The “genetics of schizophrenia” area of research is currently in disaster mode and awaits its endpoint. Instead of drawing the necessary conclusions, psychiatry and its psychiatric genetics subfield (International Society of Psychiatric Genetics [ISPG]) continue to speak—publicly—of progress, discovery, and being “driven by rapid advances in genomic technologies.” The reality, as I will show, is that the evidence psychiatry ceaselessly puts forward in support of schizophrenia as a genetic disorder is stunningly weak. This conclusion has important implications for prevention and intervention strategies, and also for other areas of psychiatry and human behavior in the larger context of the “nature-nurture” question.

In this article, I briefly review the lack of evidence that schizophrenia is a “heritable disorder” in the context of five decades of causal gene discovery failure. (The term “psychosis” is preferred by those of us who are critical of disease model approaches.) The first part of this article describes DNA-based (molecular genetic) failure and its evaluation by a well-known schizophrenia researcher. In the second part, I challenge the arguments of “Astral Codex Ten” blogger and psychiatrist Scott Alexander, who posted “It’s Fair to Describe Schizophrenia as Mostly Genetic” in January 2024.

I have been writing critically about genetic research on schizophrenia for many years, beginning with my 1998 dissertation. I summarized my dissertation’s findings and conclusions in a 1999 article, where I concluded, “Based on the weight of the evidence, it is predicted here that a gene for schizophrenia will not be found, because it does not exist.” I have continued to write about schizophrenia genetic research in articles, chapters, and four books, where I made similar predictions. In 2023, I published Schizophrenia and Genetics: The End of an Illusion, where I described the fruitless search for causal genes in the context of science’s “replication crisis.”

I published The Missing Gene: Psychiatry, Heredity, and the Fruitless Search for Genes in 2006. In that book, I concluded that genes for the major psychiatric diagnoses most likely do not exist. I predicted that the gene discovery and gene association claims of that era would not hold up. As it turned out, none of them did (see the linkage and candidate gene study discussion below). Looking back, the critics of 2006 were right and the leaders of psychiatry and psychiatric genetics were wrong (see my 2005 American Journal of Psychiatry exchange with leading psychiatric geneticist Kenneth Kendler here and here). Despite subsequent gene association claims based on the newer methods I will soon discuss, the existence of disordered genes that play a role in causing the major psychiatric diagnoses remains unlikely.

Critics often focus on original-source research publications. Relying on secondary sources and review articles by leading experts can perpetuate myths, as these accounts sometimes misrepresent basic facts and often endorse flawed, confirmation-biased original research. In some cases, authoritative writers and the authors of behavioral science textbooks, including Nobel Prize winners, appear unfamiliar with original research publications. Some leading authors discuss studies that don’t exist (see here and here).

Origins of Psychiatric Genetics

Psychiatric genetics began with Ernst Rüdin’s 1916 family study of “dementia praecox” (schizophrenia). Rüdin was a Swiss-German psychiatrist and founder of the psychiatric genetics field, as well as a 1905 co-founder of the German Society for Racial Hygiene. Rüdin, who believed that a single recessive gene caused schizophrenia, went on to establish the “Munich School” of psychiatric genetics. A major aspect of Munich School activity and research during the Third Reich involved calculating psychiatric “morbid risks” in support of the regime’s 1933 forced sterilization law and other racial hygienic (eugenic) measures. In a 2022 article, Kenneth Kendler wrote that Rüdin helped give “scientific prestige and credibility” to the regime’s “racial beliefs and policies.” For a detailed and chilling description of the work and deeds of Rüdin and the Munich School in the 1930s and ‘40s, I recommend Chapter 3 of The Nazi Symbiosis: Human Genetics and Politics in the Third Reich, a 2010 book by Sheila Faith Weiss.

In the 1920s, Rüdin performed a genetic family study of “manic-depressive insanity” based on over 600 families. He wrote a 160-page manuscript describing this study, but suppressed it because the results did not align with his genetic theories and worldview. The central fallacy of Rüdin’s early family studies was a failure to understand that psychiatric conditions can run in families for non-genetic reasons. Although most genetic researchers now correctly recognize that “running in the family” does not equal “genetic,” Rüdin and most of his eugenics movement researcher contemporaries and followers believed that it did.

The first schizophrenia twin study was published in 1928 by Hans Luxenburger, a Munich associate of Rüdin. As Kendler noted, Luxenburger was also “committed to racial hygiene.” Seventeen additional studies were performed by researchers in different countries (the most recent was published in 2018). The first schizophrenia adoption study was published in 1966. DNA-based gene-finding attempts began in the 1970s and continue to this day.

The Failed Linkage and Candidate Gene Eras

The two main methods used in an earlier era of psychiatric DNA-based research were linkage studies and candidate gene association studies. Both methods failed to identify causal genes. The authors of a 1983 DNA-based linkage study identified the gene responsible for Huntington’s disease, a genuine medical condition. This discovery gave rise to expectations that investigators would soon discover genes causing schizophrenia, bipolar disorder, major depression, and other major psychiatric (behavioral) conditions as well. From a 2013 vantage point, leading psychiatric genetic researcher Stephen Faraone recalled, “In the 1970s and 1980s, hope ran high as new methods in molecular genetics promised quick discoveries and answers to basic questions of etiology and pathophysiology.” Inspired by the Huntington’s discovery, some psychiatric genetic researchers of the 1980s mapped out family pedigrees and anticipated rapid gene discoveries and flights to Stockholm to receive their Nobel Prizes (see here, 18:50). However, despite high hopes and discovery-anticipation “euphoria” among psychiatric genetic researchers of the 1980s (including a highly publicized 1988 linkage study claim that proved unfounded), the outcome was failure.

The heyday of the failed candidate gene era (roughly 1995-2010), which overlapped with and followed linkage research, involved billions of dollars. According to top behavioral geneticist Robert Plomin in his 2018 book Blueprint, for schizophrenia alone, “over 1,000 papers reported candidate gene results for more than 700 genes.” The financial cost was approximately $250 million (or around $500 million adjusted for inflation), and Plomin asked rhetorically, “How can so many published papers have got it so wrong?”

As seen here, here, here, and here, over two decades of behavioral and psychiatric candidate gene discovery claims turned out to be false alarms. In other words, the behavioral candidate gene era was an unmitigated disaster. In Blueprint, Plomin described the era as a “flop,” a “fiasco,” and an “approach” that “failed everywhere.” Previously, Plomin had conducted his own candidate gene studies and claimed discoveries, and cited others’ supposed discoveries in his Behavioral Genetics textbook and elsewhere.

Nevertheless, candidate gene mythology continues in the social media, the internet, and popular works. For example, journalist Robert Kolker published his bestselling 2020 book Hidden Valley Road: Inside the Mind of an American Family about a Colorado family in which six of the ten male offspring were diagnosed with schizophrenia. Kolker described the work of two persistent psychiatric researchers, who, he said, identified schizophrenia risk genes with the aid of the family’s blood samples. However, the two genes Kolker called “discoveries” (CHRNA7 [patent now expired] and SHANK2) were actually candidate gene non-discoveries. Journalists and researchers understand that careers are made, prizes are won, endorsements from famous people are received, and books and potential movie deals are sold by stories about discoveries, not by failure or inconclusive results.

