I recently read this article in the New York Times. The article was written by a psychiatrist and he writes about one patient, Lucy, who has schizophrenia. The doctor explains how he treated Lucy over the phone for many years and that she was able to overcome her symptoms in that way.
The doctor didn’t score points with me when almost immediately in his writing he refers to people with schizophrenia as schizophrenics. He says that he has treated “schizophrenics” since the 1960’s. He shows himself to be a little outdated just by this sentence since most people now consider it offensive to refer to people by their disease instead of as someone who suffers from a disease.
The way he refers to people with schizophrenia isn’t the main problem I have with the article though. The main problem I have with his treatment is the thought that talking can completely unravel the symptoms of schizophrenia.
(There was a study recently, also reported in the New York Times, and in that study people who were treated with therapy and low doses of medication (they also had family support) had better treatment results than those treated with high doses of medication and no talk therapy).
I am willing to admit that talk therapy can help people with many symptoms of schizophrenia. For example, a therapist may be able to help a client learn how to deal with some of their symptoms like anxiety or paranoia. If that patients was able to deal with some of their symptoms, it would lessen the impact of those symptoms and possibly give them a higher skill set and the ability to function at a higher level. I agree that managing symptoms is very beneficial and some of that can be done by seeing a therapist.
I would never trade in my medication for a regime of talk therapy though. I don’t believe that a therapist can completely unravel my symptoms. When I don’t take my medication I become actively psychotic and there is no reasoning with me. I become delusional, paranoid, hear voices, and hallucinate.
In my case, these symptoms can’t be lessened by talk therapy, because when I am psychotic I no longer have the insight to even believe I need help. Trying to treat psychosis by talking would probably prove disastrous and dangerous for me (I am often suicidal when psychotic). I imagine the lack of insight and the inability to reason while actively psychotic is not limited to just me.
I think if society moves more toward talk therapy and less toward medication as a treatment for schizophrenia that there will also be a tendency to “blame the victim.” If someone with schizophrenia isn’t doing well, people may come to believe they are not trying hard enough. People might believe that people with schizophrenia have more control over their symptoms than they actually do. I think this would be one more burden to put on people who already have a heavy load to carry. Managing schizophrenia with medication, and other treatments is a daily struggle and when you add stigma and marginalization on top of that, people with the illness have enough to deal with without people suggesting they aren’t trying hard enough to overcome their illness.
Therapy session photo available from Shutterstock