Surviving Schizophrenia : A Voice From the Grave

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But having been encouraged to see the voice not as an experience but as a symptom, my fear and resistance towards it intensified. Now essentially, this represented taking an aggressive stance towards my own mind, a kind of psychic civil war, and in turn this caused the number of voices to increase and grow progressively hostile and menacing. Helplessly and hopelessly, I began to retreat into this nightmarish inner world in which the voices were destined to become both my persecutors and my only perceived companions.

They told me, for example, that if I proved myself worthy of their help, then they could change my life back to how it had been, and a series of increasingly bizarre tasks was set, a kind of labor of Hercules. It started off quite small, for example, pull out three strands of hair, but gradually it grew more extreme, culminating in commands to harm myself, and a particularly dramatic instruction: "You see that tutor over there?

You see that glass of water? Well, you have to go over and pour it over him in front of the other students. In effect, a vicious cycle of fear, avoidance, mistrust and misunderstanding had been established, and this was a battle in which I felt powerless and incapable of establishing any kind of peace or reconciliation. Two years later, and the deterioration was dramatic. By now, I had the whole frenzied repertoire: terrifying voices, grotesque visions, bizarre, intractable delusions.

My mental health status had been a catalyst for discrimination, verbal abuse, and physical and sexual assault, and I'd been told by my psychiatrist, "Eleanor, you'd be better off with cancer, because cancer is easier to cure than schizophrenia.

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Now looking back on the wreckage and despair of those years, it seems to me now as if someone died in that place, and yet, someone else was saved. A broken and haunted person began that journey, but the person who emerged was a survivor and would ultimately grow into the person I was destined to be. Many people have harmed me in my life, and I remember them all, but the memories grow pale and faint in comparison with the people who've helped me.

The fellow survivors, the fellow voice-hearers, the comrades and collaborators; the mother who never gave up on me, who knew that one day I would come back to her and was willing to wait for me for as long as it took; the doctor who only worked with me for a brief time but who reinforced his belief that recovery was not only possible but inevitable, and during a devastating period of relapse told my terrified family, "Don't give up hope.

I believe that Eleanor can get through this. Sometimes, you know, it snows as late as May, but summer always comes eventually. But together, they forged a blend of courage, creativity, integrity, and an unshakeable belief that my shattered self could become healed and whole. I used to say that these people saved me, but what I now know is they did something even more important in that they empowered me to save myself, and crucially, they helped me to understand something which I'd always suspected: that my voices were a meaningful response to traumatic life events, particularly childhood events, and as such were not my enemies but a source of insight into solvable emotional problems.


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Now, at first, this was very difficult to believe, not least because the voices appeared so hostile and menacing, so in this respect, a vital first step was learning to separate out a metaphorical meaning from what I'd previously interpreted to be a literal truth. So for example, voices which threatened to attack my home I learned to interpret as my own sense of fear and insecurity in the world, rather than an actual, objective danger.

Now at first, I would have believed them. I remember, for example, sitting up one night on guard outside my parents' room to protect them from what I thought was a genuine threat from the voices. Because I'd had such a bad problem with self-injury that most of the cutlery in the house had been hidden, so I ended up arming myself with a plastic fork, kind of like picnic ware, and sort of sat outside the room clutching it and waiting to spring into action should anything happen.

It was like, "Don't mess with me. I've got a plastic fork, don't you know? But a later response, and much more useful, would be to try and deconstruct the message behind the words, so when the voices warned me not to leave the house, then I would thank them for drawing my attention to how unsafe I felt — because if I was aware of it, then I could do something positive about it — but go on to reassure both them and myself that we were safe and didn't need to feel frightened anymore. I would set boundaries for the voices, and try to interact with them in a way that was assertive yet respectful, establishing a slow process of communication and collaboration in which we could learn to work together and support one another.

Throughout all of this, what I would ultimately realize was that each voice was closely related to aspects of myself, and that each of them carried overwhelming emotions that I'd never had an opportunity to process or resolve, memories of sexual trauma and abuse, of anger, shame, guilt, low self-worth.

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The voices took the place of this pain and gave words to it, and possibly one of the greatest revelations was when I realized that the most hostile and aggressive voices actually represented the parts of me that had been hurt most profoundly, and as such, it was these voices that needed to be shown the greatest compassion and care. It was armed with this knowledge that ultimately I would gather together my shattered self, each fragment represented by a different voice, gradually withdraw from all my medication, and return to psychiatry, only this time from the other side.

Ten years after the voice first came, I finally graduated, this time with the highest degree in psychology the university had ever given, and one year later, the highest masters, which shall we say isn't bad for a madwoman. In fact, one of the voices actually dictated the answers during the exam, which technically possibly counts as cheating.

Laughter And to be honest, sometimes I quite enjoyed their attention as well. As Oscar Wilde has said, the only thing worse than being talked about is not being talked about. It also makes you very good at eavesdropping, because you can listen to two conversations simultaneously. So it's not all bad. I worked in mental health services, I spoke at conferences, I published book chapters and academic articles, and I argued, and continue to do so, the relevance of the following concept: that an important question in psychiatry shouldn't be what's wrong with you but rather what's happened to you.

And all the while, I listened to my voices, with whom I'd finally learned to live with peace and respect and which in turn reflected a growing sense of compassion, acceptance and respect towards myself. And I remember the most moving and extraordinary moment when supporting another young woman who was terrorized by her voices, and becoming fully aware, for the very first time, that I no longer felt that way myself but was finally able to help someone else who was.

