Beautiful Minds
October 10, 2005 10:46 AM Subscribe
In interested in case-studies of people who have "cured" their own mental disorders via pure reasoning.
John Nash ("A Beautiful Mind") used reasoning to deduce that the voices he was hearing were not real (they were caused by his schizophrenia). Howard Stern apparently talked himself out of his OCD symptoms. Though undiagnosed, I am pretty sure I have low-grade Aspergers -- the type that makes it hard for you to understand social queues. Yet, step-by-step, I taught myself to read people. Now I work successfully as a teacher and a theatre director. I recently talked to someone else who was autistic and yet used reasoning and study to learn people well enough to hold a highly social job.
I realize that these "cures" are not really cures. (I always have to remember to read people -- it doesn't just naturally happen, and by the end of the day, I am often exhausted by the effort.) But they still fascinate me as coping mechanisms.
Does anyone know of other cases besides the ones I have mentioned? Person anecdotes? Blogs? Books?
John Nash ("A Beautiful Mind") used reasoning to deduce that the voices he was hearing were not real (they were caused by his schizophrenia). Howard Stern apparently talked himself out of his OCD symptoms. Though undiagnosed, I am pretty sure I have low-grade Aspergers -- the type that makes it hard for you to understand social queues. Yet, step-by-step, I taught myself to read people. Now I work successfully as a teacher and a theatre director. I recently talked to someone else who was autistic and yet used reasoning and study to learn people well enough to hold a highly social job.
I realize that these "cures" are not really cures. (I always have to remember to read people -- it doesn't just naturally happen, and by the end of the day, I am often exhausted by the effort.) But they still fascinate me as coping mechanisms.
Does anyone know of other cases besides the ones I have mentioned? Person anecdotes? Blogs? Books?
Well, James Frey's memoir A Million Little Pieces documents his recovery from alcoholism and drug addiction. It contains a bit of an emotional yet reasonable critique of the twelve step/AA system and details how he basically came to decide not to drink and do drugs.
All that and it's an outstanding book.
posted by xmutex at 11:05 AM on October 10, 2005
All that and it's an outstanding book.
posted by xmutex at 11:05 AM on October 10, 2005
John Nash ("A Beautiful Mind") used reasoning to deduce that the voices he was hearing were not real (they were caused by his schizophrenia).
Have you read the book? While this is Nash's take on things, it's not entirely clear that it's accurate. Spontaneous remission of schizophrenia is not uncommon; it's likely that this is what happened in Nash's case.
posted by mr_roboto at 11:37 AM on October 10, 2005
Have you read the book? While this is Nash's take on things, it's not entirely clear that it's accurate. Spontaneous remission of schizophrenia is not uncommon; it's likely that this is what happened in Nash's case.
posted by mr_roboto at 11:37 AM on October 10, 2005
In the vein of xmutex's comment, there's Rational Recovery, which as far as this non-alcoholic can tell, consists of convincing yourself that the part of your brain that wants alcohol is not "you." Zen strikes me as a similar discipline although it doesn't explicitly deal with mental illness as such.
posted by callmejay at 11:38 AM on October 10, 2005
posted by callmejay at 11:38 AM on October 10, 2005
I second the Feeling Good book. But it is fairly old and may be dated. I haven't read it since it first came out. Anything else dealing with cognitive therapy sounds like what you are looking for.
posted by vronsky at 11:43 AM on October 10, 2005
posted by vronsky at 11:43 AM on October 10, 2005
IIRC, David Sedaris replaced the worst of his OCD symptoms (obsessive rocking, touching things repetitively, licking lightswitches and other innappropriate objects) with cigarette smoking. He writes about it extensively in the essay "A Plague of Tics" in his book Naked.
posted by junkbox at 11:44 AM on October 10, 2005
posted by junkbox at 11:44 AM on October 10, 2005
Barbara O'Brien's Operators and Things is an account of her own episode of, and spontaneous recovery from, schizophrenia. She didn't exactly reason herself out of it, but she was lucid about what was happening to her at some points, and it would appear that her rationalization of her symptoms played a part in her recovery. If nothing else, it's a cogent post-mortem on her illness.
While current medical thinking would seem to discount her explanation for schizophrenia, her reasoning seems compelling enough within the context of her own story.
posted by bricoleur at 11:48 AM on October 10, 2005
While current medical thinking would seem to discount her explanation for schizophrenia, her reasoning seems compelling enough within the context of her own story.
posted by bricoleur at 11:48 AM on October 10, 2005
(BTW, xmutex, there's now a sequel to Frey's book called My Friend Leanord.)
posted by callmejay at 11:48 AM on October 10, 2005
posted by callmejay at 11:48 AM on October 10, 2005
I third the "Feeling Good" book by Burns.
I dug myself out of a pretty deep hole with it.
Learning about and working with the "Ten Cognitive Distortions" alone was worth the price of the book.
posted by willmize at 11:48 AM on October 10, 2005
I dug myself out of a pretty deep hole with it.
Learning about and working with the "Ten Cognitive Distortions" alone was worth the price of the book.
posted by willmize at 11:48 AM on October 10, 2005
Viktor Frankl. Logotherapy.
An interesting approach that arose from the author's time spent in Auschwitz.
posted by Sheppagus at 12:30 PM on October 10, 2005
An interesting approach that arose from the author's time spent in Auschwitz.
posted by Sheppagus at 12:30 PM on October 10, 2005
Response by poster: Thank you for all the answers so far.
