

  4. Given the suggestion of "active schizophrenics", the thought occurs to me that there must be a few "inactive schizophrenics" out there. What kind of person would constitute an "inactive schizophrenic"? Schizophrenia in the shadows, non-relapsed schizophrenia, schizophrenia in remission, repressed schizophrenia, a non-agressive form of schizophrenia, etc., etc. How about "non-schizophrenic"? Certainly once a "schizophrenic" never a "non-schizophrenic". We're getting no estimate of the number of "inactive schizophrenics" there might be, accurate or otherwise. Torrey's apprehensions are not shared by everybody. Had we 100,000 activist "schizophrenics" in town we could effect a whole lot of changes. Now that would be a show of Mad Pride! Gee, isn't word play fun?

  5. I really think schizophrenia should be more fun, or else I wouldn't be writing this blog. Unless things have changed considerably since 2003, chances are the hospital staff will tell you that you should read Dr. Torrey's book. I couldn't get past the first chapter. It was condescending.


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