Here are 15 examples of books from the era that reported positive linkage findings and “promising” candidate genes “implicated” as causes of psychiatric conditions (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15). Among them are The American Psychiatric Publishing Textbook of Schizophrenia (2006, edited by Jeffrey Lieberman and colleagues), Behavioral Genetics (2000, by Plomin and colleagues), and Behavioral Genetics in the Postgenomic Era (2003, edited by Plomin and colleagues). These days, if the authors and other researchers of the linkage and candidate gene era see these books on a library shelf, they might experience a moment of acute embarrassment.

The initial working draft of the human genome sequence was published in 2001, which many people hoped would lead to rapid gene discoveries in psychiatry. Faraone and his psychiatric genetics colleague Ming Tsuang wrote in 1999, “From the perspective of psychiatric genetics, the Human Genome Project (HGP) is an immense factory producing and refining the tools we will need to discover the genes that cause mental illness.” And according to leading genetic researchers Kathleen Merikangas and Neil Risch, writing in 2003, “Completion of the human genome project has provided an unprecedented opportunity to identify the effect of gene variants on complex phenotypes, such as psychiatric disorders.” But it didn’t happen.

Genome-Wide Association Studies, Polygenic Risk Scores, and Rare Variants

Current schizophrenia “gene association” claims are based on the supposedly “hypothesis-free” genome-wide association (GWAS) method, which dates back to the period 2005-2007. A GWAS might find an association (correlation) between genetic variants and schizophrenia, but it doesn’t provide evidence that genes play a role in causing it. Correlations are not causes and may be spurious or the result of systematic error, or they may simply be chance findings, as earlier behavioral linkage and candidate gene researchers learned the hard way. In 2022, Thomas Insel, the biologically oriented former director of the U.S. National Institute of Mental Health (NIMH), recognized that “in contrast to the mutations discovered for cancer or rare diseases, none of the genetic variants associated with mental illness can be considered causal.”

The polygenic risk score (PRS) method is a DNA-based technique that combines statistically significant and nonsignificant individual SNP associations (“single-nucleotide polymorphism” common variants) identified in a GWAS to produce a polygenic (composite) risk score. A large-sample 2022 GWAS by the Schizophrenia Working Group of the Psychiatric Genomics Consortium calculated a modest “European cohort” 7.3% schizophrenia PRS, which fell to 2.4% “when restricted to genome-wide significant SNPs.” These low scores were buried in the text and did not appear in the article’s abstract, and can be compared with dramatically different twin study-based estimates of 80% heritability (but see the twin study critique below). In any case, like a GWAS, a PRS identifies, at best, gene-behavior correlations, not causes. As noted by behavioral geneticist Eric Turkheimer in his 2024 book Understanding the Nature-Nurture Debate (see my review here or here), PRS studies “are a definitive step backward from trying to figure out which genes are responsible for the heritability of behavior.”

Another research area focuses on potential rare variants (defined as variants found in less than 1% of the population), such as copy number variants, or “CNVs.” Many studies claiming CNV-schizophrenia associations have appeared over the years, but they are subject to many of the problems found in other DNA-based methods. In 2020, Jonathan Flint and Kendler, two of the world’s leading psychiatric genetic researchers, wrote that the “early hope that CNVs would reflect the ‘royal road’ to understanding molecular genetic effects on schizophrenia has been disappointing.”

Commenting in 2008 at the height of candidate gene era excitement, psychiatric researcher Timothy Crow wrote that although the “schizophrenia gene pond” was in fact “empty,” a “chorus of reviews…pervades the literature and will convince all but the most inquisitive that a solid foundation of evidence supports the pathophysiological relevance of these candidate genes.” We should keep in mind Crow’s 2008 “chorus of reviews” comment when assessing current claims about genes “implicated” by GWAS, PRS, and CNV studies—same chorus, slightly modified lyrics.

A Leading Schizophrenia Researcher Describes Gene Discovery Failure

E. Fuller Torrey is a well-known schizophrenia researcher and the author of several editions of Surviving Schizophrenia: A Family Manual. While believing that genetic factors play some role, Torrey sees schizophrenia as a brain disease possibly caused by infectious agents (see Peter Simons’ 2024 Mad in America article, and my discussion of disease theories below). In a 2024 publication, Torrey caused a stir by describing gene discovery failure and suggesting that “since schizophrenia does not appear to be a genetic disorder,” the NIMH’s “research portfolio should be reviewed.” Torrey’s statement smacked of psychiatric heresy, as it knocked out a key component of Eugen Bleuler’s original 1911 conception of schizophrenia as a largely hereditary disease. (Bleuler recommended sterilization on eugenic grounds and later worried that dysgenic “racial deterioration” could occur if eugenic policies were not implemented.) The concept of schizophrenia as a hereditarily predisposed brain disease remains central to the psychiatric profession’s identity.

The decades-long gene-search endeavor, Torrey said, has been “like a search for a psychiatric yeti”:

The Human Genome Project was undertaken primarily to discover genetic causes and better treatments for human diseases. Schizophrenia was targeted since three of the project’s principal architects had a personal interest and also because, based on family, adoption, and twin studies, schizophrenia was widely believed to be a genetic disorder. Extensive studies using linkage analysis, candidate genes, genome wide association studies [GWAS], copy number variants, exome sequencing and other approaches have failed to identify causal genes. (Emphasis added)

Torrey wrote that “schizophrenia alone has probably been the subject of more genetic breakthrough announcements over the last thirty years than any other human disease.” And yet, despite spending over (a non-inflation-adjusted) 8 billion NIMH dollars in attempts to find causal “schizophrenia genes,” none have been found. A major paradigm-shattering event, it would seem.

Given his insider status and reputation as a leading biologically oriented schizophrenia expert and researcher, Torrey’s article motivated psychiatrist Awais Aftab to post two 2024 “Psychiatry at the Margins” articles on the topic of schizophrenia genetics (here and here). Displaying some confusion, Aftab concluded, “It may very well be the case that schizophrenia is heritable and polygenic, and yet there are no ‘genes for’ schizophrenia.”

Back in 2020, Aftab and I had an online exchange on schizophrenia genetics, where he wrote that my “criticizing the notion that schizophrenia has a substantial genetic component” is typical of “degenerative scientific programs.” Perhaps he is now ready to modify this earlier stance.

In response to Aftab and Torrey’s 2024 articles, psychiatrist/blogger Scott Alexander posted his article, “It’s Fair to Describe Schizophrenia as Mostly Genetic,” in January 2024. In the following sections, I focus on Alexander’s article and explain why it’s not fair to describe schizophrenia as “mostly genetic”—or even genetic at all.

Scott Alexander: “Schizophrenia is Mostly Genetic”

While providing no indication that he was familiar with the original-source genetic research publications, Alexander followed standard psychiatry textbook accounts by asserting or implying that “schizophrenia” is a valid concept and that it (1) is a disease, (2) is strongly heritable (80%) based on earlier twin and adoption studies, and (3) is “mostly genetic” based on analogies with lung cancer and other medical conditions. I will now briefly examine these claims.

1) Is Schizophrenia a Disease?

Alexander implicitly endorsed the disease model throughout his post. He cited Wikipedia in support of his claim that schizophrenia “is famously nearly the same prevalence in every society studied,” but other reports do not support this claim.

