Schizophrenia: The Positive Perspective

Explorations at the Outer Reaches of Human Experience

Peter Chadwick, Peter K. Chadwick

• Publisher: Routledge
• Year: 2008
• Print ISBN: 9780415459075
• eBook ISBN: 9781134046799
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This fully revised second edition of Schizophrenia: The Positive Perspective uses biographical sketches and essays to discuss schizophrenia and related conditions, providing advice on methods of coping, routes to growth, recovery and well-being, and how schizophrenia can be viewed in a positive light. It also explores the insights of R.D. Laing and discusses how they can be applied to contemporary ideas and research.

In this expanded edition Peter Chadwick, a previous sufferer, builds on his earlier edition and introduces new topics including:

• Cannabis smoking and schizophrenia.
• Psychoanalytic approaches to psychosis and their extension into the spiritual domain.
• Using cognitive behaviour therapy in the treatment of profound existential distress.
• How experiences on the edge of madness can be relevant to understanding reality.

Schizophrenia: The Positive Perspective encourages hope, confidence and increased self-esteem in schizophrenia sufferers and raises new questions about how schizophrenia should be evaluated. It is important reading for anyone working with schizophrenic people including psychologists, psychiatrists, social workers, and other mental health professionals.

Chapter 1
Introduction

In defence of spirituality, mysticism and madness

It is not so much the cognition that is important but the music to the cognition that is important. People do not follow logic, they follow magic.

In the early 1960s, when I first started reading psychology and thinking psychologically, I’d be about 16 at the time, it really did look as if psychology could change the world. In those days Skinner, Eysenck, Broadbent and Rogers were soaring to prominence. The ambience was upbeat and bullish. We genuinely felt that we could ‘crack the code’ of the human mind, shape human behaviour, understand people’s deepest fears and aspirations and bring harmony and peace to the planet. The future was not physics, it was psychology!

I write now in 2007/8, in my seventh decade. I am a student-battered, script-battered, seminar-battered old-timer. I no longer believe it. At least I no longer believe it of psychology as it is. What psychology could be is another matter and there my hopes are greater.

In this first chapter I am trying to say that psychology needs to embrace, not scorn, the insights of the spiritually minded, the mystical, the pre-psychotic and even be prepared to listen to ‘The Impossible’ from the psychotic (and indeed from the Surrealist artist) if it is fully to understand mind and person and our place in the general scheme of things.

The problem of psychology’s relevance as an endeavour is that the positivistic attitude of the mainstream of the subject simply doesn’t have the breadth and scope to embrace the world’s problems. It has become yet another intellectual box fighting, in the epistemological evolutionary game of things, for supremacy in its physics-imitating perspective. ‘Give us power!’ the establishment seems implicitly to shout, ‘We’re like physics!’ This is in a world of Christians, Jews, Muslims, Buddhists and Hindus in their hundreds of millions. What, one might ask, does a white middle class or upper middle class Western psychologist, steeped in (so-called) Enlightenment rationalism, evidence-based practice and a leafy suburb ideology of scientific humanism know of the mindsets and mind contents of the warring factions of the Middle East? What do they really know of any spiritually guided large communities such as those of India, Pakistan, Uganda, Nigeria or southern United States? Telling these peoples, whose cultures greatly value intuition and revelation, to ‘wise up to the truths of materialistic science’, forget their ‘silly, vacuous, mystical ideas’ and embrace the (supposed) certainties of reason, fact and evidence (itself a rather nineteenth-century view of science) is psychologically not a viable proposition. Assuming that secularism is ‘The Truth’ and that religion will ‘just have to move over’ is simply not how people and the world work. To think like that is intellectually childish – and the twentieth century has shown us anyway that laboratory focused, analytical reasoning based ideologies do not give us the certainty that positivists so prize as central.

