Wednesday, August 8, 2012

Bad literary advice from Carolyn Kaufman, The Writer's Guide to Psychology

I belong to an writers group called Query Tracker. Occasionally I receive e-mails from "experts" in specific topics of interest to writers. This one makes me throw up my hands. Carolyn Kaufman trots out all the stereotypes and the recovery movement seems to have completely passed her by.

Psychology Q&A: Schizophrenia & Police Work?

Posted: 08 Aug 2012 06:00 AM PDT
Disclaimer: The information provided in this post is intended for writing purposes only and does not represent psychological advice.
QUESTION: I keep returning to schizophrenia as an interesting disorder. I'm wondering what exactly can someone who's schizophrenic (and on his medications) do for a living? Can they be a detective or a police officer? Or is there a better disorder for me to use that would allow them to be a detective or a police officer? I wasn't sure if schizophrenia would keep them from being employed as such. Also,  is there a positive side to the schizophrenia -- a creativity or something along those lines that could be harnessed in the right situations? Finally, what type of inner conflict would someone with schizophrenia have to overcome in order to be successful?
ANSWER: Schizophrenia is really one of the most disabling psychological disorders someone can have -- only about a third of people with the disorder are able to live independently. By definition, schizophrenia is a psychotic disorder, which means that the person who has it isn't in touch with reality as other people experience it. Symptoms of psychosis include:

  • Hallucinations: seeing, hearing, feeling, smelling, or tasting things that aren't there; the most common hallucinations in people with schizophrenia are voices
  • Delusions: believing things that aren't based in reality despite all evidence and logic to the contrary
  • Disorganization: this doesn't mean the person is messy; it means their mind is disorganized. This leads to disorganized speech (which means  means that people wander from topic to topic enough that it's noticeably weird; in extreme cases you get a "word salad," which means the words are all just jumbled up) and disorganized behavior (which may be silly, childlike, or aggressive, but is always completely purposeless)

People with schizophrenia can be articulate and intelligent -- John Nash, the man on which A Beautiful Mind was based, is well-spoken and obviously extremely well educated. But he does see and hear things, and he has delusions.

Nonetheless, I think it would be very unusual for someone with schizophrenia to be able to be a detective or a police officer, even if he were taking medications. The meds can often suppress the psychotic symptoms, but that doesn't mean the schizophrenia goes away. And the meds tend to work better for what we call "positive" symptoms (like hallucinations, delusions, and disorganization) than they do for "negative" symptoms like catatonia, apathy, mutism, failing hygiene, and other tendencies to withdraw from society.

However, someone who has bipolar disorder (which used to be called manic depression) could be, assuming they'd never been institutionalized.  Like schizophrenia, bipolar disorder that can be crippling, and for some people it can also involve hallucinations and delusions, particularly during a manic phase.

I know that you can't get into the CIA or FBI if you have a history of mental illness of any sort, or have been to therapy for a psychological problem. Though I doubt the police are quite as stringent, they're still on the lookout for these kinds of disorders. So it would probably need to be something that hasn't officially been diagnosed.

Martin Riggs -- Mel Gibson's character from the Lethal Weapon movies -- comes to mind. He's a great example of a great character who went a little (ok, a lot) crazy and was still a police officer.  If you're not familiar with the movies, Riggs's wife dies, and he gets crazy suicidal, which makes him a complete loose cannon. If I had to diagnose Riggs off the top of my head in the first movie, I'd say a major depressive disorder, last (current) episode severe.

While some people have begun arguing that people on the schizotypy spectrum (of which schizophrenia is a part) are more creative than others, that creativity is often so different from the way other people think that it may not been seen as creativity...just as weirdness. People with bipolar disorder have more classically been seen as creative, though. They tend to be creative within the "rules" of society -- that is, their stuff looks creative, not just bizarre, to other people.

There isn't really an inner conflict someone with schizophrenia has to overcome -- it's very much a biological disorder. So is bipolar disorder, though the person with bipolar disorder may not seem quite as bizarre, and may function more within the norms of society.

Also remember that with any disorder there's a continuum from "not bad" to "really bad" versions of the disorder. So some people will have any given disorder worse than others, based on the genetics and how stressful their environment has been throughout their lives. Less severe cases may respond better to medications and therapy.

Remember, if YOU have a psychology in fiction question you want to see answered here, use the Q&A form on my Archetype site or send an email using my QueryTracker email address to the right. (Please use Q&A in your Subject Line!). 

Carolyn Kaufman, PsyD's book, THE WRITER'S GUIDE TO PSYCHOLOGY: How to Write Accurately About Psychological Disorders, Clinical Treatment, and Human Behavior helps writers avoid common misconceptions and inaccuracies and "get the psych right" in their stories. You can learn more about The Writer's Guide to Psychology, check out Dr. K's blog on Psychology Today, or follow her on Facebook or Google+
If your email address changes, please follow these instructions: 1. Scroll down to the bottom of an email from the QTB and click UNSUBSCRIBE to remove your old email addy from the database. Then 2. Go to http://querytracker.blogspot.
com/ and SUBSCRIBE (on the right-hand side, in the sidebar) with your new address!


  1. She must have attended the E.F Torrey School of Schizophrenia Stereotyping.

    In short, she's "full of the stuff that makes grass grow".


    1. The FBI, state and local law w
      enforcement may be a no-go....

      So what?

      A person who had been given a label could go on to start their own private investigation firm, or get a license to practice law.

      Or whatever else they decided to do with their life!


  2. Re: "Schizophrenia

    A recent post (a must-read) on Mad in America, by Paris Williams, 'Brain Disease or Existential Crisis?' -


  3. Dear Rosa,

    You disagree with the article, which is fine, but could you please describe how to make the information more accurate? Right now you're complaining without actually educating anyone about what's wrong, and that doesn't allow for change.