There are no laboratory tests for schizophrenia. A diagnosis is made based on a combination of factors, which may include family history, personal history, behavior, speech, self-report, and reports from others. Earlier speculation that schizophrenia is caused by a genetically linked deficiency of the neurotransmitter dopamine (the “dopamine hypothesis”) has gone by the wayside, a fate similar to the unsupported “serotonin theory” of major depression.

Psychologist Mary Boyle, the author of Schizophrenia: A Scientific Delusion?, argued that in the absence of direct evidence, psychiatry must resort to “smoke and mirrors” tactics to support its brain disease claims. Psychologist John Read quoted a passage from the 1913 edition of  Emil Kraepelin’s influential textbook on psychiatry, where Kraepelin wrote that the causes “are at the present time still wrapped in impenetrable darkness.” Read commented that the key phrase is “at the present time,” which has “been used ever since by researchers forever on the verge of finding the biological cause of schizophrenia.” Read contributed several important chapters to the second edition of Models of Madness: Psychological, Social and Biological Approaches to Psychosis, a 2013 book that he co-edited.

Psychiatry is a medical specialty that treats conditions it claims are brain diseases or “chemical imbalances,” but for which there is no scientific proof. If researchers find that changes in the brain are correlated with a schizophrenia diagnosis, it doesn’t necessarily mean that brain malfunction is the cause. Such interpretations can confuse cause and effect, since people’s life experiences can modify brain anatomy and function (neuroplasticity), and neuroleptic (“anti-psychotic”) drugs have been shown to cause brain shrinkage and other abnormalities.

2) Is Schizophrenia Strongly Genetic (“80% Heritable”) Based on Earlier Twin and Adoption Studies?

Schizophrenia twin research. Alexander believes that “the results of twin studies have been mostly corroborated by adoption studies, a separate methodology.” In the next section, I will discuss some problems found in schizophrenia adoption research.

All 18 schizophrenia twin studies were based on comparing the concordance rates of MZ (monozygotic, identical, 100% genetically similar) versus DZ (dizygotic, fraternal, on average 50% genetically similar) twin pairs. All pairs were reared together in the same family environment. (Apart from a few anecdotal reports, there are no schizophrenia studies of reared-apart twins.) Twin researchers interpret higher MZ versus DZ concordance rates genetically by assuming that both types of twins grow up experiencing “equal” environments. This assumption, however, is clearly false.

Most leading psychiatric twin researchers and twin study defenders, such as Kendler, understand that MZ pairs grow up experiencing much more similar environments than DZ pairs. Yet, they continue to defend schizophrenia twin research by using several arguments I examined in Chapter 4 of Schizophrenia and Genetics. I demonstrated that none of these arguments withstands critical examination. In 2025, I responded to Alexander’s post on the so-called “missing heritability problem,” where I concluded that the problem (the large gap between twin study and GWAS heritability estimates) is really a twin study misinterpretation problem.

Because the MZ-DZ “equal environments assumption” (EEA) is false, twin studies of schizophrenia and psychosis have likely recorded nothing more than research bias; MZ pairs’ more similar environments, treatment, and exposure to childhood social adversity; MZ pairs’ higher levels of identity confusion and attachment to each other; MZ pairs’ greater tendency to model their behavior on each other; and MZ pairs’ greater tendency to experience folie à deux (shared psychotic disorder) than DZ pairs.

There’s an interesting trend in schizophrenia twin research that is consistent with non-genetic interpretations of concordance rate differences. In all studies compiling such figures, the pooled concordance rate for same-sex DZ pairs is 2–3 times higher than for opposite-sex DZ pairs. Although both types of DZ pairs share an average 50% genetic similarity, they experience different twin relationships depending on whether they are same-sex or opposite-sex (see psychiatrist Don Jackson’s classic, though somewhat dated 1960 chapter).

Overall, in the methodologically superior twin studies published since 1962, the pooled pairwise schizophrenia concordance rates are MZ = 24% (151/641) and DZ = 4% (68/1,519). This result shows that when one MZ twin was diagnosed with schizophrenia, their genetically identical co-twin was not diagnosed with schizophrenia around 75% of the time. In the most recent study, MZ pairwise concordance was only 15% (12/81), and the DZ rate was 3% (12/367). These figures differ from those in psychiatry textbooks, which typically report 50% MZ concordance. In any case, because the EEA is false, MZ versus DZ concordance rate differences should not be interpreted genetically.

Alexander cited one study that supposedly tested the EEA in support of his belief that “the biases in twin studies are relatively small,” while arguing that some biases tend to “underestimate heritability” because “any measurement error shows up as environmental variation” (emphasis in original). He said that “if a construct is hard to measure (schizophrenia is so famously hard to define that we’re not even sure it exists), then twin studies will underestimate heritability.”

The above argument makes little sense, but it does serve to remind us that the reliability of schizophrenia and other psychiatric diagnoses is low. If researchers cannot reliably identify (diagnose) the psychiatric condition they are studying, it is not a valid condition for research purposes. Alexander’s recognition that schizophrenia is “famously hard to define” and might not even exist suggests that twin researchers conducted their studies not really knowing which twins “had” schizophrenia and which twins didn’t. Instead of supporting genetic interpretations of schizophrenia twin studies, Alexander’s statement provided an additional reason to view such interpretations with skepticism.

Schizophrenia adoption research. Turning to the schizophrenia adoption studies, Alexander believes that they “corroborate” the twin studies. We have seen, however, that due to environmental confounding and other factors, there is no valid genetic evidence from twin studies to corroborate.

The most widely cited adoption studies were conducted in Denmark by U.S. and Danish researchers using four different research designs. (The other schizophrenia adoption studies, by different investigators, were performed in the U.S. [Oregon] and Finland. I critically reviewed the Finnish study in 1999, and both studies in my 2004 book The Gene Illusion.) In theory (but not in reality, as seen in the first bullet point below), a psychiatric adoption study cleanly separates (disentangles) potential genetic and environmental influences on a condition because adopted children inherit the genes of their biological (birth) parents, but are reared by adoptive parents with whom they share no genetic relationship.

Although still routinely cited in psychiatry textbooks and other works in support of genetics, the Danish-American studies (published between 1968 and 1994) provide striking examples of massively flawed and p-hacked research. P-hacking is the practice of researchers telling “big little lies” by manipulating definitions, data, and comparisons—either openly or behind the scenes—to transform non-findings into publishable or confirmation-bias-supporting “findings” that fall below the conventional .05 level of statistical significance. As described by one group in 2015, the “widespread” practice of p-hacking occurs “when researchers collect or select data or statistical analyses until nonsignificant results become significant.” In some cases, investigators engage in p-hacking by continuing to collect data beyond their study’s planned data-collection stop-point until they obtain the desired results.