One has to ask, ‘What is a human mind that it can have spiritual – and indeed schizophrenic – experiences?’ One needs to know why such experiences of feeling open as if to forces from beyond ourselves are so compelling, why they can be both dangerous and personally nourishing and what value they have for us as a group of communities here on this earth. Rather than spiritual experiences being merely a secondary functional product of our capacity to believe, might they – and some of the insights of the borderline psychotic and psychotic – not be a primary capacity that enables us to resonate to or ‘tune in’ to forces or dimensions at present beyond our understanding? As some would put it, do they enable us to see ‘the other side of the carpet’?

A hostile critic might say, as indeed such people do, ‘This is not science!’ or ‘You are moving away from science!’ However, as my own ideas have settled over the decades, I cannot agree with such accusations. The word ‘science’ derives from the Latin word scientia which means ‘knowledge’. As a scientist I am a knowledge-seeker and any science must use methods appropriate to its subject matter, not merely copy physics. It is not the job of a psychologist merely to find facts – where a fact is what a true theory states – but to enhance our understanding of mind and person in the cosmic scheme of things. It must recognise our capacities as symbol and metaphor users, as seekers of that which is beyond rationality and logic and also facilitate the possibilities of person.

Of course, as we move away from the materialistic to mentalism, to art, to the multicoloured world of madness, to spirituality, our language runs the risk of becoming less precise and exact. Perhaps Wittgenstein would warn us not to speak at all but remain silent? However, the root word of both ‘experiment’ and ‘experience’ is the Latin experiri which means ‘try’. I think we should at least try and that it would be intellectually unadventurous not to do so.

The admittedly ambitious integrative discourse I am proposing for such an understanding, in trying to make psychology relevant and valuable to everybody, is that of a blend of the rational side of science with art and with spirituality. This ‘scientia’ (science–art–spirituality) discourse has, as its aim, the seeking of knowledge, using both experience and experiment, in the service of broadening the actual attitude of psychology out from its current fetish with positivism, materialism and atheism.

Seeking generalised facts about human nature from very large samples, the ‘nomothetic’ way, ignores the nuance and subtlety of evidence at the level of the individual person. Therefore in this book findings will be referred to both from nomothetic and from idiographic sources. It may indeed be that it is only at the level of the single case, the idiographic level, that we can see how different levels of description interact and interweave to produce the thoughts, feelings and behaviours that they do.

All of the great mathematicians and scientists have prized the value of intuition and revelation – as if it is possible for knowledge to come in ‘on another channel’ than that of narrowly focused analytical reasoning. These might be said to be insights had in ‘altered states’, however transient or long-lasting they might be. How, in the general business of life, do we assess such insights as laying claim to knowledge? Some truths, such as, ‘You reap what you sow’, ‘Time waiteth for no man’ and ‘A man on tiptoe is bound to fall over’ we seem to accept as self-evident. On other occasions insights that have the quality of being reversals have a knack of commanding people’s respect. ‘Love your enemies’ (Jesus); ‘She who hesitates is won’ (Wilde) … statements like that somehow don’t propel us to seek the evidence of science for their acceptance as valuable to the general conduct of human affairs. They are fresh, different, clever and in a sense shock us by their novelty in comparison to the tired old platitudes to which we are used.

Also statements from highly esteemed authorities, such as Einstein’s ‘Imagination is more important than knowledge’ or Churchill’s ‘The optimist looks for opportunities in every difficulty, the pessimist looks for difficulties in every opportunity’, carry weight as people infer their value via the very success-in-life of the people who utter them. In this sense the statements have been ‘tested by life’ in a kind of ‘I got where I am today by thinking like this’ fashion. The very success also of a spiritual teacher may be taken as a sign of the truth of what they say, as of course some in the humanities and social sciences say in addition of Freud and Jung. Ideas tested by millions in life over decades can override those tested on thousands in snapshot laboratory studies.

