Managing Psychological Disorders in Surviving Schizophrenia by Fuller Torrey - Book Report/Review Example

Lecturer: Summary Surviving Schizophrenia, 5th edition by Fuller Torrey is currently being applied as a key reference with regards to the Schizophrenia. The book offers clear description of the nature of schizophrenia and how it can be distinguished from other similar conditions. It also discusses the known causes and symptoms that are exhibited by effected individuals. The book highlights some treatments that have been applied successfully to manage the condition as well as an exploration of living with schizophrenia from the patient and the family’s perspective. The information is based on new research findings with regards to causes and treatment. The author is a research psychiatrist specifying in schizophrenia and bipolar disorder. He is a professor of psychiatry at the Uniformed Services University of the Health Sciences, Maryland (Torrey, 2006). The Condition; the Person’s Experience The male patient exhibited symptoms of schizophrenia with a first incident of psychosis that was difficult for the individual to manage. It also presented significant difficulties to the patient’s family as his behavior was highly unpredictable, changing within a relatively short time span. In some instances, the patient would develop anxiety and anger with every person around him. In the family member’s view, the individual looked confused and apprehensive of family members and friends who are well known to him without any justified reason. The major problem was that it was difficult to convince the person to seek the help of a physician since he did not think that he had a mental health problem. As the problem escalated, the individual continued to develop negative symptoms that deviated from the normal functioning of a healthy person’s mind. He appeared unresponsive to the surrounding nonchalant and apathetic (Torrey, 2006). The first severe episode of psychosis was followed by reduced symptoms that were not easily noticeable. However, the person continued to be socially withdrawn and also began losing awareness of personal hygiene, which kept away friends and many of his relatives. The person lost interest in communal activities in the society and also lacked motivation in life. His lack of interest in family affairs including matrimonial issues broke up his two-year marriage. He could not concentrate on important aspects concerning the living environment and could easily be run over by vehicles as he did not reflect on any potential danger while crossing the road. At times the person would not leave the house and also extended his sleep in an unusual manner. He could not initiate any conversation and most of the times felt that there was nothing to say. The person developed depression that worsened his condition and was also accelerated by the way that people initially close to him began looking at him scornfully (Torrey, 2006). Social Issues There are many social issues associated with schizophrenia. Language and stigma are the major causes of concern in the efforts to treat the mental illness. It is possible for people suffering from the condition to experience exclusion from society. Social stigma is a major hindrance to successful recovery from the condition and other mental health problems (Jablensky, 2007). Society’s perception that mental illness is a dangerous condition that needs to be dealt with through isolation causes stigma among the affected individuals. It is a misguided view of the society against people affected by schizophrenia as fewer homicide cases are associated with the condition compared to the overall homicide cases reported in the UK (Goldman, 2006). Medications used for the condition are also a source of stigma as they are associated with some unpleasant changes in the physical and emotional character of the patient such as excessive weight gain that was experienced by the individual in this case. He also began salivating excessively creating an unpleasant image to friends and relatives. Clinical language also increases stigmatization of schizophrenia patients. They are usually regarded as schizophrenic or psychotic, which are terms that depict them as stereotypes of mental illness. Such language by healthcare staff does not help to improve the condition but rather worsens it. Employers also generalize the condition simply as madness and the intellectual ability is no longer seen in the person (Torrey, 2006). The stigma of schizophrenia is also extended to the family of a person suffering from the condition. They often assume the liability of passing on ‘bad genes’ that are associated with schizophrenia to their child. Siblings are also faced with stigma of having such a patient in the family commonly referred to as ‘mad’ by members of the society. They may also be fearful of acquiring the same condition especially in a case where two members of the family have on different occasions been