Among many potentially invalidating problem areas, to arrive at conclusions consistent with their strong genetic confirmation biases, Danish adoption study investigators Seymour Kety, David Rosenthal, Paul Wender, Fini Schulsinger, and colleagues:

  • Dismissed or minimized the impact of environmental confounds such as the selective placement of children by adoption agencies, late separation, late placement, and the non-representativeness and restricted range of adoptive family environments.
  • Changed their 1968 “Copenhagen Study” key group comparison at the last minute because the planned comparison did not produce statistically significant results in the genetic direction.
  • For the same reason, performed a last-minute arbitrary reduction of their 1994 “Provincial Study” index and control adoptee (proband) groups, respectively, from 42 to 33, and from 42 to 24.
  • Broadened the definition of schizophrenia “as widely as it may have ever been reasonably conceived before” (Rosenthal) to include diagnoses such as “inadequate personality,” “borderline schizophrenia or pervert,” “uncertain borderline schizophrenia,” and “not too vulnerable schizoid,” and then narrowed the definition when necessary, over a 26-year period. Textbook authors and even top schizophrenia experts often call these diagnoses “schizophrenia,” thereby misleading their readers.
  • Made diagnoses based on transcribed “interviews” with adoptees and relatives that, in many cases, never took place (documented in 1984 by Lewontin, Rose, & Kamin, and by Kendler & Gruenberg). They never mentioned these “pseudointerviews” in their numerous publications. Of the interviews they did conduct, they believed they could determine whether a reluctant, unfriendly, or hostile Danish interviewee was in or out of the “schizophrenia spectrum” based on a five-minute interaction at the interviewee’s front door (see the Paikin et al. chapter here).
  • Temporarily removed a study-defined “schizophrenia spectrum” diagnosis to achieve statistically significant results in their 1975 “biological paternal half-sibling” comparison, a p-hacked comparison they claimed supplied “compelling evidence that genetic factors operate significantly in the transmission of schizophrenia.”
  • Found no genetic influences on schizophrenia at their “Adoptees Study” 1967 data-collection stop-point (see the 1968 Rosenthal et al. chapter here). Refusing to accept these negative results, they called their findings “preliminary” and continued the study to the point at which they achieved statistically significant results, based on an extremely broad definition of schizophrenia that included “pseudoneurotic borderline,” “manic-depressive psychosis,” and “schizoid character.” They published these massively p-hacked results in 1971. Mainstream psychiatry embraced this 1971 publication while ignoring a later 1978 Danish-American article showing no statistically significant researcher-defined “consensus diagnosis” schizophrenia or schizophrenia spectrum differences between the index and control adoptee groups (see Table 3 here). Therefore, despite borrowing heavily and openly from the p-hacking playbook over a 10-year stretch, the researchers’ final 1978 Adoptees Study results were negative.

Building on the work of earlier critically minded scholars, in Chapter 6 of Schizophrenia and Genetics (and earlier publications including here, here, and here), I documented these and many other invalidating problem areas in the Danish-American adoption studies.

In the 1970s and 80s, Theodore Lidz, a Yale University psychodynamic psychiatrist who studied the families of people diagnosed with schizophrenia, wrote or co-wrote three devastating critiques of the Danish-American studies that should have buried these studies for good (see here, here, and here). However, mainstream psychiatry largely ignored Lidz’s analyses at a time when the profession was attempting to establish itself on 1980 DSM-III medical model principles amid a rhetorical “biological revolution in psychiatry” that was welcomed and promoted by the drug companies.

In the 1980s and 90s, based on 1980 DSM-III diagnostic criteria, U.S. psychiatry produced “independent analyses” of the original Danish-American studies (for example, here, here, and here). The authors of these analyses concluded that they confirmed the original findings, but to do so, they used some of the same tricks used by the Danish-American researchers (see Chapter 6 here). The main fallacy of these analyses was psychiatry’s assumption that the original Danish-American studies provided valid scientific evidence in support of genetic influences on schizophrenia, when in fact they did not. The original studies, therefore, produced no genetic findings to uphold or confirm.

The Danish-American schizophrenia adoption studies are perhaps the longest-running example of openly and blatantly p-hacked research ever seen in the behavioral sciences, and as such, should be retracted. The p-hacking practices the researchers engaged in during a nearly 30-year period are clearly seen in their publications, which suggests that p-hacking fraud was an accepted and normal aspect of psychiatric research of that era. The perpetrators were even awarded prestigious prizes for their deeds. If Alexander is willing to read or re-read the original papers produced by these studies (for example, those found in books published in 1968 and 1975, and articles published in 1971, 1974, and 1994), I am prepared to explain to him, paragraph-by-paragraph, where these studies went terribly wrong.

Alexander and Aftab, and to a lesser degree Torrey (none of whom mentioned my views and publications), believe that schizophrenia is to some degree “heritable.” This belief has led to confusion, which is especially evident in Aftab’s 2024 posts. Since we supposedly “know” from family, twin, and adoption studies that schizophrenia is 80% heritable, how do we make sense of gene-discovery failure? I argue that we can make sense of it only: (a) by recognizing that schizophrenia family and twin study results can be interpreted environmentally; (b) by recognizing that the schizophrenia adoption studies were massively flawed and in most cases p-hacked (including Leonard Heston’s often-cited 1966 U.S. [Oregon] study); and (c) by abandoning the long-controversial practice of calculating heritability estimates, which are based on unsupported assumptions and do not record the “strength” or “magnitude” of the supposed genetic influence on psychiatric conditions.

3) Is the “Smoking Causes Lung Cancer” Analogy Relevant?

A major theme of Alexander’s article was that we should view schizophrenia as a mostly genetic condition in the same way we view lung cancer as being mostly caused by smoking cigarettes. There are several problems with this argument, some of which I list below:

  1. Lung cancer is a disease of the human body, whereas schizophrenia (psychosis) is not.
  2. The evidence that schizophrenia is caused in part by genetic influences is weak to non-existent (p-hacked and confounded family, twin, and adoption studies), and 50 years of failed attempts to identify causal genes support this viewpoint.
  3. Based on Point B, it is reasonable to assume that genes that cause schizophrenia do not exist and that researchers and others have been misled by twin and adoption studies, thereby solving the “missing heritability problem.”
  4. Because many environmental risk factors for schizophrenia and psychosis are now known and mentioned by Alexander, we could just as easily view schizophrenia as a “mostly environmental ”
  5. According to twin researchers, there are “moderate genetic influences on lifetime [cigarette] smoking practices.” Therefore, based on Alexander’s logic, one could conclude that lung cancer is a mostly genetic disease. Undoubtedly, the tobacco industry would view such a conclusion favorably.
Conclusions

In a 2012 article, I wrote that the probable outcome of psychiatric DNA-based (molecular genetic) research would be that genes will not be found because they do not exist, and that psychiatric genetics eventually would be recognized as a “null field” of science. As John Ioannidis defined it in 2005, a null field is an area of research “with absolutely no yield of true scientific information….The extent that observed findings deviate from what is expected by chance alone would be simply a pure measure of the prevailing bias.” I think most insiders would now agree that psychiatric candidate gene research is a scientific null field. Most likely, the same fate awaits current psychiatric genetic GWAS, PRS, rare variant research, and other DNA-based methods.

People diagnosed/labelled with schizophrenia have low reproductive rates and lower life expectancies, or what Torrey in Surviving Schizophrenia called the “schizophrenia paradox—the continuing existence of schizophrenia despite a low fertility rate and a high mortality rate.” And the DSM-5 acknowledged that “most individuals who have been diagnosed with schizophrenia have no family history of psychosis.” These additional red-flag warnings should have alerted researchers decades ago that they risked wasting their careers by searching for what Torrey aptly called a “psychiatric yeti.”