Obviously when faced with claims to knowledge and truth we must think but also feel carefully. Coherence; generalisibility; plausibility; explanatory power; testability; novelty; the insight it brings to matters previously puzzling; relevance to current concerns; ideational beauty and elegance; practical value; clarity; accessibility, all in different measure in different circumstances are important.

Like psychoanalysis, the insights of the spiritual quester, the mystic and the psychotic access and inhabit such an intimate and precious realm of the human psyche that the usual, rather impatient methods of impersonal science are often crass in their evaluation. However, just as psychoanalysis has moved on and is not, as some would have us believe, still chained to 1890s thinking (see Stern, 1985; Tyson and Tyson, 1990; Milton et al., 2004) it is perfectly legitimate for insights that span, in their claims, the breadth of mind and life, to be assessed by the relevant ‘interest community’. Such insights cannot be shot down by a singular experiment but over the decades they are put to work and assessed in the complex engine room of life.

Spiritual insights and those had on the edges of madness tend to have a status, growth and movement in life that is amoeba-like. They are not targets for ‘do or die’ critical experiments as utterances such as ‘The Universe is one Great Thought’ (Sir Arthur Eddington) or that from a psychotic patient I know: ‘Don’t try and climb rain or sweep sun off the pavement’, are often at a metalevel that does not give access to such things. In the end we move forward in the knowledge quest as best we can, always adjusting methods and approaches to the subject matter. It may be somewhat messy but it is all we can do. It is just life.

In the chapters that follow, writ large will be experiences in altered states of consciousness from the drug-induced to the psychotic. We will explore to the limits of human phenomenology but in saying this I have to confess that qualitative investigations of this kind that I have conducted over the decades have provided me personally with at least as much nourishment for the conduct of life and for the apprehension of mind and reality as all the thousands of papers I have read in empirical science these last 47 years (since beginning science A level study) that were essentially predicated on (what is often taken to be) the Pythagorean belief that ‘all is number’. One must wonder at the outset that there is some important truth to be derived from this.

Chapter 2
Demystifying madness and mystifying sanity

In dreaming, aspects of reality are incorporated into the dream; in delusion, aspects of one’s past, and of fantasy, are incorporated into the reality.

Although it is a mistake to believe that R.D. Laing thought the sane to be mad and the mad sane, Laing did try to show that insanity was at least intelligible and hence that schizophrenia sufferers are kith and kin with the rest of humanity and not a categorically different group of people.

In this book I am taking the Laingian argument (see Laing, 1990/1960, 1990/1967, 1970) a step further by arguing that the processes involved in schizophrenia are in themselves quite normal processes but that a concatenation of them, in a person in a certain catalytic situation, will produce what we see as psychosis. They are like chemicals, harmless in themselves, that are toxic or explosive when combined together. This, in itself, is, I think, one particular way in which one can put a positive and less stigmatising slant or perspective on schizophrenia. But there are others.

‘DEEP TRUTH’

Another aspect of the thinking of Laing and also of Carl Jung – although neither of them articulated it very fully or clearly – is that psychosis, or at least the very edges of psychosis, where one might be said to be ‘supersane’ rather than insane, can give one a profound insight into the nature of reality. This is a very fragile state on the penumbra of madness where the boundary between within and without is dissolved or partially dissolved and the state of consciousness changes such that the uncanny becomes the rule rather than the exception. I call this ‘The Borderline’ (one might also refer to it as ‘Tertiary Process’) and I had first-hand knowledge of it myself, independently of Laing and Jung, on my way to a schizoaffective psychotic episode in London in 1979. Although Jung has written on these matters (see Chapter 7), his colleague, quantum physicist Wolfgang Pauli (see Jung and Pauli, 1955), was concerned that Jung did not really understand his own discovery nor that he had got it particularly clear in his mind (Laurikainen, 1988). In Chapter 7 I try to unpack the experience at The Borderline as I remember it myself to present the case for this, admittedly very controversial, view as clearly as I can manage. This very precious state of consciousness is more akin to ‘superphrenia’ (Karlsson, 1972) than schizophrenia but is one also with its own dangers. Indeed most who venture there either do not return or return at a heavy price (Greenberg et al., 1992).

