Intended for healthcare professionals

Clinical Review

Schizophrenia

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39227.616447.BE (Published 12 July 2007) Cite this as: BMJ 2007;335:91

Making Schizophrenia worse - iatrogenic inhumanity

What a toxic fiasco – surely at the start of the twenty-first century
we can do
better
than Picchioni and Murray’s review of schizophrenia1. Doubtless their
review
faithfully reflects current views of psychosis – but what an awesomely
impoverished
view that is. When the term ‘medical model’ is deployed to abuse
psychiatry,
then
some effort to restore medicine’s good name should at least be attempted.
Sadly
those accusing present-day psychiatry of reducing sufferers to ‘mindless
unfeeling
robots’ will find ample supporting evidence here.

But first, why no reference to the abundant data that neuroleptics
prolong
psychoses? For 50 years there has been a continuous stream of damning
evidence
– from the Nine Hospital Study2 when after 12 months the non-drugged
group were
twice as healthy, through WHO studies in the 1970s3 where if you developed
schizophrenia in countries too poor to afford neuroleptics you went back
to
work
within 3 years, to the latest4 where stopping medication improved recovery

rates
eight-fold. You’ll be much better off going against what the doctor says –

hardly the
best basis for any medical practice. Even flimsier whiffs of iatrogenic
damage
should
be intolerable in any medical speciality, especially one as important as
psychiatry.

Whichever way you define psychosis, and the definitions offered are
unhelpful, it is
self-evidently a disease of the mind. Yet this most important of all human

organs, is
never mentioned. Half baked philosophy, such as the banal obfuscation
about
‘mindbody
dualism’ in DSM–IV5, doesn’t help – but if doctors use their own minds to
puzzle out diagnoses, surely they should afford the same courtesy to their

clients.

Not only are sufferers from schizophrenia presented as mindless –
they are
also
seen as emotionless. In the opening sentences of their review, everyone is

allowed
to feel fear – except the sufferers themselves. And yet this is the key to
the
disease,
as also to its cure – eliminate the fear by extending the ‘healing hand of

kindness’,
and recovery rates rocket, as they did in 17966. Recent fMRI studies7
indicate
how
fear degrades cognition. Reducing fear allows sufferers to blossom. When
psychiatrists reintroduce emotions into their practice, as I was trained
to do8,
their
tasks become infinitely more rewarding.

Robots and automatons are incapable of intent, let alone consent. Yet

consent is the
foundation stone of democracy, indeed of civilisation, and thereby also of
the
stable
mind. By enlisting it, rational thought becomes available in even the
severest
psychosis – a happy outcome that remains unobtainable as long as doctors
refuse to
allow themselves to talk openly about infantile terrors and traumagenesis.

Picchioni and Murray’s review is based on meta-analyses. A rather
different
perspective emerges in a public debate9. Here parents and others
eloquently
describe their suffering, and the damage done by medication. Also on
display
is a
psychiatric nihilism bordering on the inhumane – enough to make you wince.
Psychiatry should be queen of all medical specialities, but first it must
eliminate every
last thing portraying human beings as ‘mindless unfeeling robots’.

Dr Bob Johnson


Consultant Psychiatrist, P O Box 49, Ventnor, Isle of Wight, PO38 9AA


e-mail DrBob@TruthTrustConsent.com www.TruthTrustConsent.com


formerly Head of Therapy, Ashworth Maximum Security Hospital, Liverpool

Consultant Psychiatrist, Special Unit, C-Wing, Parkhurst Prison, Isle of
Wight.

MRCPsych (Member of Royal College of Psychiatrists),

MRCGP (Member of Royal College of General Practitioners).

Diploma in Psychotherapy Neurology & Psychiatry (Psychiatric Inst New
York),

MA (Psychol), PhD(med computing), MBCS, DPM, MRCS.

Author Emotional Health ISBN 0-9551985-0-X

Author Unsafe at any dose ISBN 0-9551985-1-8

author of" curing mental pain 1" at --
http://video.google.co.uk/videoplay?docid=1580550859337309430&hl=en-
G

1 Marco M Picchioni and Robin M Murray Clinical Review of
Schizophrenia
BMJ 2007;335:91-95 (14 July), doi:10.1136/bmj.39227.616447.BE

2 cited in Robert Whitaker 2002, Mad in America, Basic Books, New York,
ISBN
0738203858

3 Robert Whitaker 2002, op cit

4 Martin Harrow and Thomas Jobe. “Factors involved in outcome and
Recovery in
Schizophrenia patients Not on Antipsychotic Medications: A 15-Year
Multifollow up
Study”. The Journal of Nervous and Mental Disease, 2007; 195:406-414.

5 Diagnostic and Statistical Manual of Mental Disorders. 4th Edition,
American
Psychiatric Association 1994 (DSM-IV), xxi.

6 Robert Whitaker 2002 “The healing hand of kindness”. op cit, ch 2.

7 Dean Mobbs, et al. When Fear Is Near: Threat Imminence Elicits
Prefrontal-
Periaqueductal Gray Shifts in Humans Science 24 August 2007:Vol. 317. no.
5841,
pp. 1079 – 1083 DOI: 10.1126/science.1144298

8 Bob Johnson, 2005. Emotional Health Trust Consent Publishing, Isle of
Wight, UK.
ISBN 978-0-9551985-0-2

9 Public Debate 2006, ‘Psychiatric drugs do more harm than good’,
transcribed at www.TruthTrustConsent.com

Competing interests:
None declared

Competing interests: No competing interests

03 September 2007
Bob Johnson
Consultant Psychiatrist
PO38 9AA