I'm now very proud to be a part of Intervoice, the organizational body of the International Hearing Voices Movement, an initiative inspired by the work of Professor Marius Romme and Dr. Sandra Escher, which locates voice hearing as a survival strategy, a sane reaction to insane circumstances, not as an aberrant symptom of schizophrenia to be endured, but a complex, significant and meaningful experience to be explored.

Together, we envisage and enact a society that understands and respects voice hearing, supports the needs of individuals who hear voices, and which values them as full citizens. It is clear that Whitaker would favor an attempt to replicate the results of the Quakers achieved in their asylums, treating people with severe mental illnesses gently and giving them time for their period of insanity to pass.

One of the problems for research into testing new psychiatric medications these days is that it is difficult to find patients who have never taken any psychiatric medication and to compare the results in a double blind studies with patients randomly assigned to either the test group or the control group. Studies that would be able to compare medication against no treatment may be flawed or they simply have not been done.

Far more frequent are comparisons between different medications, where one is shown to be more effective than another. Whitaker explains some of the methodological problems of many of these experiments, casting doubt on the apparently positive results they give for new medications. Also alarming are recent cases of clear fraud that have occurred in some important drug trials. Whitaker goes into the details, which do not need repeating here. He acknowledges that these cases of unethical behavior by researchers do not show that medications are unsafe, but they do suggest that there are not sufficient safeguards to prevent breaches in scientific procedure.

The picture he paints is of a testing process that is vulnerable to the corruption of individuals ready to make money from drug companies at any cost, with drug companies ready to turn a blind eye to such irregularities because it helps them in their grab for the huge profits they can make from a new medication. In its rush to become more biological and avoid the accusations of being pseudoscientific that came from its affiliation with psychoanalysis, it has linked itself too closely with the financial interests of the pharmaceutical industry.

Psychiatry tries to give the impression that it has left its dark past long behind, but in fact it may actually just be repeating the mistakes of the past. They put in a difficult position both those who need to decide whether to take medication for schizophrenia, and those who need to decide whether to encourage or discourage someone they love to take medication. One issue that will occur to some is that Whitaker is not a psychiatrist himself; he is an investigative journalist.

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Some may say that since he himself is not a psychiatric expert, he is not qualified to make judgments on these issues. He has clearly researched his book very carefully, and has gathered and assessed the views of many researchers in the field, and his arguments cannot be so easily dismissed. More problematic is the fact that Whitaker does not address the problems of assessing the positive results of the Quaker asylums and comparing them with modern treatments.

Unless one knows what kind of illnesses those people classified as insane in the early nineteenth century actually had, it makes little sense to compare the high rates of success in treatment with the current success rates. Indeed, it seems that there is very little data concerning the relapse rates for those treated in the asylums, so we have little basis to judge how successful the moral-treatment actually was. Also worth noting is the fact that Whitaker spends little time discussing the experience of schizophrenia itself and the seriousness of the illness, and this seems like a weakness of the book.

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While Breggin downplays the seriousness of the condition by calling it a psychospiritual crisis, Whitaker gives very little description of schizophrenics at all. But many would say that paying attention to the experience and behavior of schizophrenics shows that they need to be protected against themselves, and that we need to protect society from them. Whether or not the medications currently in use actually stop the symptomatic delusions or simply stop patients from acting on them, they are effective in changing the behavior of people with schizophrenia.

That much is uncontroversial. Whitaker has not made a strong case that there is a viable alternative to using medication — unless we bring back large-scale compulsory hospitalization, which was abandoned because it was though too expensive and simply fostered the helplessness of patients.

Whitaker himself often quotes from FDA reports in making his case against medications, and the cases of scientific fraud were ones that were uncovered. It is certainly not the case that the pharmaceutical industry is unregulated ; there are safeguards in place. Unless one is ready to come to the conclusion that government and regulatory bodies are utterly in the pocket of big business and that none of the scientists working in these areas has any integrity, one should acknowledge that there is evidence for the relative safety of FDA approved medication.

Finally, if I were making a decision for a family member, I would also take into account the advice of psychiatrists and other mental health professionals I trust, who have a great deal of experience with the treatment of schizophrenia. Even though the current health care system is putting psychiatrists into the role of pill-prescribers and leaving other, less well paid, workers to do the rest of the work in the care of the mentally ill, it still remains true that most mental health professionals I know care deeply about their patients.

The health care system may be bureaucratic and may turn individuals into faceless cases, but people who work with patients chose their work for a reason, and that reason is rarely the money, since they could make more money more easily by doing something else. So, even after being so impressed by Mad in America , I think I would advise a family member diagnosed with schizophrenia to take the advice of psychiatrists if I knew those psychiatrists and had developed a relationship with trust with them. If anything is clear from the available evidence, it is that medication alone will not solve the problems of schizophrenia.

That said, Mad in America shows how pressing is the need for the public to be able to get an unbiased assessment of current psychiatric treatment, untainted by the profit motive of the pharmaceutical industry.

Manual Surviving Schizophrenia : A Voice From the Grave

Even though Whitaker himself could be accused of being overly critical of psychiatry, his argument against schizophrenia medication is cogent enough to urgently require an answer. I strongly recommend this book to anyone interested in the current state of psychiatry. First Serial Rights. Christian Perring , Ph.



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