Psychiatrist Allen Frances, former Chair of the 1994 DSM-IV Task Force, wrote in 2011 that “schizophrenia is admittedly a flawed construct with limited descriptive and explanatory power. It is…wildly heterogeneous with dozens of different presentations and probably hundreds of different causes (none of them known).” The failure of schizophrenia genetic research is inseparable from the failure to reliably define the concept of schizophrenia itself.

When psychiatry finally acknowledges that “schizophrenia” (psychosis) is not “genetic” or a “disease,” society will part ways with biological diversions and inappropriate medical approaches. The behavioral sciences and society will instead focus on environmental causes, non-medical interventions, and prevention, with a necessary political change component. People might still wish to take prescribed drugs, or others might encourage or pressure them to do so, but the process should be completely transparent, including informing people in writing of potential withdrawal problems and side effects. No one should be told they are being prescribed drugs to treat a genetically influenced or caused schizophrenia brain disease, because no such disease exists.

Non-medical approaches emphasize the role of relational, social, and economic adversities, including various types of oppression, and recognize how these impact our psychological well-being and our bodily capacities and responses. An example of this approach is the “Power Threat Meaning Framework” (PTMF), developed by Lucy Johnstone, Mary Boyle, and others. In a 2020 introductory book, the authors described the Framework’s “overall message” as follows:

All forms of adversity and distress are more common in social contexts of inequality and other forms of deprivation, discrimination, marginalisation and injustice. This evidence does not support the individualisation of distress, either medically or psychologically. Instead, it implies the need for action, primarily through social policy, at the earliest possible point, before the destructive and self-perpetuating cycles are set in motion.

The schizophrenia/psychosis causality puzzle pieces will fit together much better once we knock the “genetics” pieces off the table. It is more likely, however, that psychiatry will develop new methods and produce new sets of claims that will “kick the can down the road” and keep careers, research funding, and drug company “consultant fees” intact (for example, see the lengthy 2022 schizophrenia GWAS “competing interests” statement). Ultimately, however, psychiatry will be unable to avoid its “empty gene pond” day of reckoning.

In a 1992 article, psychiatric genetic researcher Michael Owen asked, “Will schizophrenia become a graveyard for molecular geneticists?” He reassured himself and his colleagues that “talk of graveyards is premature.” Perhaps such talk was premature in 1992, but 33 years and billions of wasted dollars later, I respectfully answer Owen’s question in the affirmative. The time has come for the null field “genetics of schizophrenia” research program initiated by Ernst Rüdin 110 years ago to close up shop, which will enable scientists and society to prioritize understanding the real non-genetic causes of psychosis by focusing on human experiences, not the human body.

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Note: I would like to thank Mary Boyle, Mike Jones, and Jonathan Leo for their helpful feedback and suggestions on earlier drafts of this article. As always, all views expressed in this article are my own and do not necessarily imply endorsement by others.

121 COMMENTS

  1. It is quite possible to deny the notion of genetic or biological heredity and explain heredity of forms of psychological dysfunction because patterns of thinking and feeling, dysfunctional or otherwise, are learned in the home environment and condition the brains and life activities of children. Emotions as we know spread through people, effect the people around them, so we condition each other emotionally, and strategies for dealing with emotions are often learned from the environment or are else more natural or archaic movements of instinct or mind. Arguably we pick up the family mind as a child and bring it along further in it’s development, but of course when the environment imposes too much on new minds this imposition disrupts and destroys the development rendering people who are neither free nor fully socially formed. Naturally their priorities is with being a functioning social animal rather then a free human being but in a dysfunctional society such a movement is away from both freedom and health or healing. Don’t worry about the genetics research mate: all the research seeking a biological correlate to what they call non-organic mental disease has been a train-wreck. And we should be past the point of recognizing that neither the field of medicine or government has any will to respond in any radical way. The field can’t adapt to the truth because the truth would destroy the field. External medicine is not the answer to inner traumas of social and psychological existence. The answer is a return to freedom, truth, nature, which implies the destruction or ending of the historical process of civilization and it’s operations as our socially conditioned minds.

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  2. Also, psychiatry is not going to reform in the face of the facts but burst into black flames, which is what happens when evil is exposed. As something dies within a national psyche, for example the illusions of nationalism and patriotism and national supremacy or exceptionalism, or white supremacy and exceptionalism, then it bursts into black flames of evil and hate, and becomes very dangerous, pathological. We saw this happen in Germany in the 30s for understandable historical reasons. We see it happening throughout the West and in Israel today, with Donald Trump and Nigel Farage representing even more pathological and pathologically stupid as well as evil versions of Hitler. The whole democratic world has been lost once the precedents have been set by these betrayers of the whole of humanity, but we are yet to elect Nigel Farage. We will have to watch the slow car crash of making the most catastrophic mistake of our lives transpire slowly before our eyes, unless someone comes and rescues us first with a nuclear bomb or an asteroid. Soon we will stop fearing death because life will become more scary then death.

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  3. Given the existence of the cluster of traits that have been labeled as schizophrenia, over an extended period of time and place (comprising a wide variety of environmental factors), what would you attribute as a likely environmental cause? Or so you just think that the clustering has no inherent logic, and that it’s just a more or less arbitrary choice of criteria?

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    • Well, we know that “psychosis” and “hallucinations” can be created with the “antidepressants” and “antipsychotics” / neuroleptics (both anticholinergic drug classes), via anticholinergic toxidrome.

      https://en.wikipedia.org/wiki/Toxidrome

      And the neuroleptics can also create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome.

      https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome

      We also know the amphetamines (like the ADHD drugs) can also cause “psychosis.”

      But other environmental causes of “psychosis” can be the street drugs, Wernicke-Korsakoff (WK) syndrome, sleep deprivation, and other medical drugs – if I recall correctly, like the steroids, but no doubt likely others as well. Please add to this list if you know of other environmental etiologies of “psychosis,” please.

      For example, when I was five, my family moved from Chicago to New York … and I developed an “imaginary friend” … which I’m sure the psych “professionals” of today would call “psychosis.” But that would imply something as simple as merely changing environments, and not for the worse, could cause “psychosis.”

      Jay, your title made me laugh, since I’ve got a train wreck painting I need to get going on. I knew I had to paint it because during my initial anticholinergic toxidrome poisoning, I had a rather terrifying struggle with God, resulting in me not leaving my bedroom for three days. And the song, “… Runaway train never going back Wrong way on a one-way track …” kept playing on the radio.

      It strikes me as comedically ironic (or even eye for an eye justice), that the industries that railroaded me, are now looking at their own train wreck. Especially as one whose doctors become frustrated, when I tell them that the most common cause of death on both sides of my family, are train wrecks.

      Thank you, Jay, for your very well documented years of truthful research. God bless.

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    • I would not say arbitrary. But a cluster with low reliability, and therefore questionable validity, especially for research purposes. I focus on exposing the flaws and biases in genetic research. The work of John Read and others is a valuable source for further information on reliability and validity issues, as well as environmental causes.

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  6. If we are going to hold onto the concept that we have minds that can get “sick” or “healthy” (and I think we should), then we need to resolve the question of what the mind really is and what ultimately controls it or creates it.