I guess the key issue here is how much do common mental disorders disrupt one's reasoning ability? (My guess is that there isn't a single answer to this -- I'm sure it depends on the individual person and the intensity of the disorder.) In other words, does schizophrenia primarily affect your senses and emotions (you hear voices; you're scared) or does it (also) impaired your reasoning. (Again, I realize this is a dirty test-tube. Even if schizophrenia doesn't directing affect reasoning, many people my find it difficult to reason if they are highly emotional and constantly disturbed by voices.)
I'm wondering how much one's self-model, PRIOR to the onset of the disorder, affects the disorder. For instance, is a fundamentalist Christian likely to react to schizophrenia different from, say, an atheist?
More to the point, many people seem to basically trust their senses. If they saw a dragon walking down the street, their gut reaction would be, "OH MY GOD, A DRAGON!" Now if you take someone like this and give them schizophrenia, they're not going to be able to reason themselves out of it.
On the other hand, I distrust my senses. This used to be highly intellectual (having seen a bung of optical illusions, etc.), but over the years it has sunk in. Now, when I see something really odd, my immediate reaction is, "Hmm. There's probably something wrong with me." This plays itself out in little ways all the time. My wife is SURE she left her keys on the table, yet they're not there and she gets flummoxed. I strongly recall leaving my keys on the table, but my mental-map includes the idea that memories are easily damaged and often faulty. So I don't freak out when they're not where I clearly remember them to be. I also don't get upset about myself or worry that I'm getting old. I accept that memory is vastly imperfect.
I've always wondered what would happen to me if I came down with schizophrenia. Would I be able to use my "skill" to reason myself out of it? My mom, a therapist, says no: that the schizophrenia would impaired my reasoning ability. But cases like Nash's and Stern's make me wonder.
posted by grumblebee at 12:39 PM on October 10, 2005
I guess the key issue here is how much do common mental disorders disrupt one's reasoning ability? (My guess is that there isn't a single answer to this -- I'm sure it depends on the individual person and the intensity of the disorder.) In other words, does schizophrenia primarily affect your senses and emotions (you hear voices; you're scared) or does it (also) impaired your reasoning. (Again, I realize this is a dirty test-tube. Even if schizophrenia doesn't directing affect reasoning, many people my find it difficult to reason if they are highly emotional and constantly disturbed by voices.)
I'm wondering how much one's self-model, PRIOR to the onset of the disorder, affects the disorder. For instance, is a fundamentalist Christian likely to react to schizophrenia different from, say, an atheist?
More to the point, many people seem to basically trust their senses. If they saw a dragon walking down the street, their gut reaction would be, "OH MY GOD, A DRAGON!" Now if you take someone like this and give them schizophrenia, they're not going to be able to reason themselves out of it.
On the other hand, I distrust my senses. This used to be highly intellectual (having seen a bung of optical illusions, etc.), but over the years it has sunk in. Now, when I see something really odd, my immediate reaction is, "Hmm. There's probably something wrong with me." This plays itself out in little ways all the time. My wife is SURE she left her keys on the table, yet they're not there and she gets flummoxed. I strongly recall leaving my keys on the table, but my mental-map includes the idea that memories are easily damaged and often faulty. So I don't freak out when they're not where I clearly remember them to be. I also don't get upset about myself or worry that I'm getting old. I accept that memory is vastly imperfect.
I've always wondered what would happen to me if I came down with schizophrenia. Would I be able to use my "skill" to reason myself out of it? My mom, a therapist, says no: that the schizophrenia would impaired my reasoning ability. But cases like Nash's and Stern's make me wonder.
posted by grumblebee at 12:39 PM on October 10, 2005
I think Theraveda seems relevant to this.
May I ask, grumblebee, if you have any write-ups of your body language thinking, or were there any books you read that influenced your thought?
Dunno if I'm aspie, but I find attempting to follow non-verbal cues exhausting. I'm slowly improving, now that I have identified my trouble, but it is sloooowww.
posted by sonofsamiam at 12:41 PM on October 10, 2005
May I ask, grumblebee, if you have any write-ups of your body language thinking, or were there any books you read that influenced your thought?
Dunno if I'm aspie, but I find attempting to follow non-verbal cues exhausting. I'm slowly improving, now that I have identified my trouble, but it is sloooowww.
posted by sonofsamiam at 12:41 PM on October 10, 2005
Perceval's narrative may be an interesting read for you. The subtitle is "A Patient's Account of His Psychosis, 1830-1832," and it is an extraordinarily lucid account of how John Perceval (who was the son of a prime minister of England) managed to move his way out of his schizophrenia. Obviously this was before the advent of psychotherapy, and Mr. Perceval was confined to several asylums. He was very articulate and introspective.