diagnosed with the problem (Jablensky, 2007). Therapeutic Treatments Medications such as clozapine are commonly applied to quell the most distressing symptoms that cause isolation in the community. They help to curtail delusions and deliriums progressively for several weeks while clearing the patient’s thoughts. The individual’s motivation is increased leading to consciousness of personal hygiene and care (Fabrega, 2005). Nevertheless, medications need to be prescribed by a competent physician as they may have different side effects on different people. The wrong medication may aggravate the situation. The drugs are currently administered as a single dose as the traditional dose of several times a day was difficult to be followed by the patients due to forgetfulness. Antipsychotic injections are also administered fortnightly or after 3 to 4 weeks for individuals who have difficulties maintaining a daily dose. Medications do not eliminate the symptoms completely but help to control them and therefore have to be taken for a long time to prevent recurrence. The symptoms may come back in 3 to 6 months after stopping the medications (Goldman, 2006). Psychological therapy has been found to be successful in managing schizophrenia. Cognitive behavioural therapy helps an individual to manage difficult hallucinations and false impressions. They comprise between 8 and 20 one hour sessions with psychoanalysts as well as psychiatrist courses that help an individual to concentrate on the issues that are considered to be extremely difficult such as wrong judgement and hallucinations of being mistreated. The person is also helped to view things and behave differently by adjusting the thinking and behaviour habits. A person learns how the thinking and behaviour habits affect him/her and also learns to analyse whether they are idealistic or obstructive. The psychiatrists help the patient to work out better ways of approaching and thinking about and reacting to issues. This facilitates behavioural change in the individual (Fischer, 2002). Counselling and supportive psychotherapy helps the affected person to analyse issues affecting him/her with the assistance of a trained counsellor. A person is able to discuss the things that affect them emotionally thereby releasing stress and beginning to view life differently. He/she may not realize that there are solutions to the daily problems encountered until they are discussed with an experienced person. Family meetings with the psychotherapist help all the people involved in taking care of the patient to understand the condition and learn the best way to support the schizophrenia patient (Fabrega, 2005). They also acquire useful information regarding solving problems that can emerge in the absence of the psychotherapist. Two family meetings per month for the first 6 months are necessary to develop the desired competences to manage the condition. Art therapy comprises the application of creativity to display feelings that the person could not express in words. He/she derives satisfaction from creating an image. More gratification is achieved when other people appreciate the person’s creativity, which motivates him/her to participate in communal activities (Bolton, 2007). Causes of Schizophrenia The exact cause of schizophrenia has not yet been understood but several theories revolve around interaction of genetic and environmental influences. The stress vulnerability model postulates that different people have varying degrees of susceptibility to schizophrenia that are influenced by the interaction between social, genetic and psychological factors. Environmental stressors are critical in the generation of vulnerability. High vulnerability poses a high risk of problems even with little stress levels (Fischer, 2002). The dopamine hypothesis postulates that schizophrenia results from complications hindering effective regulation of dopamine, which is an important neurotransmitter in the pre-frontal cortex. The symptoms of schizophrenia may result from psychological factors that affect a person’s cognitive functions unsettling learning capabilities, attention, recollection, organization and reasoning, which are associated with the structure and functions of the brain. Social factors on the other hand affect the emotional functions. Psychological theories therefore create a link between biological (cognitive) and social (emotional) factors in the development of schizophrenia (Fabrega, 2005). Depression has also been found in recent research to cause symptoms of schizophrenia. Severe social and environmental adversity such as stressful lifestyles of street families, drug and substance use can facilitate development of symptoms of schizophrenia. High stress levels are associated with increased production of cortisol that is a hormone associated with development of schizophrenia symptoms. Stress contributing to schizophrenia may result from pre-natal and infancy viral infections, protracted