Late adolescence and early adulthood is arguably the most difficult period of life. Transitioning from childhood to adulthood entails many challenges. The young person (male or female) is expected to emancipate successfully from parents; launch a career; and find a partner – all in the space of a few short years.
Some individuals cope remarkably well. Others squeak through, and a small minority “crash and burn.” The latter group usually return home.
The optimum response when we experience significant failure is to say something like: “Well, I made a mess of that. Clearly I have some serious skill deficits. I need to remediate these promptly and try again.” Unfortunately this kind of response is very rare, and it needs to be acknowledged that our culture makes the admission of failure very difficult. We place such importance on success that failure in any area is almost the modern equivalent of the mortal sin.
So our hapless young person returns to the bosom of his family, who often have difficulty recognizing or understanding where the problem lies. The skill deficits in question are usually in the social area (e.g. inability to engage in conversation; abrasiveness; etc.) or in the occupational area (e.g. resentment of authority figures; failure to follow directions; failure to see tasks to completion, etc.) Often parents who have spent the past 20 or so years in close contact with the individual have become so accustomed to his “ways,” that they don’t see them as problems.
So they’re mystified as to what the difficulty is, and a measure of alienation inevitably develops.
The young person, for his part, hangs around the house playing parent-aggravating music, smoking pot, practicing yoga, writing great American novels, etc., etc.: anything, in other words, but improve his skills and get on with the challenges of life.
Meanwhile, his existential challenge is to make some kind of sense of his life. Unfortunately, most people in this predicament achieve this by blaming their parents. “They don’t understand.” “They don’t care about me.” “They prefer my brother/sister,” etc… Sometimes there’s a grain of truth in some of these assertions. (No parents are perfect), and the grains of truth are routinely adduced as evidence of the “mistreatment.” And once you’ve convinced yourself that your parents had it in for you, it’s a small step to extend this policy of malicious victimization to other players: employers, colleagues, boy/girlfriends, etc..
The phenomenon we call paranoia always develops (in a most understandable way) from a profound sense of failure. And the only successful treatment is regular doses of feelings of success, which can only come from actual successes.
So our young person is hanging around the house (or the streets) blaming others for his problems and getting nowhere with life. At some point in this process he learns of a role that he is perfectly qualified to play – the role of mental health patient. This doesn’t usually come as a flash of insight, out of the blue, so to speak, but typically is introduced to the individual piecemeal by various agents – peers, family, caseworkers, even police.
Now I’m not suggesting that the individual says: “Ha! That’s it, I’ll become a mental health patient. That’s the life for me.”
The fact is that we all find roles in life, and these roles develop around us in subtle, barely-noticed ways. When we take a job, for instance, we get drawn into a role, much of which is defined by the culture of the organization. Similarly when a couple has their first child, they get drawn into the role of parenthood. The point is that the context in which we find ourself elicits actions from us in various subtle ways. And mental health patient is one of the options available to the young person described above.
Schizophrenia is not an illness, but rather a role that people can adopt when they feel overwhelmed by a sense of failure. I have written extensively on these topics before.
What brings the matter to mind again is an article dated November 2012 in the Schizophrenia Bulletin titled: The Myth of Schizophrenia as a Progressive Brain Disease. The authors, Robert B. Zipursky, Thomas J. Reilly,and Robin M. Murray, are all psychiatrists. The gist of the article is clear from the title.
Their primary conclusion is:
“Thus, the idea that schizophrenia is a progressive brain disease is not supported by the weight of longitudinal neuroimaging and cognitive studies, and it is not consistent with what is now known about the clinical course of schizophrenia. It is important for optimum clinical care that the idea that underlying schizophrenia there exists an intrinsically malignant process be reconsidered. It has contributed to an undue pessimism among mental health professionals and their consequent alienation from sufferers and their representatives, who increasingly advocate for the ‘recovery model.’”
The authors marshal compelling arguments and detailed research findings to support their conclusion, and the article is well worth reading.
“‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another.”
Both articles are challenging the illness explanation of the behavior labeled schizophrenia. And both articles stress the damage that the illness approach entails.
They are also noteworthy in that up to a few years ago they would never have seen the light of day. Today, the spurious psychiatric illness model is under increasing scrutiny and attack.
I strongly recommend these two articles.