‘RECOVERABILITY’

A third perspective on schizophrenia of a generally more positive tone is one that focuses on the educability and ‘recoverability’ of the person. It is quite wrong, and indeed counter-therapeutic, to regard this disorder as inevitably a life-destroying phenomenon. Psychotic illness can at times be a creative illness, as it was for Freud and Jung (Ellenberger, 1994/1970) and there are occasions when patients not only get well, they go on to become better still with time such that they become better than they were before (Silverman, 1980; Chadwick 2002a and Chapter 6 this volume). Harding et al. (1987a, 1987b, 1988) have shown that schizophrenia does not have to have a deteriorating course and found that about 50 per cent of schizophrenic patients were classifiable as ‘cured’ or only slightly disabled. Patients treated in certain therapeutic communities where the philosophy has been that the illness offers possibilities for growth and integration tend to have markedly better capacities for independent living than those treated only by medication (see Mosher and Menn, 1978; Bola and Mosher, 2003; Mosher, 2004).

The tractability of psychotic symptoms to psychological and psychosocial interventions is now becoming very apparent (see Chapter 13) and education of both families and patients about psychosis is extremely helpful (Atkinson et al., 1996; Freeman et al., 2006). It also is not therapeutically damaging for patients to increase, by private reading, their own knowledge about schizophrenic illness (MacPherson et al., 1996). It is quite wrong to assume that reading about psychosis will itself cause problems for those closely involved.

THE BENEFITS OF PSYCHOSIS-PRONENESS

A fourth positive perspective on schizophrenia relates more directly to the positive capacities there imbricated into the very proneness to the illness itself. A delusional episode may be a release of a fiction-making capacity and betray considerable imaginative inventiveness (Chadwick, 2005c) as well as giving an individual the feeling that they are at least a person of consequence (Storr, 1958). Patients often report that a delusion made life exciting and spectacular and took them away from a boring existence (Chadwick, 1992, 2006a) while others have ‘successful’ delusions which protect them chronically against unbearable intrapsychic anguish. Such chronically successful delusions also can protect against depression and give the person a feeling of considerable purpose and meaning in life (Roberts, 1991). At the physical level Brüne (2004) discusses work that shows also that schizophrenia sufferers have a greater activity of killer cells that could give them a greater resistance against infectious diseases. This advantage also seems to be possessed by their relatives.

Individuals who score higher than normal people on psychometrically assessed paranoia also score higher than them on empathy (Chadwick, 1988, 1997a, p. 140) and diagnosed paranoid patients are better than normal controls at the detection of lying (La Russo, 1978). Schizotypal individuals have generally been found to be higher (than non-schizotypals) in creative fluency and flexibility of thought (Schuldberg et al., 1988; Poreh et al., 1993; Chadwick, 1997a) as have non-paranoid schizophrenic patients (Keefe and Magaro, 1980), and the number of outstanding creative individuals over the course of history who have been thought to possess a paranoid, schizoid, schizotypal or schizophrenic disposition is huge (see Post, 1994, 1996; Chadwick, 1997a, p. 16). John Nash, Ludwig Wittgenstein and James Joyce are those most frequently mentioned in the psychological and psychoanalytic literature although Einstein also had schizophrenia in his family. John Nash himself said (ABI, 2007):

I would not dare to say that there is a direct relation between mathematics and madness, but there is no doubt that great mathematicians suffer from maniacal characteristics, delirium and symptoms of schizophrenia.

It is important to note that although Nash suffered schizophrenia from 1959, his ability to produce mathematics of the highest quality did not leave him (ABI, 2007). He made a recovery in the 1990s, was awarded the Nobel Prize in 1994, with Harsanyi and Selten, for his work on game theory and did say of himself that he wouldn’t consider himself recovered if he could not still produce good things in his work (ABI, 2007, p. ccxci).