It's a very obscure book, and the only reason I came across it was that the brilliant anthropologist Gregoray Bateson was inspired by the account. He edited it and also wrote an extraordinary introduction to it. I found it quite illuminating - it's a story that should be more widely known, in my view.
posted by jasper411 at 1:09 PM on October 10, 2005
It's a very obscure book, and the only reason I came across it was that the brilliant anthropologist Gregoray Bateson was inspired by the account. He edited it and also wrote an extraordinary introduction to it. I found it quite illuminating - it's a story that should be more widely known, in my view.
posted by jasper411 at 1:09 PM on October 10, 2005
In the cognitive therapy vein, have you checked out "The Six Pillars of Self-Esteem" by Nathaniel Branden or "The Road Less Traveled" by M. Scott Peck? Nuts-and-bolts (no pun intended) stuff.
posted by ZenMasterThis at 1:10 PM on October 10, 2005
posted by ZenMasterThis at 1:10 PM on October 10, 2005
grumblebee: "I've always wondered what would happen to me if I came down with schizophrenia. Would I be able to use my "skill" to reason myself outof it? My mom, a therapist, says no: that the schizophrenia would impaired my reasoning ability. But cases like Nash's and Stern's makeme wonder."
I'd agree with your mother. The problem is, schizophrenics and people with very severe levels of social disorders are ostracized and feared by our culture. They have no support network (outside of immediate family - if they're lucky) and are constantly reminded of how they don't exactly fit in to the larger picture.
To make matters worse, the medications don't exactly address the problem at the chemical levels (on the correct front). IANA professional psychologist or neurosurgeon, but from speaking with various individuals about their disorders and their medications the general answer is "I don't like it (lithium, etc) - it takes me out of my "zone". They are very comfortable with the patterns of their mental activity and the medications don't seek to stop the chemical precursors to this state, they simply seek to mute it or place it in the background.
I'm imagining that you haven't interfaced with a person with severe schizophrenia. Sit in a room with them for an hour and attempt to have a reasonable, cogent discussion with them about their life. You will change your opinion on "self-therapy" after fifteen minutes, and probably be mentally exhausted after half an hour.
The most horribly traumatic event of my young life was seeing my most brilliant and respected peer succumb to schizophrenia while he was living in close contact with me. He is no longer with us, and there isn't a day I go by that I don't think of his situation and the various attributing factors (internal, external... everything) to his parting. To this end, I would suggest that there are many things that can be done to address pyschological disorders of this magnitude and isolation/self-therapy is not one of them.
posted by prostyle at 1:13 PM on October 10, 2005
I'd agree with your mother. The problem is, schizophrenics and people with very severe levels of social disorders are ostracized and feared by our culture. They have no support network (outside of immediate family - if they're lucky) and are constantly reminded of how they don't exactly fit in to the larger picture.
To make matters worse, the medications don't exactly address the problem at the chemical levels (on the correct front). IANA professional psychologist or neurosurgeon, but from speaking with various individuals about their disorders and their medications the general answer is "I don't like it (lithium, etc) - it takes me out of my "zone". They are very comfortable with the patterns of their mental activity and the medications don't seek to stop the chemical precursors to this state, they simply seek to mute it or place it in the background.
I'm imagining that you haven't interfaced with a person with severe schizophrenia. Sit in a room with them for an hour and attempt to have a reasonable, cogent discussion with them about their life. You will change your opinion on "self-therapy" after fifteen minutes, and probably be mentally exhausted after half an hour.
The most horribly traumatic event of my young life was seeing my most brilliant and respected peer succumb to schizophrenia while he was living in close contact with me. He is no longer with us, and there isn't a day I go by that I don't think of his situation and the various attributing factors (internal, external... everything) to his parting. To this end, I would suggest that there are many things that can be done to address pyschological disorders of this magnitude and isolation/self-therapy is not one of them.
posted by prostyle at 1:13 PM on October 10, 2005
Response by poster: sonofsamiam, I can't point you to one book. People are my life's study. I read/watch/experience everything I can get my hands on. What did it to me -- and unfortunately I don't know how to replicate this -- was a passionate interest in people despite my lack of ability with them. When I was a kid, people were the biggest mystery in my life. And my mind doesn't tolerate mysteries. They MUST be solved.
As a teen, I read every pop-psychology book I could afford. I watched people. I studied facial expressions. I experimented by interacting with people in different ways. I was the Anthropologist on Mars -- or maybe I was the Martian Anthropologist on Earth. When I was in full-blown Aspergers, I pretty much only liked/watched typical "guy" movies. Any character-based story sent me to sleep. I've tipped over to the other extreme. My taste is not totally "chick-flick" oriented. If it's not about character and relationships, it doesn't interest me.
But I will always feel like a foreigner. I'm like a foreigner who has learned English very well -- but it's still not my first language. I have to consciously translate. As I suggested, this can be tiring. There is a plus side though. If found that I can often view human interactions accurately, but dispassionately, like a scientist studying a lab animal. I know this sounds cold, but it often gives me an edge as a teacher or director. I tend not to take sides in an argument. I tend to focus on each participant's point-of-view and see where they are coming from. I'm often a good mediator.
One writer who was really helpful when I was younger was Eric Berne (Transactional Analysis, "I'm Ok, You're Ok.") Berne's psychological model is overly simplistic, I think. He views human interactions as games in which each participant is player, trying to win something from the other participant. But it's a good model of something human-LIKE. It gave me a good starting point, and much of it is still useful, as-long-as I don't take it as dogma. It's extremely useful for narrative artists. Berne's simplistic world maps very well onto fictional characters, who are, of course, also human-LIKE.
posted by grumblebee at 1:15 PM on October 10, 2005 [1 favorite]
As a teen, I read every pop-psychology book I could afford. I watched people. I studied facial expressions. I experimented by interacting with people in different ways. I was the Anthropologist on Mars -- or maybe I was the Martian Anthropologist on Earth. When I was in full-blown Aspergers, I pretty much only liked/watched typical "guy" movies. Any character-based story sent me to sleep. I've tipped over to the other extreme. My taste is not totally "chick-flick" oriented. If it's not about character and relationships, it doesn't interest me.