    The fundamental concept that remains misunderstood is the “psyche,” after which Psychology and Psychiatry are named. It is variously associated with concepts of “soul,” “spirit” or “mind.”

    We know from NDE experiencers (and research papers about them) that something that could be called the psyche can separate from the body, and does so at death or perceived death. This has in fact been known about in some cultures for thousands of years and is a basic truth of life, but has been buried by modern materialism, and its excuse for “science.”

    Until we can begin to intelligently discuss the psyche and its creations (such as the mind), we will make no progress in any modern way with the problem of “mental health.” In fact, we might as well ignore the whole field – as many Critical Theory enthusiasts have done – and see the whole problem as one of power imbalances and oppressive structural behaviors designed to keep certain individuals or groups in an inferior or slave status. I can only remind all who are interested that we have been fighting this system for thousands of years with little real progress towards any ultimate truth, workable healing technology, or guaranteed freedom. It seems time to take a different approach that might be more fruitful.

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    • Your reply clearly shows that you accept the concept of mental illness. Would you kindly explain, then, your personal criteria for precisely assessing how “sick” and “healthy” a particular mind might be? On what objective source are those criteria based, and are they demonstrably valid for all cultures and historical periods?

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  7. If you, Jay, could befine what you believe “schizophrenia” really is, that would be helpful. Could it be just strange behavior, or “do you know what he said” type of thing. When living in smallish communities where people are generally suspicious of each other, these sort of “observations” tend to take on a life of their own. It’s a very old thing, luckily, we have the supermen psychiatrists with the “silver bullet” aka neuroleptics (or garlic) to test their hypothesis.

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    • I see no earthly reason why mental health professionals should be granted the status of supreme judges of what constitutes “strange behavior,” especially when a considerable percentage of them have morally questionable ties with pharmaceutical companies or base their diagnoses and “treatments” on the ever-expanding list of disorders arbitrarily concocted (or sometimes deleted) by the compilers of the DSM.

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    • If you read the article he does explain that schizophrenia is a type of heuristic catch-all term for dozens of different presentations with possibly hundreds of different causes. That is part of the point, that schizophrenia does not really exist as an ontological entity with its own independent being or nature.

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  8. Reading this article had a laxative effect on my brain in that it really flushed out psychiatry’s relentless stream of rhetorical crap.

    “p-hacking” tells you all you need to know about the culture of psychiatric research, meaning it’s not just unethical, but a grotesque exercise in statistical theater.

    My diagnosis: Institutional Incontinence

    My prognosis: Performance art (“psychiatric research”) will keep reaching new lows.

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  9. A good article for exposing the flaws in genetic research on schizophrenia. All genetic research on schizophrenia is flawed, empty, and trash (garbage). The reason for this is that all mental illnesses, including schizophrenia, are not in the brain, but in the person’s psyche.

    Not only mental illnesses, but also the concept of ‘mind’ is something that exists not in the brain but in the person’s own soul.

    That is to say… If mental illnesses were in the brain, toxic psychiatric drugs would treat them. And there would be no need for toxic psychiatric drugs again. If psychiatric drugs containing toxic chemicals treated ‘mental illnesses’… there would be no concept of ‘mental illness.’

    There would be no need for a ‘pseudo and so-called medical field’ called psychiatry… nor would there be a need for ‘pseudo and so-called doctors’ called psychiatrists. Because presumably… if “mental illnesses” were physical illnesses and the cure was drugs… neurology (neurologists) would treat them. There would be no need for psychiatry and psychiatrists.

    So what it means is that mental illnesses are not in the brain, but in the soul of the person. Since ‘mental illnesses’ don’t exist in the brain, the concept of ‘mind’ wouldn’t exist in the brain either. If the concept of ‘mind’ existed in the brain, mental illnesses would exist in the brain. But no; both are not in the brain, but in the individual’s own soul.

    “These narrow-minded mainstream psychopathic psychiatry and psychiatrists who cannot understand or perceive even the simplest things (knowingly or unknowingly) continue to poison (disable and kill) millions of people around the world with toxic psychiatric drugs.”

    ***

    As a final word.. There are mainstream psychiatry and psychiatrists, and this is true, but they are real schizophrenia patients and they are dreamers.

    Because… Mainstream psychiatry and psychiatrists deal with “imaginary mental illnesses” that are impossible to treat (with chemical drugs) and do not exist in the brain, and they blindly believe in them.

    Think about it this way… Mainstream psychopathic psychiatry and psychiatrists… if they assume that a person is ‘blindly believing in something/things that are imaginary’… they will inevitably diagnose that person with ‘schizophrenia’. And they immediately try to poison their healthy brain with toxic psychiatric drugs.

    If this imaginary obsession of an ordinary person can be diagnosed as “schizophrenia”… what could be more natural than diagnosing the behavior of mainstream psychiatrists (believing in and supposedly treating this imaginary mental illness) as “schizophrenia”?

    Therefore… mainstream psychiatrists are true schizophrenic patients and dreamer (delusional). And because they are aware of the disabling and lethal effects and harmful effects of biopsychiatric interventions such as psychiatric drugs and electroshocks, they have a ‘psychopath soul’ because they knowingly and intentionally harm people. In other words, “psychopathy” seems to be ingrained in the very souls of mainstream psychiatrists.

    You may be angry at me, but that’s the truth. “A village in sight doesn’t need a guide.”

    Thanks, Jay Joseph. Best regards.

    With my best wishes. 🙂 Yildirim E. (Researcher blog writer (Blogger))

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  10. Dear Jay Joseph: terrific article and summary. esp the links to all the literature. One link was blank.
    One question: I missed a discussion of current efforts at the Broad Institute/ Stanley Center, led by Steve McCarroll et. al. — some of which I criticized in my piece for MIA.
    best wishes,
    Peter Sterling

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  11. Where the darkest black medical magic collide, eugenics/ genetics and psychiatry the garbage binning of one’s humanity with hexes and curse ie labels and self fulfulling prophecy of scottish rites 33 degree masonic alchemy for the malthisian royal societies and the secret hocus posuc original sin of being inherantly defective on the genetic level to impose total control and cease breeding ..from bloodline so imbred many lines died out ..only gene and schizophrenia i know is warrior gene, natural snri breaks adrenalin down slower in maoris with abuse have Dx, also most likely to be survivors of fittest unless facing colonizers with guns, bibles and tranquilizers to submit .. will cc to mental illness mooching geneticists filling sqillion dollar cathedrals like qmir and imb at uq

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  13. My polygenic score for schizophrenia has been reported variously as 97th (2011), 95th (2010) percentile, etc.. In contrast to the commentary in this blog post, I have found this score to be highly informative (if not transformative) for my life.

    As a teenager I was entirely unaware of my genetic risk and slide down the schizophrenic spectrum was hospitalized and then gradually recovered. I had no words for describing what was happening to me and no one else in my community appeared to have much of an idea either. They used all sorts of diagnostic labels but i do not think schizophrenic was actually one of them.