James Joyce, whose daughter Lucia does seem to have suffered the illness, was a man of phenomenal linguistic ability generally but of singularly unstable temperament – though he was supported, emotionally, a great deal by his brother. Certainly as the publication of Ulysses approached, Joyce’s paranoid fears about people he had mentioned scornfully in the book, with only thinly veiled identities, were reaching near-psychotic intensity (Ellmann, 1982/1959, pp. 516–18; Chadwick, 2001a, p. 50). Interestingly Wittgenstein, a man of the most extreme intellectual intensity and rigour, was also a man who was said to have about him a somewhat distant, other-worldly, mystical ambience (Edmonds and Eidinow, 2002). When a person says, as Wittgenstein did, that it is very difficult, when confronted with great art, to say anything that is better than saying nothing at all, one knows that this is someone who is far more than a rationality machine.

Jung, a man who seems to have had more acquaintance with psychotic experience than he was comfortable in admitting, also of course was prepared to confront the uncanny and the ineffable to a degree far beyond that dared by traditionally minded scientists.

The enhanced spiritual sensitivity of schizophrenia-prone people has, since the work of Buckley (1981; Buckley and Galanter, 1979), been a topic of considerable recent research (Chadwick, 1992, 1997a, 1997b, 2001c, 2002b; Jackson, 1997, 2001; Clarke, 2001, 2002). It is in fact becoming apparent that having a personality organisation that has a high loading on a dimension conferring vulnerability to psychosis in no way means that the person has a dysfunctional existence. Their lives may indeed be enhanced in quality over those of their more sober peers (McCreery and Claridge, 1995; Jackson, 1997).

Even people right ‘on the edge’ do not have to be seen as a mass of deficits, dysfunctions and disorders (see also Gergen, 1990 on this). The artist Andy Warhol once said:

Sometimes people having nervous breakdown problems can look very beautiful because they have that fragile something to the way they walk or move. They put out a mood that makes them more beautiful.

(Warhol, 2007/1975, p. 64)

In this book we are exploring out to the very edges of the phenomenology of person, to the edges – as did the Surrealists (see Short, 1994) – of what it is possible for a person to think and experience at all. I feel, therefore, that it is valuable for us to see, in the sense of ‘grounding’ us in the here and now, how the processes involved in such a venture relate to those operative in everyday life. This takes us back to the first perspective mentioned at the beginning of this chapter.

THE NORMAL INGREDIENTS OF MADNESS

One of the processes that goes awry in psychosis is so-called confirmation bias (Wason, 1960; Chadwick, 1992). This is the seeking of evidence and ideas that confirm a belief while relatively neglecting that which discredits it. It is doubtful that any scientific theory or indeed religion, political stance, business plan or rationale for anything in life could be created without confirmation bias. I even have suggested (Chadwick, 1992) that it could be itself an anti-entropic force in nature working against ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Preface
• Acknowledgements
• 1 Introduction: in defence of spirituality, mysticism and madness
• 2 Demystifying madness and mystifying sanity
• 3 Cannabis and altered states – a positive view
• 4 Cannabis and altered states – the dark side
• 5 Getting in to psychosis: the story from the inside
• 6 Getting out of psychosis: hints and strategies
• 7 Thinking at The Borderline: the ‘Deep Music’ theory of reality
• 8 Desmond: comedian mystic
• 9 Ivo: fugitive from crassness
• 10 Denys: adventures in meaning
• 11 Reflections on the biographical sketches
• 12 On the acceptance and emotional understanding of psychotic thought
• 13 Issues in diagnosis, therapy and understanding
• 14 Conclusions and overview
• Appendix I Borderline thinking: mysticism as ‘supersanity’
• Appendix II ‘We’re tough’: on the paranoid psychology behind positivism and falsificationism
• Bibliography