But I will always feel like a foreigner. I'm like a foreigner who has learned English very well -- but it's still not my first language. I have to consciously translate. As I suggested, this can be tiring. There is a plus side though. If found that I can often view human interactions accurately, but dispassionately, like a scientist studying a lab animal. I know this sounds cold, but it often gives me an edge as a teacher or director. I tend not to take sides in an argument. I tend to focus on each participant's point-of-view and see where they are coming from. I'm often a good mediator.
One writer who was really helpful when I was younger was Eric Berne (Transactional Analysis, "I'm Ok, You're Ok.") Berne's psychological model is overly simplistic, I think. He views human interactions as games in which each participant is player, trying to win something from the other participant. But it's a good model of something human-LIKE. It gave me a good starting point, and much of it is still useful, as-long-as I don't take it as dogma. It's extremely useful for narrative artists. Berne's simplistic world maps very well onto fictional characters, who are, of course, also human-LIKE.
posted by grumblebee at 1:15 PM on October 10, 2005 [1 favorite]
Thanks :)
posted by sonofsamiam at 1:30 PM on October 10, 2005
posted by sonofsamiam at 1:30 PM on October 10, 2005
prostyle, just out of curiosity, you mention that your friend has passed away. If you don't mind me asking, was this as a result of his disorder, or for other unrelated reasons? I only ask because I've often wondered if there's any reason why mental illness might reduce your life expectancy. That is, I'm curious about the connection between mental wellness and physical wellness (I realize that clinically, the mental is part of the physical, but that's not what I'm referring to).
If you don't wish to talk about it, please ignore my query.
posted by Civil_Disobedient at 1:31 PM on October 10, 2005
If you don't wish to talk about it, please ignore my query.
posted by Civil_Disobedient at 1:31 PM on October 10, 2005
Response by poster: prostyle, I'm very sorry to hear about your friend. Actually, I CAN relate (at least somewhat). My best friend from childhood is severely schizophrenic. His story has -- so far -- a more happy ending than that of your friend, in that he is still alive and marginally self-reliant. Knowing him is what originally started me thinking about these things.
Still, according to your post, schizophrenics have a hard time reasoning because they are ostracized and don't like medication. In other words, they are under various stresses that make it difficult for them to think clearly. But this still doesn't answer my question, which is do schizophrenics have trouble reasoning because schizophrenia directly impairs reasoning -- or is it because schizophrenia tends to give people highly stressful lives, and people under stress have a hard time reasoning (or both)?
I don't want to make myself sound special or gifted (any assets I have are balanced by major deficiencies), but in my experience, my mental model is INCREDIBLY rare. I'm not religious or superstitious: I don't have even a slight belief in ghosts, voices, spirits, etc. I don't believe that my senses are an accurate meter of reality. This isn't THAT unique. Many people have these thoughts. But I've met very few who feel these things in their gut. Most people who are skeptical about their senses seem to think that it's POSSIBLE that their senses might be wrong. I EXPECT my senses to fool me.
So I'm still wondering how much pre-mental-illness beliefs affect one's condition once the illness takes over.
posted by grumblebee at 2:03 PM on October 10, 2005
Still, according to your post, schizophrenics have a hard time reasoning because they are ostracized and don't like medication. In other words, they are under various stresses that make it difficult for them to think clearly. But this still doesn't answer my question, which is do schizophrenics have trouble reasoning because schizophrenia directly impairs reasoning -- or is it because schizophrenia tends to give people highly stressful lives, and people under stress have a hard time reasoning (or both)?
I don't want to make myself sound special or gifted (any assets I have are balanced by major deficiencies), but in my experience, my mental model is INCREDIBLY rare. I'm not religious or superstitious: I don't have even a slight belief in ghosts, voices, spirits, etc. I don't believe that my senses are an accurate meter of reality. This isn't THAT unique. Many people have these thoughts. But I've met very few who feel these things in their gut. Most people who are skeptical about their senses seem to think that it's POSSIBLE that their senses might be wrong. I EXPECT my senses to fool me.
So I'm still wondering how much pre-mental-illness beliefs affect one's condition once the illness takes over.
posted by grumblebee at 2:03 PM on October 10, 2005
I have been told by a schizophrenic that she knows the voices are not real (but then she is medicated.)
Bipolars I have talked to who are schizoaffective and have hallucinations often say they can tell they are not real-but when an episode reaches a certain point evidently that ability is lost.
posted by konolia at 2:23 PM on October 10, 2005
Bipolars I have talked to who are schizoaffective and have hallucinations often say they can tell they are not real-but when an episode reaches a certain point evidently that ability is lost.
posted by konolia at 2:23 PM on October 10, 2005
Grumblebee, as you're aware, I've been struggling with low-grade depression/melancholia for the past year or so. I've always had elements of it in my personality, but during the past twelve months it has defined my personality.