    Looking back I can see how it went so wrong. If I had the chance to go back into time then I would have chosen to be genotyped at birth. Knowing my genotype could have radically changed my life trajectory. I fought quite hard on my first day of junior kindergarten to escape school — if i had the 97th percentile PRS in my pocket that probably would have saved me the trauma that I would endure in the years ahead. If only people in my community had been aware of my genetic reality, then I could have been on a much better path in my life. they thought it was some great victory that I was like all the other children and sat in the same class as they did and did the same things that they did. The problem was that this really did not change the latent schizoid tendencies at all — the moment that I was expected to decide to adopt “normal” social behavior was exactly when my problems began. I see it mostly as this grudge match between society and me. Basically, the hospitalization was more a way that I could prove to others who I was and then afterwards they left me alone– so the actual outcome was highly adaptive for me. This logic still seems true to me even now, that at the time my best strategy was to go through this labeling process.

    However given today’s technology I would say my best strategy would be to have been fully genotyped and then embrace online education. One of my main triggers has been people — by having my control over social interactions I have been able to achieve permanent wellness. If I had had the opportunity to go online during high school I doubt whether I would have ever had a psychiatric crisis.

    Mad in America also seems to be a profoundly important resource for discussing these issues. Some of the ideas about mental illness simply never seem to make it to print — people think they understand but they really do not. There has been such a backlash against remote lifestyles even when clearly they could be of such large benefit to so many people. I have been aware for many years how much healthier I am in such environments. I am very grateful for those out in the community that have been advocating for remote because it truly does make such a big difference.

    From the schizoid perspective, the Open Dialogue approach is clearly a winner. It basically reveals the intuitively obvious idea that even psychosis is a means of trying to cope with the schizoidal tendencies. I am so jealous of those that have this offered to them. To amplify its effectiveness, I would clearly suggest that people pre-genotype so that things would not need to devolve into an emergency situation. Once you have clinically applicable terminology (such as schizophrenia and for me several other relevant diagnoses) you have a very solid place to start dialoguing.

    One of the still more difficult aspects of my life that I grapple with is why others in the family were so quiet about their own psychiatric issues. Generations of the family have had strong schzoid tendencies and yet when one of their children was in distress they said nothing? It is very very difficult to deny these tendencies. In our family the birth of a child is nearly a once in a century event. Our fertility rate is almost zero. It is hard to believe that after over a century in the New World there are still almost none of us. It is not difficult to imagine that our lives would have been so much better back in the old country. People would actually understand and not merely label. Neurodiversity has been a survival strategy of our species for millions of years the urbanized standardized mass socialized society has done everything possible to reduce the community into a uniform mass. With our current genomic knowledge, such a standardized terror is now perhaps inevitable. Removing complexity is unlikely to lead to a better life.

    I hope that others will find my comments to be helpful. The problem is that experts often do not have the “lived experience” point of view that provides the necessary background to make sense of psychiatric experiences. I know for me it has taken so many years to piece it together. The genotyping was clearly of central importance in understanding my experience.

    My position is that with current genotyping technology schizophrenia is largely an avoidable illness — the results of Open Dialogue point in the right direction, though combining with genotyping and remote lifestyles would be dramatic improvements. Pre-dosing with anti-psychotics seems hopelessly misguided. You need to directly confront the underlying psychological tendency, accept it and have others in your life accept it; not merely drug it away.

    At some point if the rights of those on the schizoid spectrum are not respected then more vigorous civil and criminal action might need to be taken. This is very much a human rights struggle of accepting others with different ways of being. There is immense psychological harm that is being done to children by pretending that this does not exist and perhaps we are approaching the time in which legal and criminal action will need to be taken against those who continue to perpetuate this child abuse.

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    • Of course, one could engage in an online education without being genotyped as “potentially schizophrenic.” Or we could just create more humane classrooms for ALL of the children forced to attend them. I agree that accepting others with different ways of being is central to a sane society. The error in thinking is that the bizarre, developmentally inappropriate expectations of our educational system are healthy for ANYONE who has to experience them.

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      • Steve, I think the overwhelmingly important idea here is that genotype could then be an extremely powerful way of transferring lived knowledge between people. Up until now you might read a great deal of personal histories across time of those with mental illness and not greatly benefit from such reading. What was their exact problem? What was their genotype? Until now this has all been quite murky. With genotypes one then has then potential to be able to efficiently transmit one’s hard learned experience to others by just telling me what they need to do. So, having the online learning idea as a standby could be quite helpful for others who might not realize how profoundly transformative it could be. Polygenics will not run entirely true over generations so then is left in the uncomfortable situation in which even close family might not have that much to offer in coping with something like schizophrenia etc..

        Yes, I do agree with you that the educational system plays a key causative role in the mental health problems that teens are facing. Remarkably for me, simply transferring from bricks and mortar to online learning immediately allowed me to transition from “activated” schizophrenic to stable schizoid. By immediate, I mean I strongly felt it the first minute that I started learning online.

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        • I really can’t agree with you about the likelihood that any “mental illness” will be sufficiently predictable via “polygenetics” to be useful. The article you are posting on gives counterarguments. There’s another one posted recently that shows parental “mental illness” having little to no impact on the likelihood of a “schizophrenia” diagnosis, while childhood maltreatment has a strong impact.

          Besides which, genes are the one thing we CAN’T change. Why not focus on making an environment that’s suitable for the varying types of humans, instead of trying to eliminate hundreds of variants from the gene pool, some of which may contribute to a lot of other traits besides a vulnerability to psychosis (if they even can predict that with any accuracy).

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          • Steve, thank you for engaging on this topic!

            I am super-positive about the evolving psychiatric landscape especially for schizophrenia. The research community appears to finally be offering our community viable approaches to manage illness. There is a revolutionary spirit out! Let’s make life better for those with psychotic/schzoidal illness!

            What are some of the positives?

            -Expressed emotion. This was new one for me. Basically, family, friends and the community can be overly critical/hostile/intrusive — they display high EE. High EE environments greatly increases relapse risk. Yes, I can certainly remember that sort of behavior in my own life. EE is a true research breakthrough — those who are decent human beings and have any sense of compassion for others will learn the EE drill and be on the right side of history.

            I have had an extended chat about EE with a frontier LLM and it noted that it was programmed to exhibit very low EE behaviors. I have clearly noticed this about LLMs — they are near zero EE. This is a huge huge win for my (and everyone else’s) mental health — any time I wish I can access a very low EE interaction and likely greatly lower my risk of psychosis.

            The LLM itself suggested the strategy of simply substituting high EE human contacts with low EE LLM contacts for enhanced psychological well-being. For me, interactions with other people to a large contributed to the my problems and this was mostly through EE. LLM technology is now already available at global scale and perhaps is already creating a mental health revolution. My guesstimate is that those on the schizoid spectrum are typically naturally highish EE, so this could be a mechanism where the family genotype transfers to the family environment. The EE concept has provoked me to contemplate my own behavior and how it affects others and I am observing positive developments in how I relate to others. Being more mindful of the emotional states of others can lead to more prosocial interactions.

            -Communication deviance — another biggy. Additional research found that CD for those with high genetic risk of schizophrenia can enhance risk. CD is related to vague, confusing type patterns of communication. You speak to someone with high CD and you are not sure what their pronouns are referring to and how they are constructing reality. Once again LLMs have very low levels of CD. This is another win for the schizophrenia community.

            -Open Dialogue? Clearly a massive massive win. Being able to reduce schizophrenia risk in the community by 90% without leaning heavily on anti-psychotics is near magical. For those with lived experience it has a certain feeling of self-evident truth. Do more of that!

