I have always thought of hallucinations as manifestations of the mind somewhat akin to dissociations. From listening to hundreds of impassioned descriptions of hallucinations from clients, they seem to fit a pattern. The thoughts and the feelings associated with the hallucination are often personally unacceptable to the client, yet seem like a possible human response to their circumstances. For example, one of the most common auditory hallucinations involved self-deprecating statements, the client hears a voice telling them they aren’t worth living, they ought to kill themselves, or their presence is a burden to everyone.
It’s been apparent to me for a number of years that there appeared to be problems with the concept of schizophrenia. Sub-types of the disorder have very different symptoms. Some include paranoia, some do not. Some include prominent disorganization, some do not. Today, I tripped over an article with information on another part of the disorder that fits only into some sub-types. Symptoms are roughly divided into three groups, positive (i.
[Updated] Ideas about treating schizophrenia seem to be gradually coming full circle. What began as little more than blaming, shaming and confining, evolved over hundreds years into a state policy of institutional care with “humane treatment”. Over the next hundred years treatment has evolved into primarily a highly professionalized medication regime with an inconsistently available community based supports. Now there is evidence that early intervention in the course of schizophrenia with psychotherapy, medication, and consistently applied community based supports may sometimes prevent the usual long-term permanent disability. Medication alone is not sufficient treatment. What has always been assumed as a manifestation of the illness, may in fact be a by-product of a paternalistic and de-humanizing treatment by the community and service agencies as well as isolation due to the pervasive experience of stigma and discrimination by the individual. In this article, I will review some of the relevant history of treating schizophrenia, and reveal the uncanny convergence of new seemingly unrelated research that could shift the paradigm in the treatment of schizophrenia. This article is an expression of my opinion, not peer reviewed literature. In fact, I invite my peers to comment tell me where I’m wrong or help me develop the ideas presented herein.
Anti-psychotic medication has gotten very expensive, especially when compared to long standing generics. Now research is finding the generics work just as well as the new “atypicals”. But the fact is, medication has to be subscribed one client at a time. While on average, some of the generics work as well with low side effects, some individuals have extreme side effects from the generics or don’t benefit from them any where near as effectively as the new “atypicals”.