I tried improving my diet and exercise. I tried natural anti-depressants. I gave up video games. I did everything I could think of to fight this thing. (And I knew that it was a "thing" that I needed to fight. This wasn't the natural me.)
Ultimately, what seems to have helped most is a prolonged period of self-examination. I've been trying to do just what you suggest: to apply logic and reasoning to my life and my feelings, and to determine why it is I feel the way I do and to discover what I can do to make myself feel better.
For me, there's an element of displacement that's caused some of my depression. (I recently moved from my hometown of 35 years to a large nearby city.) More importanty, someplace along the way I lost confidence. I forgot what it was like to believe in myself and to stand up for myself. I began to worry too much about what other people thought.
Over the past couple weeks I've been forcing myself to behave confidently. I know that I enjoy being a confident person, and so I'm continually forcing myself to remember this. If I'm at the grocery store and have a question, I tell myself to be confident. If I have to make a phone call, I tell myself to be confident. (I don't want to make it sound like I've been non-functional; I've been getting on perfectly fine. But I want to be better than fine.)
So, yes, I believe it is possible to reason oneself out of mental illness, especially low-grade cases. I have a friend who is very, very depressed, though, to such an extent that I don't think he can help himself through pure reason. Or, perhaps it's more true that he can only save himself through pure reason. Nothing else has helped, and I think only he can save himself...
posted by jdroth at 2:23 PM on October 10, 2005
I tried improving my diet and exercise. I tried natural anti-depressants. I gave up video games. I did everything I could think of to fight this thing. (And I knew that it was a "thing" that I needed to fight. This wasn't the natural me.)
Ultimately, what seems to have helped most is a prolonged period of self-examination. I've been trying to do just what you suggest: to apply logic and reasoning to my life and my feelings, and to determine why it is I feel the way I do and to discover what I can do to make myself feel better.
For me, there's an element of displacement that's caused some of my depression. (I recently moved from my hometown of 35 years to a large nearby city.) More importanty, someplace along the way I lost confidence. I forgot what it was like to believe in myself and to stand up for myself. I began to worry too much about what other people thought.
Over the past couple weeks I've been forcing myself to behave confidently. I know that I enjoy being a confident person, and so I'm continually forcing myself to remember this. If I'm at the grocery store and have a question, I tell myself to be confident. If I have to make a phone call, I tell myself to be confident. (I don't want to make it sound like I've been non-functional; I've been getting on perfectly fine. But I want to be better than fine.)
So, yes, I believe it is possible to reason oneself out of mental illness, especially low-grade cases. I have a friend who is very, very depressed, though, to such an extent that I don't think he can help himself through pure reason. Or, perhaps it's more true that he can only save himself through pure reason. Nothing else has helped, and I think only he can save himself...
posted by jdroth at 2:23 PM on October 10, 2005
p.s. After seeing many recommendations for Feeling Good here and elsewhere, I finally borrowed it from the library. I've not read it yet, but I plan to.
posted by jdroth at 2:24 PM on October 10, 2005
posted by jdroth at 2:24 PM on October 10, 2005
I've been diagnosed as bipolar more than once and I think it's BS and pretty much use Choice Theory to keep myself afloat. Some find it drivel but it works for me.
I also recommend Frey's book.
posted by dobbs at 2:50 PM on October 10, 2005
I also recommend Frey's book.
posted by dobbs at 2:50 PM on October 10, 2005
My brother has been schizophrenic for more than 25 years. He lives with me, and is functionally disabled by the disease to the point it is unlikely he will ever lead a "normal" life. And yet, thanks to a newer atypical anti-psychotic medication, which he was put on about 9 years ago, he is able to care for himself, help with housework, and enjoy some of life's simple pleasures. He's a good guy, who is making the best of a tough hand life has handed him, and is a frequent source of inspiration to those that know and love him.
Like many medical conditions, schizophrenia has a continuum of severity, on which, my brother might be said to be nearer the severe end. Yet, with minimal help, he remains medication compliant, and has come to some understanding of both the positive symptoms of the disease (auditory hallucinations, disordered thinking, obsession, paranoia, episodic depression) which his meds attempt to control, and the negative symptoms (lack of initiative, memory issues, poor adaptability to stress and novelty) which are largely left to him to deal with through self-management and familial help. All in all, he is currently doing very well, but helping him deal with this disease has made me more than curious about the processes of mental illness in general, and this illness, specifically.
I've done a lot of reading about this illness in the last couple of years, and what I've learned is a mixed bag of hope and cautions against greater hope. First problem is, that there is no comprehensive understanding of what causes this illness (although recent research offers new hypotheses), or exactly how the medications given to control its symptoms actually do so. Research continues, but it is damnably difficult to sort out the biology and bio-chemistry, and the clinical process is complicated because of the simple fact that just because you have schizophrenia, doesn't mean you might not also have other problems.
