/ 15 October 2007

Beating schizophrenia

Pete Bullimore will never forget the day he opened his front door to a French spy. The spy, he recalls, was disguised as a social worker. ‘My wife and I had applied to become foster carers, but when the social worker turned up, I was warned that she was actually a spy. It was the first of many destructive, frightening and uncontrollable voices from within that began to bombard my life,” he recalls.

Bullimore and his wife did not become foster carers. He was diagnosed with chronic schizophrenia, a verdict that eventually led to him losing his family and his business. He was given loads of drugs. ‘I’ve been spat at, verbally abused and was even slashed with a knife.” Eventually Bullimore reduced his cocktail of medication and tried a self-help model of recovery. It worked. He is now in a successful job, using his experiences to help others.

More and more people are turning their backs on the label of schizophrenia and its conventional treatments in an attempt to reclaim their lives. In fact, many have joined a growing group of renowned psychologists and psychiatrists to form the Campaign for Abolition of the Schizophrenia Label (CASL). ‘The idea that schizophrenia can be viewed as a specific, genetically determined, biologically driven brain disease has been based on bad science and social control since its inception,” says Paul Hammersley of the University of Manchester, who is leading the campaign.

Schizophrenia, a word with Greek origins that roughly translates as ‘shattered mind”, simply does not exist, insists Hammersley. ‘What’s more, it is extremely damaging to those to whom it is applied.” There is, he says, no consistency in how people are diagnosed. ‘It has been shown that it is possible for 15 individuals with nothing in common to be gathered together in one room and all to be diagnosed with schizophrenia.” The significance of genetic inheritance in schizophrenia is uncertain, he says.

‘There is a widespread assertion that schizophrenia has a prevalence rate of 1% in all societies, but in fact there is wide disparity between rural and urban environments and between different countries. The lowest rates have been found in the Amish population, one of the most peaceful populations, where prevalence drops below 1%, whereas in Somalia rates of schizophrenia go through the roof. If it really is a genetic brain disease, how can such disparity be explained?”

A more likely explanation, he believes, is that the psychotic episodes that lead to a diagnosis of schizophrenia are brought on by trauma. In fact, tests have shown that a high proportion of people who have psychotic episodes have experienced trauma.

Advocates of schizophrenia as a diagnosis say it is a chronic, deteriorating condition in all cases. But, says Hammersley, many people recover and, like Bullimore, some do so outside psychiatry, using techniques ranging from cognitive behavioural therapy to family intervention and self-help methods of controlling their inner voices.

Robin Murray, a professor of psychiatry, would like to see schizophrenia replaced by the term ‘dopamine disregulation disorder”. ‘We know that disregulation of [the brain chemical] dopamine is the final common pathway to developing psychotic symptoms,” he says.

At the other end of the spectrum, Jeffrey Lieberman, director of the department of psychiatry at Columbia University, says: ‘People with schizophrenia have abnormalities in brain structure and function seen on neuroimaging and electrophysiological tests.” —