Thinking of Schizophrenia as Normal Can Be Helpful

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Daniel Helman had a psychotic episode at age 20, but has been off all psychiatric medications since 2006 and is now 44. In Schizophrenia Bulletin, he describes how he always refused to resign himself to the notion that he would never recover, the practical strategies that have helped him, and how important it has always been to recognize that the “symptoms” of schizophrenia can also be seen as normal and even life-affirming in different contexts.

“In the 1990s I was told many times that I would never recover,” writes Helman. “I would have to be on psychiatric medication for the rest of my life. In being adamant that the professionally accepted treatment modality of being on psychiatric medication forever was not warranted, I opened myself up to being labeled as refusing to cooperate. I suffered because of my interest in speaking plainly. Professionals using the PANSS (a test to evaluate the presence or severity of schizophrenia) have always scored me poorly for refusing medication. That is, category G.12 (which is a general psychopathology term and not specific to schizophrenia) states ‘Lack of Judgement or Insight: 7. Extreme—… the patient may … refuse to cooperate with therapists, medication, or other aspects of treatment.'”

“My actions need not have been interpreted this way,” continues Helman. “I would follow the notion of being able to recover to the end of the earth, notwithstanding. One needs to have faith in oneself! Psychiatric medications were a short-term solution for me. I do not see how they could be a long-term solution for anyone, what with the toxicity involved, and the paucity of long-term studies. I believe the main problem for me was metabolic, and the main solution was changing my lifestyle: diet, exercise, work, social endeavors, religious belief (charity), and responsibility.”

“At least in religious circles, seeing things is basically normal,” writes Helman. “It is important for those with schizophrenia to see themselves as normal. A religious framework affords this to a very large degree. Hopefully, the contents of that framework are positive and life-affirming!”

Schizophrenia Is Normal: My Journey Through Diagnosis, Treatment, and Recovery (Helman, Daniel S. Schizophrenia Bulletin. September 2, 2014. doi: 10.1093/schbul/sbu131)

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12 COMMENTS

  1. Thanks for this article. I agree that religious frameworks allow for these kinds of experiences and that sometimes those experiences are profoundly life affirming and, in fact, valuable for people.

    The psychiatric delusion that all patients with ideas of their own “lack insight” is what marks out psychiatrists not as just a bunch of greedy blockheads, but a bunch of greedy blockheads with an unparalleled arrogance towards life and towards others.

  2. Hear, hear! Normalizing the experience is so important. Religion is also a club you can join where you can practice many of the things you already know to be true. It’s easy enough to blend in (pass for normal!) amongst the robes, the chanting, the foot washing, the incense, the speaking in tongues, the nonsensical things you read in the Bible.

    • Whatever you may think of religion, I believe we are better off with a context which normalizes the extreme states that have always characterized human experience. You may see religious groups as clubs, and they are. However, they are also human assemblies which give a place to spiritual experience.

      Psychiatry is in denial of whole sections of human experience and history. We are not the best, the last, and the smartest civilization. And they don’t have the truth. If anything, theirs is the Roman Empire to its nth degree – brutal, materialistic, and truly arrogant.

  3. Its great that he saw through the Fraud.
    What I take from this article is that there is no such thing as the illness of ‘schizophrenia’, because it can be dealt with outside of medicine. The dishonesty of the medical people when it came to intereferring with his diagnosis demonstrates this as well.

  4. “‘Lack of Judgement or Insight: 7. Extreme—… the patient may … refuse to cooperate with therapists, medication, or other aspects of treatment.’”
    Mount Everest of arrogance. He does not agree with me so he must be completely out of his mind. Yeah…

  5. ….he patient may … refuse to cooperate with therapists, medication, or other aspects of treatment.

    It should have said that he refused aspects of mistreatment , a sign that he is of sound mind. It should be noted how much money Mr Helman saved after he discontinued the psych meds. The fact that he never had a rebound psychosis strongly suggests that those meds were totally unproductive and financially unjustifiable..

  6. I like his attitude however I have a few problems with a few of his conclusions. Schizophrenia is a creation of psychiatrists and, as such, it is mostly jargon. Normal is a popular delusion held by people who have not been given any psychiatric labels in order to explain the people who have been given psychiatric labels. A good number of the people with normality disorder are on their way to being given psychiatric labels, perhaps even dual or triple labels. The whole business is pretty phoney baloney. One just has to consider how phoney baloney minor mental disorders are, possessed by the so-called ‘worried well’, to realize that the problem is taking the whole business too seriously. Shrinking a mental disorder from major to minor, in my book, is a good deal easier than shrinking a tumor. Self-indulgence can be a problem. When the focus is outwardly directed, it is not so selfish, nor is it so distorted. The night-sky, given all those stars, each a separate sun, and all those separate universes we call galaxies, help to put matters into perspective. If each of us are less than specks in relation to the whole, how important does one need to make oneself and one’s individual concerns? Likewise, standing on the ground, those suns can become awfully small again, and this, too, represents a correction in perspective. I don’t think a schizophrenia is such a difficult thing to lose. Notice, I’m not saying schizophrenia is like cancer either.

  7. I love how in the world of psychiatry “I can see through your self-important lies, misrepresentations and false prognoses, and through objective observation and careful assessment of my own experience have drawn an independent and carefully considered conclusion that your meds are innefective, unhelpful and damaging” equals “Lack of insight”

  8. I agree that “It is important for those [diagnosed] with schizophrenia to see themselves as normal.”

    I believe professionals need to be trained to help people see themselves that way: my post “How Can Professionals Learn to Reduce Fears of Psychotic Experiences Rather Than Emphasize Pathology?” at https://www.madinamerica.com/2014/07/normalizing_psychosis/ links to a free training on how to talk to people in a way that encourages this.

  9. “Normalization” of difficult or confusing experiences is a critical element of psychological healing in my experience. Psychiatry does the opposite – it takes normal experiences and makes them seem wrong, and takes difficult experiences and makes them seem terrifying. It is the opposite of what is actually helpful, without even considering the drug aspect.

    —- Steve