As to John Nash's story, I suspect that he is one of those persons who, while having the disease, has found ways of adapting to life with its various symptoms, essentially with minimal on-going medication support. Some small minority of people with this illness are able to do so, and from what I understand of his story, he would have a number of factors identified in a 2002 UCLA study in his favor, but he can hardly be considered typical. Yet some people can apparently learn to manage the disease successfully, and some self-help organizations exist which even treat the illness with social supportive techniques adapted from drug addiction management programs. And yet, for the majority of young adults first experiencing the symptoms of this condition, the overall statistics remain chilling, at least in the U.S., if they have any interest in such.
posted by paulsc at 3:07 PM on October 10, 2005
Like many medical conditions, schizophrenia has a continuum of severity, on which, my brother might be said to be nearer the severe end. Yet, with minimal help, he remains medication compliant, and has come to some understanding of both the positive symptoms of the disease (auditory hallucinations, disordered thinking, obsession, paranoia, episodic depression) which his meds attempt to control, and the negative symptoms (lack of initiative, memory issues, poor adaptability to stress and novelty) which are largely left to him to deal with through self-management and familial help. All in all, he is currently doing very well, but helping him deal with this disease has made me more than curious about the processes of mental illness in general, and this illness, specifically.
I've done a lot of reading about this illness in the last couple of years, and what I've learned is a mixed bag of hope and cautions against greater hope. First problem is, that there is no comprehensive understanding of what causes this illness (although recent research offers new hypotheses), or exactly how the medications given to control its symptoms actually do so. Research continues, but it is damnably difficult to sort out the biology and bio-chemistry, and the clinical process is complicated because of the simple fact that just because you have schizophrenia, doesn't mean you might not also have other problems.
As to John Nash's story, I suspect that he is one of those persons who, while having the disease, has found ways of adapting to life with its various symptoms, essentially with minimal on-going medication support. Some small minority of people with this illness are able to do so, and from what I understand of his story, he would have a number of factors identified in a 2002 UCLA study in his favor, but he can hardly be considered typical. Yet some people can apparently learn to manage the disease successfully, and some self-help organizations exist which even treat the illness with social supportive techniques adapted from drug addiction management programs. And yet, for the majority of young adults first experiencing the symptoms of this condition, the overall statistics remain chilling, at least in the U.S., if they have any interest in such.
- The rate of suicide for schizophrenics is several times that of the general population. Suicide is the leading cause of death for schizophrenics, and by some estimates, more than 40% of those with this illness will attempt suicide at least once.
- A recent study widely reported in the popular press showed that anti-psychotic medications "didn't completely alleviate symptoms or enable the majority of the patients to experience a complete recovery."
- Of all those diagnosed with schizophrenia, after 10 years, only 50% will be relatively independent, and 10% will be dead (usually suicide).
posted by paulsc at 3:07 PM on October 10, 2005
For the whole time I was mad, reasoning was worse than useless - because it kept me awake.
My psychosis was brought on by a combination of work-related stress, cultural isolation (I'm a monolingual Australian and was working in Germany), and sleep deprivation. It seemed to me at the time as if I was well on the way toward reconciling quantum mechanics and relativity (both of which subjects I actually have only a popular-science grasp of) by means of a bold new understanding of the true nature of time and space. The excitement of this journey of discovery kept me awake and scribbling incoherent notes all night, night after night, further depriving me of much needed sleep.
I was doing tremendous amounts of reasoning, but my reasoning process was damaged and the assumptions I was basing my reasoning on were totally at odds with reality. I didn't see myself as mentally ill; I saw myself as Finally In Touch With The Source Of All Enlightenment.
On the way out of this state, I did of course do a tremendous amount of reasoned review and reality checking - but the main thing that enabled me to do that was stopping work and returning home.
Part of my journey through madness involved being an involuntary patient at a psych hospital in Singapore for a week or so, where I received a daily dose of haloperidol. I don't know how much that actually helped, because I distinctly remember, during the pre-release interview with the panel of doctors, feeling like I was just mercilessly scamming them. I mean, I told them I realized that my mind wasn't working properly etc. etc. etc. but what I was actually thinking was "what do I have to tell these guys so they'll let my beloved take me home and let me get on with my discoveries?"
They gave me a prescription for haloperidol and strongly recommended I keep taking it once I got home; I never did.
Having returned to a familiar physical and cultural environment, I slept better and ate properly - and gradually came to understand that I had in fact been quite ill.
For the next six months I lived in fear of going mad again, and would deliberately change the subject every time my mind turned to the kinds of things I'd been thinking about while mad. Later, I allowed myself to think about that stuff again, but deliberately imposed a fact-checking regime on each new insight - and this helped me realize just how mad I'd actually been. I do think that if I hadn't been fairly disciplined about this during that period, I might well have ended up somewhere near Time Cube territory again.
In short: reasoning is a very useful skill, and can certainly be helpful to somebody on the way out of mental illness; but "pure reasoning" is a two-edged sword. Reason can very easily become decoupled from reality, and when it has, it does more harm than good.
posted by flabdablet at 5:57 PM on October 10, 2005 [2 favorites]
My psychosis was brought on by a combination of work-related stress, cultural isolation (I'm a monolingual Australian and was working in Germany), and sleep deprivation. It seemed to me at the time as if I was well on the way toward reconciling quantum mechanics and relativity (both of which subjects I actually have only a popular-science grasp of) by means of a bold new understanding of the true nature of time and space. The excitement of this journey of discovery kept me awake and scribbling incoherent notes all night, night after night, further depriving me of much needed sleep.
I was doing tremendous amounts of reasoning, but my reasoning process was damaged and the assumptions I was basing my reasoning on were totally at odds with reality. I didn't see myself as mentally ill; I saw myself as Finally In Touch With The Source Of All Enlightenment.
