Particularly noteworthy in today's prevailing intellectual climate in which mental illness is considered to have biological or chemical causes is what DSM-III-R, says about such physical causes of this catch-all concept of schizophrenia: It says a diagnosis of schizophrenia "is made only when it cannot be established that an organic factor initiated and maintained the disturbance" (p. 187).  Underscoring this definition of "schizophrenia" as non-biological is the 1987 edition of The Merck Manual of Diagnosis and Therapy, which says a (so-called) diagnosis of schizophrenia is made only when the behavior in question is "not due to organic mental disorder" (p. 1532).

              Contrast this with a statement by psychiatrist E. Fuller Torrey, M.D., in his book Surviving Schizophrenia: A Family Manual, published in 1988.  He says "Schizophrenia is a brain disease, now definitely known to be such" (Harper & Row, p. 5).  Of course, if schizophrenia is a brain disease, then it is organic.  However, the official definition of schizophrenia maintained and published by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders for many years specifically excluded organically caused conditions from the definition of schizophrenia.  Not until the publication of DSM-IV in 1994 was the exclusion for biologically caused conditions removed from the definition of schizophrenia.  In Surviving Schizophrenia, Dr. Torrey acknowledges "the prevailing psychoanalytic and family interaction theories of schizophrenia which were prevalent in American psychiatry" (p. 149) which would seem to account for this.

              In the November 10, 1988 issue of Nature, genetic researcher Eric S. Lander of Harvard University and M.I.T.  summarized the situation this way: "The late US Supreme Court Justice Potter Stewart declared in a celebrated obscenity case that, although he could not rigorously define pornography, `I know it when I see it'.  Psychiatrists are in much the same position concerning the diagnosis of schizophrenia.  Some 80 years after the term was coined to describe a devastating condition involving a mental split among the functions of thought, emotion and behaviour, there remains no universally accepted definition of schizophrenia" (p. 105).

             According to Dr. Torrey in his book Surviving Schizophrenia, so-called schizophrenia includes several widely divergent personality types.  Included among them are paranoid schizophrenics, who have "delusions and/or hallucinations" that are either "persecutory" or "grandiose"; hebephrenic schizophrenics, in whom "well-developed delusions are usually absent"; catatonic schizophrenics who tend to be characterized by "posturing, rigidity, stupor, and often mutism" or, in other words, sitting around in a motionless, nonreactive state (in contrast to paranoid schizophrenics who tend to be suspicious and jumpy); and simple schizophrenics, who exhibit a "loss of interest and initiative" like the catatonic schizophrenics (though not as severe) and unlike the paranoid schizophrenics have an "absence of delusions or hallucinations" (p. 77).  The 1968 edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-II, indicates a person who is very happy (experiences "pronounced elation") may be defined as schizophrenic for this reason ("Schizophrenia, schizo-affective type, excited") or very unhappy ("Schizophrenia, schizo-affective type, depressed")(p. 35), and the 1987 edition, DSM-III-R, indicates a person can be "diagnosed" as schizophrenic because he displays neither happiness nor sadness ("no signs of affective expression")(p. 189), which Dr. Torrey in his book calls simple schizophrenia ("blunting of emotions")(p. 77).  According to psychiatry professor Jonas Robitscher, J.D., M.D., in his book The Powers of Psychiatry, people who cycle back and forth between happiness and sadness, the so-called manic-depressives or suffers of "bipolar mood disorder", may also be called schizophrenic: "Many cases that are diagnosed as schizophrenia in the United States would be diagnosed as manic-depressive illness in England or Western Europe" (Houghton Mifflin, 1980, p. 165.)  So the supposed "symptoms" or defining characteristics of "schizophrenia" are broad indeed, defining people as having some kind of schizophrenia because they have delusions or do not, hallucinate or do not, are jumpy or catatonic, are happy, sad, or neither happy nor sad, or cycling back and forth between happiness and sadness.  Since no physical causes of "schizophrenia" have been found, as we'll soon see, this "disease" can be defined only in terms of its "symptoms", which as you can see are what might be called ubiquitous.  As attorney Bruce Ennis says in his book Prisoners of Psychiatry: "schizophrenia is such an all-inclusive term and covers such a large range of behavior that there are few people who could not, at one time or another, be considered schizophrenic" (Harcourt Brace Jovanovich, Inc., 1972, p. 22).  People who are obsessed with certain thoughts or who feel compelled to perform certain behaviors, such as washing their hands repeatedly, are usually considered to be suffering from a separate psychiatric disease called "obsessive-compulsive disorder".  However, people with obsessive thoughts or compulsive behaviors have also been called schizophrenic (e.g., by Dr. Torrey in his book Surviving Schizophrenia, pp. 115-116).

 

THE AUTHOR, Lawrence Stevens, is a lawyer whose practice has included representing psychiatric "patients".  His pamphlets are not copyrighted.  Feel free to make copies.