Schizophrenia: A Nonexistent Disease
Wayne Ramsay, J.D.
The word “schizophrenia” has a scientific sound that seems to give it inherent credibility and a charisma that seems to dazzle people. In his book Molecules of the Mind–The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin calls schizophrenia and depression “the two classic forms of mental illness.”1 According to the cover article in the July 6, 1992 Time magazine, schizophrenia is the “most devilish of mental illnesses.”2 This Time magazine article says “fully a quarter of the nation's hospital beds are occupied by schizophrenia patients.”3 Books and articles like these and the facts to which they refer (such as a quarter of hospital beds being occupied by so-called schizophrenics) delude most people into believing there really is a disease called schizophrenia. Schizophrenia is one of the great myths of our time.
In his book Schizophrenia–The Sacred Symbol of Psychiatry, psychiatry professor Thomas S. Szasz, M.D., says “There is, in short, no such thing as schizophrenia.”4In the Epilogue of their book Schizophrenia–Medical Diagnosis or Moral Verdict?, Theodore R. Sarbin, Ph.D., a psychology professor at the University of California at Santa Cruz who spent three years working in mental hospitals, and James C. Mancuso, Ph.D., a psychology professor at the State University of New York at Albany, say:
We have come to the end of our journey. Among other things, we have tried to establish that the schizophrenia model of unwanted conduct lacks credibility. The analysis directs us ineluctably to the conclusion that schizophrenia is a myth.5
In his book Against Therapy, published in 1988, Jeffrey Masson, Ph.D., a psychoanalyst, says “There is a heightened awareness of the dangers inherent in labeling somebody with a disease category like schizophrenia, and many people are beginning to realize that there is no such entity.”6 Jim van Os, professor and chair of the Department of Psychiatry at Maastricht University Medical Center in the Netherlands, states this conclusion in the February 2, 2016 British Medical Journal: “'Schizophrenia’ does not exist.”7
Rather than being a bona-fide disease, so-called schizophrenia is a nonspecific category which includes almost everything a human being can do, think, or feel that is greatly disliked by other people or by the so-called schizophrenics themselves. There are few so-called mental illnesses that have not at one time or another been called schizophrenia. Because schizophrenia is a term that covers just about everything a person can think or do which people greatly dislike, it is hard to define objectively. Typically, definitions of schizophrenia are vague or inconsistent with each other. For example, when I asked a physician who was the Assistant Superintendent of a state mental hospital to define the term schizophrenia for me, he with all seriousness replied “split personality–that’s the most popular definition.” In contrast, a pamphlet published by the National Alliance for the Mentally Ill titled “What Is Schizophrenia?” says “Schizophrenia is not a split personality.” In her book Schizophrenia: Straight Talk for Family and Friends, published in 1985, Maryellen Walsh says this:
Schizophrenia is one of the most misunderstood diseases on the planet. Most people think that it means having a split personality. Most people are wrong. Schizophrenia is not a splitting of the personality into multiple parts.8
In the Foreword to the second edition of the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders (DSM-II), Ernest M. Gruenberg, M.D., D.P.H., Chairman of the American Psychiatric Association's Committee on Nomenclature, said:
Consider, for example, the mental disorder labeled in the Manual as ‘schizophrenia,’... Even if it had tried, the Committee could not establish agreement about what this disorder is.”9
The third edition of the APA's Diagnostic and Statistical Manual of Mental Disorders, published in 1980, commonly called DSM-III, was also quite candid about the vagueness of the term. It said: “The limits of the concept of Schizophrenia are unclear”10 The revision published in 1987, DSM-III-R, contains a similar statement: “It should be noted that no single feature is invariably present or seen only in Schizophrenia.”11 DSM-III-Ralso says this about a related diagnosis, Schizoaffective Disorder:
The term Schizoaffective Disorder has been used in many different ways since it was first introduced as a subtype of Schizophrenia, and represents one of the most confusing and controversial concepts in psychiatric nosology.12
In Frances Farmer– Shadowland, a biography of a once well-known actress who became an involuntarily committed mental patient, William Arnold observes that “since the term schizophrenia was coined in 1911 it has had a thousand different meanings to a thousand different psychiatrists.”13
Particularly noteworthy in today's prevailing intellectual climate in which mental illness is considered to have biological or chemical causes is what the 1987 edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R says about such physical causes of this catch-all concept of schizophrenia: It says a diagnosis of schizophrenia “is made only when it cannot be established that an organic factor initiated and maintained the disturbance.”14 Underscoring this definition of “schizophrenia” as non-biological is the 1987 edition of The Merck Manual of Diagnosis and Therapy, which says a (so-called) diagnosis of schizophrenia is made only when the behavior in question is “not due to organic mental disorder.”15
Contrast this with a statement by psychiatrist E. Fuller Torrey, M.D., in his book Surviving Schizophrenia: A Family Manual, published in 1988. He says “Schizophrenia is a brain disease, now definitely known to be such.”16 If schizophrenia is a brain disease, it is organic. However, the official definition of schizophrenia maintained and published by the American Psychiatric Association in various editions of its Diagnostic and Statistical Manual of Mental Disorders specifically excludes organically caused conditions from the definition of schizophrenia. In Surviving Schizophrenia, Dr. Torrey acknowledges “the prevailing psychoanalytic and family interaction theories of schizophrenia which were prevalent in American psychiatry”17 that would seem to account for this.