On the way out of this state, I did of course do a tremendous amount of reasoned review and reality checking - but the main thing that enabled me to do that was stopping work and returning home.
Part of my journey through madness involved being an involuntary patient at a psych hospital in Singapore for a week or so, where I received a daily dose of haloperidol. I don't know how much that actually helped, because I distinctly remember, during the pre-release interview with the panel of doctors, feeling like I was just mercilessly scamming them. I mean, I told them I realized that my mind wasn't working properly etc. etc. etc. but what I was actually thinking was "what do I have to tell these guys so they'll let my beloved take me home and let me get on with my discoveries?"
They gave me a prescription for haloperidol and strongly recommended I keep taking it once I got home; I never did.
Having returned to a familiar physical and cultural environment, I slept better and ate properly - and gradually came to understand that I had in fact been quite ill.
For the next six months I lived in fear of going mad again, and would deliberately change the subject every time my mind turned to the kinds of things I'd been thinking about while mad. Later, I allowed myself to think about that stuff again, but deliberately imposed a fact-checking regime on each new insight - and this helped me realize just how mad I'd actually been. I do think that if I hadn't been fairly disciplined about this during that period, I might well have ended up somewhere near Time Cube territory again.
In short: reasoning is a very useful skill, and can certainly be helpful to somebody on the way out of mental illness; but "pure reasoning" is a two-edged sword. Reason can very easily become decoupled from reality, and when it has, it does more harm than good.
posted by flabdablet at 5:57 PM on October 10, 2005 [2 favorites]
I read somewhere that Carl Jung theorized that James Joyce was schizophrenic but kept the disease from completely taking hold by writing Finnegans Wake. Jung treated Joyce's daughter, Lucia, for schizophrenia.
posted by dagnyscott at 7:46 PM on October 10, 2005 [1 favorite]
posted by dagnyscott at 7:46 PM on October 10, 2005 [1 favorite]
Reasoning ability is definitely impaired in most of the severely schizophrenic folks I've interviewed. DSM and psychiatrists infected with it use shorthand phrases like "loose associations," "disordered thinking," "fixed delusions," and so on, but these are all things that make proper reasoning impossible.
The analytic theory, of course, is that proper reasoning can lead to insight, and insight can "cure" psychiatric disease. The analytic theory is wrong as a general statement; it works passably well in people whose ability to be rational and insightful was already developed pretty well before they got sick.
Back to the people with schizophrenia: most of them know perfectly well that what they're hearing isn't real. Knowing this doesn't matter to them; the stuff still disturbs them to the very core. The medication can interrupt this very powerful and terrible-feeling emotional response; medicated schizophrenic people can still hallucinate, but it doesn't bother them so much. And, oddly enough, the major tranquilizers that make most folks become sedated, can make a schizophrenic person's thinking more orderly and rational.
Trying to cure a schizophrenic person by appealing to their ability to reason their way out of their problems, in 2005, strikes me as barbaric and ineffective.
posted by ikkyu2 at 12:42 AM on October 11, 2005
The analytic theory, of course, is that proper reasoning can lead to insight, and insight can "cure" psychiatric disease. The analytic theory is wrong as a general statement; it works passably well in people whose ability to be rational and insightful was already developed pretty well before they got sick.
Back to the people with schizophrenia: most of them know perfectly well that what they're hearing isn't real. Knowing this doesn't matter to them; the stuff still disturbs them to the very core. The medication can interrupt this very powerful and terrible-feeling emotional response; medicated schizophrenic people can still hallucinate, but it doesn't bother them so much. And, oddly enough, the major tranquilizers that make most folks become sedated, can make a schizophrenic person's thinking more orderly and rational.
Trying to cure a schizophrenic person by appealing to their ability to reason their way out of their problems, in 2005, strikes me as barbaric and ineffective.
posted by ikkyu2 at 12:42 AM on October 11, 2005
Another vote for Feeling Good here. Before I read it, I was plagued by every-two-years-like-clockwork major depressive episodes; after I mastered cognitive therapy (and I had some one-on-one, and a period on Prozac, too) it's been largely manageable. For the longest time I would give myself a depression inventory every week or month, and if I tumbled into a trough I'd use daily cognitive dialogues to work myself out. I probably could have used group therapy, too, but I didn't want it.
At the time it was written cognitive therapy was a relatively new thing; today it's the norm, driven in part by insurers' preferences for short rounds of effective therapy. Burns has updated his book since the original publication, too.
Another set of books in the same vein I can also recommend is the David Reynolds, Ph.D. works on Japanese Morita therapy -- which arrives at much the same end point as cognitive therapy through a lens of Western psychotherapy modified by Buddhist and Zen principles. You can't get out of bed? Don't think about why you can't get out of bed; get out of bed and by getting out of bed much of what caused you not to want to get out of bed will be solved if only by momentum. You'll get cleaned up; you'll dress; you'll eat breakfast. Maybe then you'll watch TV instead of going back to bed, which is an improvement.
The first is Playing Ball on Running Water; the latest is Constructive Living.
I used to think that depression was the root cause, but I now suspect that, like you, "low-grade Asperger's" or what they call "high-functioning autism" has been a larger part of my set of issues. (I took that online test and fell smack dab in the middle between "normal" and "Asperger's".) At the time there wasn't any discourse for this. It's probably the reason I was (mistakenly) leery of group therapy. Like you, I'm approaching it as a problem to be solved through practice or exercises, which I'm modeling roughly on what the Burns books taught me.