    I'm also disappointed you didn't address me directly with an email, or in the comments of the post -- I welcome input, and am always open to correcting mistakes I've made. I'm not sure why, if you were so frustrated, you didn't try to engage in an educational conversation and instead simply threw up your hands? I understand that you were frustrated, but frustration without a desire to engage in positive change isn't helping me or anyone else break down stereotypes.

    And Duane,

    I absolutely agree that someone with a diagnostic label could start a private investigation firm; the individual was asking about police detectives in particular. With regards to getting a JD to practice's my understanding that it's very hard to pass the bar if someone has psychological problems that other people know about. As I mentioned, if the diagnosis isn't obvious or documented, that certainly keeps other people from using it to discriminate against you! I'm also not advocating discrimination, but I am aware that it does exist.

    My best to both of you.

  4. Carolyn,

    Jim Gottstein is an attorney who had a "psychotic" break and now practices law -

    There are other professionals listed on this link (see recovery stories) -

    Psychosis (schizophrenia) is an EVENT (sometimes, a series of episodes), not a person!

    And people go on to full recovery from these events, as long as they ignore statements made by their psychiatrists and other "experts" in the mental health field (along wirh journalists who claim to be knowledgeable).

    Spend some time on the recovery link (above)...
    The misinformation campaign needs to stop!

    Duane Sherry, M.S.
    Retired Counselor

    1. The majority of people who have been diagnosed with "schizophrenia" fully recover -

      The recovery rate (without drugs) is 85 percent with "Open Diaogue" -

      More here (scroll down to mental health) -


  5. Hi, Carolyn,
    Thanks for tracking me down. I don´t have time to personally educate everybody about the recovery movement, except through my blog. The task is daunting. I couldn´t find a place in Query Tracker to contact you directly, and I was leaving on vacation anyway. What I will say is that the recovery movement is gathering force, like the civil rights movement in the 1960s and the gay rights movement in the 1970s. Can you imagine if someone wrote an article now saying that black people or gay people aren´t suited to certain jobs or that gay people had a lifelong illness? Your article read like a standard textbook explanation of schizophrenia that is becomign increasingly out of date because of the recovery moement demanding honest research. No more ghost written articles funded by pharma. I don´t expect you to read up on all the nuances, but here are a few. Current research points to the fact that the drugs are ineffective, and dangerous to one´s health. Furthermore, there is increasing evidence that continuing on medication prevents recovery. Duane Sherry lists a lot of resources on his site, and the Mad in America site is a great forum for the recovery movement and lots of documented research. One fictional character who comes to mind is police dectective Adrian Monk. He sees a psychiatrist, he avoids medications. As far as I can see, he exhibits a lot of characteritics that could get labelled "schizophrenic." He is not employed back in his old job, but the premise is that he is just not well enough now to resume full time work. That is no different from how people are with schizophrenia. Schizophrenia is temporary, but unfortunately what becomes almsot a self-fulfiling prophecy is the diagnosis (the diagnosis of doom!). Once diagnosed, then people are told to lower their expectations and not even try to be the best they can be. Families go along with this prediction from the doctor, and they reinforce the behavior. We can see this happening with Monk. Much as I enjoy his assistants (Natalie and Sharona) they are not the right people to be helping Monk to get back on the force. Dr. Abram Hoffer claimed that one his schizophrenia patients recovered, many went on to be doctors and professors, or engineers. If I were wanting to create a fictional character who was a police detective with a diagnosis of schizophrenia, I would do want to make it as interesting as Adrian Monk. All writers need is a little imagination about schizphrenia and they might have a best seller on their hands. Whoever created Monk didn´t believe that obsessive compulsive disorder was a barrier to great detective work. Actually, all the OCD does is give the show an interesting twist. OCD properly channeled gives people an edge whether it is in the arts, the law, medicine, science or whatever. Schizophrenia can do the same. An author could play up the empathy, the intelligence, the ability to "act" or a particular talent the person might have as a musician. He could play up the fact that the person may have lied about ever being institutionalized and has a special expertise when he investigates mysteries involving psyhiatrists and murder. Your explanation, while textbook, didn´t allow the imagination to soar as it did for whoever creatd the character of Monk. The OCD in Monk is simply a prop for a good story line. Thanks very much for contacting me, and I apologize for waving your writing around without more generosity on my part.
    Best wishes,

  6. Carolyn,

    Here's another example of Hollywood's use of literary license to create a psychologically complex character. Psychiatrist and psychopharmacologist David Healy discusses the Claire Danes character in his blog entitled "Homeland Security."

    "In the latest hit series Homeland Claire Danes plays Carrie Mathison a CIA agent with bipolar disorder taking Clozapine. She takes the drug to prevent herself tipping over into frank paranoia in a world where being paranoid is necessary for survival.

    "Anyone who knows anything about Clozapine knows Claire Danes is definitely not on it – she would not be as slim and svelte as she is if she were taking it. Weight gain is something Evident about Clozapine that stands in contrast to the Evidence showing no weight gain that companies have gone out of their way to produce for Clozapine and related drugs like Zyprexa and Seroquel (see False Friends."

    Carolyn, many people think that bipolar disorder is not the same as schizophrenia, but actually the two conditions are part of the same spectrum and the diagnosis is based on observation not on medical tests. You could exhibit more bipolar characteristics one day, especially if manic, yet get a schizophrenia label another day if you happened to enter a clinic when you were more on the depressed end of the spectrum. Needless to say, most people if they care to divulge their label at all, would opt to divulge bipolar over schizophrenia. The stigma for schizophrenia is that bad.


I am no longer approving comments. All I ask is that you be respectful of others and refrain from using profanity.