In 1988, in Nature, genetic researcher Eric S. Lander of Harvard University and M.I.T. summarized the situation this way:
The late US Supreme Court Justice Potter Stewart declared in a celebrated obscenity case that, although he could not rigorously define pornography, ‘I know it when I see it.’ Psychiatrists are in much the same position concerning the diagnosis of schizophrenia. Some 80 years after the term was coined to describe a devastating condition involving a mental split among the functions of thought, emotion and behaviour, there remains no universally accepted definition of schizophrenia.18
In Surviving Schizophrenia, Dr. Torrey quite candidly concedes the impossibility of defining what “schizophrenia” is. He says:
The definitions of most diseases of mankind has been accomplished.... In almost all diseases there is something which can be seen or measured, and this can be used to define the disease and separate it from nondisease states. Not so with schizophrenia! To date we have no single thing which can be measured and from which we can then say: Yes, that is schizophrenia. Because of this, the definition of the disease is a source of great confusion and debate.19
What puzzles me is how to reconcile this statement of Dr. Torrey’s with another he makes in the same book, which I quoted above and which appears more fully as follows:
Schizophrenia is a brain disease, now definitely known to be such. It is a real scientific and biological entity, as clearly as diabetes, multiple sclerosis, and cancer are scientific and biological entities.”20
How can it be known that schizophrenia is a brain disease when we do not know what schizophrenia is?
The truth is that the word schizophrenia, like the words “pornography” and “mental illness”, indicate disapproval of that to which the word is applied and nothing more. Like “mental illness” or “pornography”, “schizophrenia” does not exist in the sense that cancer and heart disease exist but exists only in the sense that good and bad exist. As with all other so-called mental illnesses, a diagnosis of “schizophrenia” is a reflection of the speaker’s or “diagnostician’s” values or ideas about how a person “should” be, often coupled with the false (or at least unproven) assumption that the disapproved thinking, emotions, or behavior results from a biological abnormality. Considering the many ways it has been used, it’s clear “schizophrenia” has no particular meaning other than “I dislike it.” Because of this, I lose respect for mental health professionals when I hear them use the word schizophrenia in a way that indicates they think it is a real disease. I do this for the same reason I would lose respect for a person’s perceptiveness or intellectual integrity after hearing him or her admire the emperor’s new clothes. While the layman definition of schizophrenia, internally inconsistent, may make sense in some situations, using the term “schizophrenia” in a way that indicates the speaker thinks it is a real disease is tantamount to admitting he doesn’t know what he is talking about.
Many mental health “professionals” and other “scientific” researchers do however persist in believing “schizophrenia” is a real disease. They are like the crowds of people observing the emperor’s new clothes in Hans Christian Andersen’s short story. They are unable or unwilling to see the truth because so many others before them have said it is real. A glance through the articles listed under “Schizophrenia” in Index Medicus, an index of medical periodicals, or an Internet search, reveals how widespread the schizophrenia myth has become. Because these “scientists” believe “schizophrenia” is a real disease, they try to find physical causes for it. As psychiatrist William Glasser, M.D., said in 1976: “Schizophrenia sounds so much like a disease that prominent scientists delude themselves into searching for its cure.”21 This is a silly endeavor, because these supposedly prominent scientists can’t define “schizophrenia” and accordingly don't know what they are looking for.
