BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7310.449 (Published 25 August 2001) Cite this as: BMJ 2001;323:449

There is nothing postmodern in what people with schizophrenia want

  1. Christopher Bagley, research fellow (chrisbagley@lycos.com)
  1. Academic Department of Psychiatry, Royal Free Hospital, London NW3 2QG
  2. School of Psychology, Murdoch University, Perth, 6150, Western Australia
  3. Maudsley Hospital, London SE5 8AZ
  4. School of Social Policy, Sociology and Social Research, University of Kent at Canterbury, Canterbury CT2 7NY
  5. St Bartholomew—s and the Royal London School of Medicine, London EC1A 7BE
  6. Psychopharmacology Unit, University of Bristol, Bristol BS8 1TD
  7. Department of Adolescent Psychiatry, Possilpark Health Centre, Glasgow G22 5EG
  8. Department of Applied Social Sciences, University of Bradford, Bradford BD7 1DP

    EDITOR—As a social scientist, and as one of a growing number of professionals who can say publicly that they have been treated for schizophrenia, I found the adoption of the term “postpsychiatry” by Bracken and Thomas unsatisfactory.1 They have fallen under the spell of a current fad, which in psychiatry—as in other disciplines—amounts to the dressing of an emperor in non-existent clothes.

    Bracken and Thomas imply that in postpsychiatry—s new age the person with mental illness is part of a complex, interacting matrix of social influences in which the mind cannot be abstracted or studied as an independent phenomenon. The individual, it seems, is a creature of his or her social environment. Jaspers—s phenomenology of mind is rejected as isolating the individual from this social matrix. But in my experience, the mind is an independent phenomenon—not merely a system of neuropsychological complexes but the seat of emotion, will, and creativity that transcends the environment.

    The most important advances in psychiatry in the modern age are the development of pharmacological treatments that, helping the mind to operate efficiently, can release self reflective energy. Social factors of course are important in the emergence and relapse of illness, but it is our brain that is the author of progress in the network of social relationships.

    It is not accidental that many user groups have adopted biological models of schizophrenia. The social psychiatrist Querido reported that patients eagerly accepted his view that voices were caused by a malfunction in brain circuitry, just as we sometimes hear voices on a crossed telephone line. This idea, of symptoms as alien and controllable, is of great comfort for patients and forms the basis of much successful cognitive behaviour therapy. Schizophrenia is not caused by relatives, or by cruel environments. It is an illness like epilepsy that …

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