dr richard gosden controversies over

Dr. Richard Gosden: Controversies Over the Cause of Schizophrenia

Schismatic Mind: Controversies over the cause of the symptoms of

schizophrenia

Abstract

Doubts about the real nature of schizophrenia are long-standing. There

are no laboratory tests to confirm diagnoses and it is not certain

whether there is consistency in the diagnostic process. Various models

have been developed to explain the cause of the symptoms. The dominant

explanatory model is based on medical assumptions that the symptoms

are pathological and are caused by an illness of the mind or brain.

The medical model embraces a wide variety of psychological and

biological theories of aetiology but there is no scientific/medical

consensus and all the evidence supporting medical theories is

equivocal. This apparent confusion gives rise to questions concerning

the validity of a medical interpretation. Alternative, non-medical

models explain the cause of the symptoms as being either a

mystical/spiritual emergency (mystical model) or as social alienation

(myth-of-mental-illness model).

When a comparative analysis of the medical, mystical and

myth-mental-illness models is undertaken in the light of interest

group theory it is apparent that competing interest groups are

promoting different explanatory models to achieve political ends. A

key determinant of this political struggle involves the selection and

emphasis of conflicting human rights imperatives. Human rights are

central to the issue of schizophrenia because people who display the

symptoms tend to be socially disruptive and, as a result, are

frequently hospitalised involuntarily and forcibly treated with drugs

that are mentally and physically debilitating.

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Table of Contents

1. INTRODUCTION (pdf-330 kb)

Objectives of the Thesis

Methodology and Underlying Theoretical Perspective of the Thesis

A Brief Description of Schizophrenia

Schizophrenia Controversies

Expanding the Diagnostic Net

The DSM Diagnostic System

Growth of the Mental Health Industry

Social Control, Youth and Unemployment

2. INTEREST GROUPS AND HUMAN RIGHTS (pdf - 340 kb)

Interest Group Theory

Human Rights and Activism

Background to Human Rights

Human Rights, Science and Technology

Human Rights and Psychiatry

Soviet Psychiatry

UN Principles on Mental Illness

The Burdekin Inquiry

3. THE MEDICAL MODEL: SCHIZOPHRENIC SYMPTOMS AS PATHOLOGY (pdf - 370

kb)

Regression Theories

Current Diagnostic Criteria

ICD-10 Diagnostic Criteria for Schizophrenia

DSM IV Diagnostic Criteria for Schizophreni

Origins of descriptive psychopathology for Schizophrenia

Kraepelin and Bleuler

4. THE PSYCHIATRIC DICHOTOMY AND THE PROLIFERATION OF MODELS (pdf -

520 kb)

Biochemical Hypotheses -- and Associated Drug Treatments

Atypical Neuroleptics

Other Biochemical Theories

Uncertainties in Schizophrenia Research

Brain Imaging

Scanning For Causes

Infection Theories

Nutrition

Genetic Theories

Theories of an Environmental/Experiential Aetiology

Developmental Theories

Family Environment

Double Bind Theory

Family Stress

Social Stress

5. THE MEDICAL MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES

(pdf - 300 kb)

Interest Groups

Campaign to Extend Involuntary Treatment in NSW

Human Rights Imperatives

Right to Treatment

Informed Consent

6. THE MYSTICAL MODEL: SCHIZOPHRENIC SYMPTOMS AS A NATURAL EXTENSION

OF CONSCIOUSNESS (pdf - 450 KB)

Background to the Mystical Tradition

Dealing With the Knowledge of Mortality

Attaining Mystical Experience

Mysticism and Psychiatry

Anti-Psychiatry, Laing and the Mystical Model

Jung

John Weir Perry -- a Jungian

Mythological Heroes and Schizophrenia

Summary of the Mystical Model

7. THE MYSTICAL MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES

(pdf - 340 kb)

Interest Groups

Human Rights Imperatives

The Spirit of Article 18

The Technical Requirements of Article 18

Involuntary Treatment Provisions in New South Wales (NSW), Australia

Incarceration of Alleged Schizophrenics

Hypothetical Mental Patient

Neuroleptic Treatment

Human Rights Report on Freedom of Religion and Belief

8. THE MYTH-OF-MENTAL-ILLNESS MODEL: SCHIZOPHRENIC SYMPTOMS AS

MANUFACTURED ARTIFACTS (pdf - 490 kb)

Sub-Type 1: Schizophrenic-as-Cultural-Outsider

Negative Symptoms

Outsider Case Studies

Sub-type 2: Schizophrenic-as-Scapegoat

Sub-Type 3: Schizophrenia-as-Role-Play

9. THE MYTH-OF-MENTAL-ILLNESS MODEL: INTEREST GROUPS AND HUMAN RIGHTS

IMPERATIVES (pdf - 380 kb)

Interest Groups

Human Rights Imperatives

Background to the Insanity Plea

Relevant Human Rights

Torture and Cruel Treatment

Neuroleptics, the M-M-I Model and Human Rights

Treatment or Torture

10. EARLY PSYCHOSIS: PREVENTIVE MEDICINE, SCIENTIFC ASSAULT ON

MYSTICAL TENDENCIES, OR AN EXTENSION OF SOCIAL CONTROL? (pdf - 520 kb)

Early Psychosis as Preventive Medicine

Early Psychosis Programmes

Case Study -- The EPPIC Programme

Critical Analysis of Early Psychosis

Drug Company Influence

CONCLUSION (pdf - 170kb)

BIBLIOGRAPHY (pdf - 480kb)