At the same time I want to reiterate that I have confidence in medical approaches. That was the biggest leap for me, back in the day -- realizing that I had an illness, which left untreated would likely kill me; and that I could treat it, and must. I didn't eschew meds, and I didn't use cognitive as a crutch because I believed in a self-cure or wanted to rationalize my way out of illness. I don't think that's where you're going with this, but I feel compelled to stake that territory.
Good luck. E-mail me if you want to compare notes.
posted by dhartung at 12:58 AM on October 11, 2005 [1 favorite]
At the time it was written cognitive therapy was a relatively new thing; today it's the norm, driven in part by insurers' preferences for short rounds of effective therapy. Burns has updated his book since the original publication, too.
Another set of books in the same vein I can also recommend is the David Reynolds, Ph.D. works on Japanese Morita therapy -- which arrives at much the same end point as cognitive therapy through a lens of Western psychotherapy modified by Buddhist and Zen principles. You can't get out of bed? Don't think about why you can't get out of bed; get out of bed and by getting out of bed much of what caused you not to want to get out of bed will be solved if only by momentum. You'll get cleaned up; you'll dress; you'll eat breakfast. Maybe then you'll watch TV instead of going back to bed, which is an improvement.
The first is Playing Ball on Running Water; the latest is Constructive Living.
I used to think that depression was the root cause, but I now suspect that, like you, "low-grade Asperger's" or what they call "high-functioning autism" has been a larger part of my set of issues. (I took that online test and fell smack dab in the middle between "normal" and "Asperger's".) At the time there wasn't any discourse for this. It's probably the reason I was (mistakenly) leery of group therapy. Like you, I'm approaching it as a problem to be solved through practice or exercises, which I'm modeling roughly on what the Burns books taught me.
At the same time I want to reiterate that I have confidence in medical approaches. That was the biggest leap for me, back in the day -- realizing that I had an illness, which left untreated would likely kill me; and that I could treat it, and must. I didn't eschew meds, and I didn't use cognitive as a crutch because I believed in a self-cure or wanted to rationalize my way out of illness. I don't think that's where you're going with this, but I feel compelled to stake that territory.
Good luck. E-mail me if you want to compare notes.
posted by dhartung at 12:58 AM on October 11, 2005 [1 favorite]
Have you read Oliver Sacks' An Anthropologist on Mars? Sacks gives you a wonderful look into the world of autism, particularly in his interview with Temple Grandin. She is a fascinating example of one who has adapted to autism and become extremely successful.
I am not sure I would compare autism with schizophrenia or manic-depressive disorder both of which can be cured in some cases. Autism, as a developmental disorder does not appear to be curable, at least at present, but many autistics have adapted and lead successful lives.
posted by phewbertie at 8:05 AM on October 11, 2005
I am not sure I would compare autism with schizophrenia or manic-depressive disorder both of which can be cured in some cases. Autism, as a developmental disorder does not appear to be curable, at least at present, but many autistics have adapted and lead successful lives.
posted by phewbertie at 8:05 AM on October 11, 2005
I was diagnosed with bipolar type 2 a few years ago after I had a manic episode in reaction to an antidepressent. While going through the manic episode, I realized something was amis even though I didn't know what it was (particularly when they hadn't figured out I was having a manic episode yet).
Through much of it I coped just by being aware that something was wrong with my perceptions, and I used Occam's Razor to rule out delusions. They certainly felt real, but after thinking about them I could tell they were delusions. I certainly wasn't perfect at it though.
Later, I watched a friend go through a much more severe manic episode. I do not think he could have thought through it like I did. After it was over, I realized he didn't even know the mania was coming on. After my experience, I knew my triggers and the mindfeel of an altered mental state, and I would adjust my behavior accordingly to avoid it (if possible).
I agree strongly with flabdablet that reasoning can be counterproductive. Much of my experience from the manic episode fits that description. (fast thoughts, expansive thinking, etc). Some type of reasoning is constructive, but that kind just makes it worse. I guess the trick is to get it right.
posted by furvyn at 6:45 AM on October 14, 2005
Through much of it I coped just by being aware that something was wrong with my perceptions, and I used Occam's Razor to rule out delusions. They certainly felt real, but after thinking about them I could tell they were delusions. I certainly wasn't perfect at it though.
Later, I watched a friend go through a much more severe manic episode. I do not think he could have thought through it like I did. After it was over, I realized he didn't even know the mania was coming on. After my experience, I knew my triggers and the mindfeel of an altered mental state, and I would adjust my behavior accordingly to avoid it (if possible).
I agree strongly with flabdablet that reasoning can be counterproductive. Much of my experience from the manic episode fits that description. (fast thoughts, expansive thinking, etc). Some type of reasoning is constructive, but that kind just makes it worse. I guess the trick is to get it right.
posted by furvyn at 6:45 AM on October 14, 2005
...and A Beautiful Mind made me cry. I don't know how it really was for Nash, but the fiction described some of what I felt so closely.
posted by furvyn at 6:48 AM on October 14, 2005
posted by furvyn at 6:48 AM on October 14, 2005
This thread is closed to new comments.
posted by callmejay at 11:04 AM on October 10, 2005