labor, early birth as well as child abuse (Jablensky, 2007). These stress factors interact with genetic factors increasing the vulnerability. Genetic causes of the condition are associated with a high hereditary characteristic whereby people with an affected first degree family member such as parent or sibling have a 10% chance of acquiring the symptoms. Nevertheless, there are many families that have only one member affected by the condition (Murphy, 2006). Szasz is one of the mental health theorists who viewed the mind and the body as two inseparable components of the human body as they functionally form a union. On the other hand, Szasz’s theory contradicts the earlier assertion of the unity of mind and body by stating that illness affects the body and not the mind portraying the mind as an independent territory that is detached from the body (Szasz, 2003). In Szasz’s perspective, mental illness can be considered to be an oxymoron as when a person is regarded as mentally ill, it depicts that the illness is mental and not physical such as an ulcer in a body part. However, such a person experiences physical suffering as well. Conversely, considering mental disorder as an illness infers a biological aetiology yet mental illness has no recognized bodily cause. It is therefore evident that both arguments are biased and inconsistent when used to define the term “mental illness” (Johnstone, 2000). The harmful dysfunction theory put forward by Jerome Wakefield portrayed mental disorder as a destructive malfunction of a person’s mental processes. Both social (harmful) and evolutionary (dysfunction) aspects are put in to consideration in this definition and therefore provides psychologists with a compound criteria to assess mental illness (Wakefield, 2007). However, the various definitions of abnormality are debatable and the generally accepted definition of disorders is the Diagnostic and Statistical Manual of Mental Disorders (DSM) that clinical psychologists use to diagnose and treat mental health patients. DSM-5defines mental disorder as a clinically significant disturbance in regards to reasoning, feelings or behaviour that portray a malfunction in mental processes. These malfunctions are retaliated with substantial anguish or incapacity in daily activities and relationships among other fields of mental functioning (Fischer, 2002). The DSM-5 definition is closely related to that of the harmful dysfunction theory as it combines social and evolutionary processes. The DSM model categorises various disorders with their corresponding symptoms. There are several versions of DSM beginning from DSM I to DSM V (5), which is the latest version. These have developed through progressive additions and revisions of disorders. Some disorders in DSM IV include autistic and Asperger’s among other pervasive developmental disorders. These were combined under DSM-5 to form the autism spectrum disorder. New disorders in DSM-5 include “premenstrual dysphoric disorder, disruptive mood dysregulation disorder, binge eating disorder, mild neurocognitive disorder, somatic symptom disorder and hoarding disorder” (Guha, 2014). Conclusion Social and environmental adversities interact to increase an individual’s vulnerability to schizophrenia. Medications applied to treat the symptoms may cause unpleasant physical changes in the affected person such as excessive weight and salivation. Psychological therapy is effective in helping the affected person to analyse issues that influence the condition. The stress vulnerability model, dopamine hypothesis, Szasz’s theory, harmful dysfunction theory and DSM are useful for practitioners trying to define and establish the causes of mental disorders. References Bolton, D. 2007. The usefulness of Wakefield’s definition for the diagnostic manuals. World Psychiatry, 6, pp.164-165. Fabrega H. 2005. Psychiatric conditions and the social sciences. Psychopathology, 38 pp. 223-227. Fischer, C.T., 2002. Introduction, The Humanistic Psychologist, 30, pp.1-9. Goldman, A. 2006. Personality disorders in leaders: Implications of the DSM IV-TR in assessing dysfunctional organizations, Journal of Managerial Psychology, 21(5), pp.392-414. Guha, M. 2014. Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th edition), Reference Reviews, 28(3), pp.36-37. Jablensky A. 2007. Does psychiatry need an overarching concept of “mental disorder”? World Psychiatry, 6 pp.157-158. Johnstone, L. 2000. Users and abusers of psychiatry: a critical look at psychiatric practice. 2nd edition, London: Routledge. Murphy, D. 2006. Psychiatry in the scientific image. Cambridge, MA: The MIT Press, 2006. Szasz, T., 2003. The Secular Cure of Souls, Journal of the Society for Existential Analysis, 14(2), pp. 67-86. Torrey, F. E. 2006. Surviving Schizophrenia, 5th edition, Hammersmith: HarperCollins LLC. Wakefield J. C. 2007.The concept of mental disorder: diagnostic implications of the harmful dysfunction analysis. World Psychiatry, 6, pp.149-156. Read More