According to three Stanford University psychiatry professors, “two hypotheses have dominated the search for a biological substrate of schizophrenia.” They say these two theories are the transmethylation hypothesis of schizophreniaand the dopamine hypothesis of schizophrenia.22 The transmethylation hypothesis was based on the idea that “schizophrenia” might be caused by “aberrant formation of methylated amines” similar to the hallucinogenic pleasure drug mescaline in the metabolism of so-called schizophrenics. After reviewing various attempts to verify this theory, they conclude: “More than two decades after the introduction of the transmethylation hypothesis, no conclusions can be drawn about its relevance to or involvement in schizophrenia.”23
Columbia University psychiatry professor Jerrold S. Maxmen, M.D., describes the second major biological theory of so-called schizophrenia, the dopamine hypothesis,in his book The New Psychiatry, published in 1985: “...many psychiatrists believe that schizophrenia involves excessive activity in the dopamine-receptor system...the schizophrenic's symptoms result partially from receptors being overwhelmed by dopamine.”24 But in the article by three Stanford University psychiatry professors I referred to above they say “direct confirmation that dopamine is involved in schizophrenia continues to elude investigators”25 In 1987 in his book Molecules of the MindProfessor Jon Franklin said “The dopamine hypothesis, in short, was wrong.”26
In that same book, Professor Franklin aptly describes efforts to find other biological causes of so-called schizophrenia:
As always, schizophrenia was the index disease. During the 1940s and 1950s, hundreds of scientists occupied themselves at one time and another with testing samples of schizophrenics’ bodily reactions and fluids. They tested skin conductivity, cultured skin cells, analyzed blood, saliva, and sweat, and stared reflectively into test tubes of schizophrenic urine. The result of all this was a continuing series of announcements that this or that difference had been found. One early researcher, for instance, claimed to have isolated a substance from the urine of schizophrenics that made spiders weave cockeyed webs. Another group thought that the blood of schizophrenics contained a faulty metabolite of adrenaline that caused hallucinations. Still another proposed that the disease was caused by a vitamin deficiency. Such developments made great newspaper stories, which generally hinted, or predicted outright, that the enigma of schizophrenia had finally been solved. Unfortunately, in light of close scrutiny none of the discoveries held water.27
Other efforts to prove a biological basis for so-called schizophrenia have involved brain-scans of pairs of identical twins when only one is a supposed schizophrenic. They do indeed show the so-called schizophrenic has brain damage his identical twin lacks. The flaw in these studies is the so-called schizophrenic has inevitably been given brain-damaging drugs called neuroleptics as a so-called treatment for his so-called schizophrenia. It is these brain-damaging drugs, not so-called schizophrenia, that have caused the brain damage. Anyone “treated” with these drugs will have such brain damage. Damaging the brains of people eccentric, obnoxious, imaginative, or mentally disabled enough to be called schizophrenic with drugs (erroneously) believed to have antischizophrenic properties is one of the saddest and most indefensible consequences of today’s widespread belief in the myth of schizophrenia.
Belief in biological causes of so-called mental illness, including schizophrenia, comes not from science but from wishful thinking or from desire to avoid coming to terms with the experiential and environmental causes of people’s misbehavior or distress. The American Psychiatric Association’s definition of “schizophrenia” as non-organic, and the repeated failure of efforts to find biological causes of so-called schizophrenia suggest “schizophrenia” belongs only in the category of socially or culturally unacceptable thinking or behavior rather than in the category of biology or “disease” where many people place it.
1John Franklin, Molecules of the Mind – The Brave New Science of Molecular Psychology (Dell Publishing Co., 1987, p. 119
2July 6, 1992 Timemagazine, p. 53
3Id., p. 55
4Thomas S. Szasz, M.D., Schizophrenia–The Sacred Symbol of Psychiatry (Syracuse University Press, 1988), p. 191
5Theodore R. Sarbin, Ph.D., and James C. Mancuso, Ph.D., Schizophrenia–Medical Diagnosis or Moral Verdict?(Pergamon Press, 1980), p. 221
6Jeffrey Masson, Ph.D.,Against Therapy(Atheneum 1988), p. 2
7Jim van Os, British Medical Journal, February 2, 2016, “`Schizophrenia’ does not exist” https://www.bmj.com/content/ 352/bmj.i375
8Maryellen Walsh, Schiz-o-phre-nia: Straight Talk for Family and Friends(Warner Books 1985), p. 41
9Ernest M. Gruenberg, M.D., D.P.H., Diagnostic and Statistical Manual of Mental Disorders (DSM-II) American Psychiatric Association 1968), p. ix
10American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-III, 1980), p. 181.
11American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), p. 188
12Id., p. 208
13William Arnold, Frances Farmer– Shadowland(Berkley Books 1982), p. 125
14DSM-III-R, p. 187
15Merck Manual of Diagnosis and Therapy, 1987, p. 1532
16E. Fuller Torrey, M.D.,Schizophrenia: A Family Manual(Harper & Row 1988), p. 5
17Id., p. 149
18Eric S. Lander, Nature, November 10, 1988, p. 105
19E. Fuller Torrey, M.D., Surviving Schizophrenia – A Family Manual (Harper & Row 1988), p. 73
20Id., p. 5
21William Glasser, M.D., Positive Addiction(Harper & Row 1976) p. 18.
22Jack D. Barchas, M.D., et al., “Biogenic Amine Hypothesis of Schizophrenia”, appearing inPsychopharmacology: From Theory to Practice, Oxford University Press, 1977, p. 100
23Id., p. 107
24Jerrold S. Maxmen, M.D., The New Psychiatry(Mentor 1985), pp. 142 & 154
25Barchas, et al. (note 22), p. 112
26Franklin (note 1), p. 114
27Id., p. 172
THE AUTHOR, Wayne Ramsay, is a lawyer whose practice has included representing psychiatric “patients”.