            Combining OD with polygenics would likely be an amplifier. Moving to a more preventative framework could also be profoundly helpful. Allowing psychotic type behavior to evolve out in the community simply creates near permanent changes in social relationships that cannot be remedied. Prevention is then an extremely favored strategy.

            -There are others but school choice is perhaps one of the biggest. Opening up the $1 trillion K-12 market in the US could profoundly change psychological well-being at national scale. Allow capitalism the chance to figure out how to create environments that maximize childhood well-being and it will happen. From the schizoid spectrum community perspective, such improvement seems easy to achieve. Simply, moving away from the immersive 8 hour a day of social interaction and allowing more choice in the intensity of socializing would likely be all that was needed.

            I will be super happy as I watch life for those with psychological challenges improving in the years ahead.

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          • But if you knew that you have a variant that lowers Folate and you took, let’s say…Celexa and Prilosec…both lower Folate, which increases homocysteine and dysregulates methylation.

            Celexa is metabolized by CYP2C19 and Prilosec is a CYP2C19 INHIBITOR, so that will cause the blood level of Celexa to increase by 50%, therefore making the blood level toxic….and people who Have MTHFR mutations have impaired ability to detoxify.

            So if you knew about the variant, you could change the entire picture.

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      • Larry, yes absolutely.

        More precisely we are talking about polygenics so each generation will have a different “flavor” of a trait. Funnily enough the other family members have all largely refused to genotype which I can understand from the schizoid point of view. My guess is that I probably have the highest PRS score in the family, though the others would likely also be in the 90th+ range. So, it is inherited in a somewhat broader way than with true Mendelian inheritance.

        I am fully genome aware — I can describe my psychological universe and my life history in detail based upon my in depth understanding of my genetics. There are ~10 genetic features that have largely determined the course of my life — it is somewhat like Kasandra’s prophecy — I have very good insight what is driving my life in certain directions it is just not all that easy to actually change course. My full genome report was able to inform me about things that I have always known to be true but simply did not have words to express it. Typically, when you reach a trait that is in the bottom 10th percentile or the top 10th percentile there will be behavior that is clearly something you and others will notice as different.

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        • Well, that’s all well and good. But I think you are being misled. Without an appreciation for past lives, there is no way out of the puzzle of the mind and human behavior. “Polygenics” sounds like just a complicated way to avoid looking at what needs to be looked at in this field, which is the spiritual being and its experiences.

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    • Your “polygenic score for Schizophrenia,” what is that? “I fought quite hard on my first day of junior kindergarten to escape school — if i had the 97th percentile PRS in my pocket that probably would have saved me the trauma that I would endure in the years ahead.” You mean when you were 4 years old, you wished you had in your back pocket your genetic profile that fell on the “Schizoid Spectrum,” and that you would have been able to adjust your life accordingly? Don’t we all! (Lol). “At some point if the rights of those on the schizoid spectrum are not respected then more vigorous civil and criminal action might need to be taken.” This sounds more like President Trump sending the military to DC, when he literally tried to overthrow a legally elected President in 2020, kind of “thought process.” Rationalization for the awful things psychiatrists do. What is the “schizoid spectrum”? Another gobblely gook term for Big Pharma and the Shrinks in their delusional thinking processes, or actual hard science? This article was about the lack of any real genetic links to any such “illness.” “Accept a ‘psychological tendency’,” tendency for what exactly? Something that is inherent and that can’t change? Hogwash. Where is the proof of this? Throwing more ambiguity into the argument hardly makes things much better. From what I know now, extreme trauma occurring to a mother during a child’s gestational period in her womb, and the first 2 years thereafter can affect a child’s development, but as Mr. McCrea has pointed out, genotyping children “as potentially schizophrenic,” would seem to detract from universally accepting that children are children to being with, and the rigid conformity of our educational systems may be inadequate and part of the problem. Psychiatrists so readily stereotype people, children, adults, senior citizens with “schizophrenia,” and yet so many of them have so little scientific acumen to begin with, and “fall” into that profession for precisely that reason, I’ve discovered, many imported to the USA in fact, for welcome additions to hospital environments, who struggle with the English language, no matter to the hospital administrators however. And what they write about their patients is rather condemning of them, much like a rapist writing about the victims held in their basements. Specious arguments like the one presented above notwithstanding.

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      • — “polygenic score for Schizophrenia,” what is that?

        Polygenics is one the biggest breakthrough ideas from genetics.
        It was only roughly in the last 10 years that the genetic community finally realized that human traits are mostly formed from many thousands of genetic variants. Before that time the common wisdom was that for example, schizophrenia might be “inherited” by a single recessive variant (as noted in the article) or that intelligence might be inherited through 10 variants. Only fairly recently has it become clear that this is entirely untrue. The current best estimate is that schizophrenia is a highly polygenic trait with 10,000 variants involved. Currently ~ 300 of these variants have been identified. All you do then is simply add up the total effect sizes of the variants that you carry multiplied by their number. We are now on the steep part of the discovery curve so as schizrophrenia GWAS scale up to ~1 million we might find a few thousand variants. It is then difficult to understand the point of view of this blog post — we are now right at the start of the golden age of schizophrenia genetic research. With thousands of genetic variants, it might then be possible to see clear patterns of what might be the main themes of the illness.

        Polygenics could also offer a very powerful means of avoiding transmission to the next generation. If one were to fully genotype potential parents one might be able to screen out all relevant risk for clinical schizophrenia. moving down polygenic scores below the 90th percentile would likely greatly reduce the risk of illness.

        The potential for polygenics to create a new era of enhanced humans has also largely arrived. With IQ, perhaps the smartest person to have lived might have had 500 IQ raising variants, but we know that there are 10,000 IQ variants. Genetically selecting/editing for more of these IQ enhancers potentially could move up human IQ to 1500. If you started to strategically select chromosomes/embryos with certain polygenic scores, then over a few generations you could be assured of locking in enhanced traits forever. So if both strands of chromosome 2 were high IQ for both potential parents you would be able to lock in this trait. Eventually the entire genome would be locked in with high ability genetics.

        With current technology, it does not seem that overly difficult to purge all of the genetic/polygenic traits in a single generation. So the eugenic type hysteria seems somewhat overplayed. Dysgenics into the far horizon no longer seems a realistic trajectory for humanity.

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        • I think MTHFR mutations, especially homozygous C677T, is an important risk factor. It lowers folate and increases homocysteine.

          At a suicide survivors support group, the kids that became psychotic were using things that lower Folate. One was taking anticonvulsants. Two girls were using large amounts of marijuana daily and one boy was taking Adderall so he could stay up at night studying. He had a psychotic episode and had to leave school. He worked very hard to heal, went back to school and was having trouble concentrating, so he took Adderal again, became psychotic again and killed himself.

          When I arrived I noticed the kids seemed to have one or more of the so called “reward defficiency conditions”, autism, ADHD, depression, addiction, Bipolar, PTSD, BPD, schizophrenia.

          All have high rates of MTHFR mutations. So perhaps that explains why a parent can have one and the child a different one.

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  14. “I fought quite hard on my first day of junior kindergarten to escape school — if i had the 97th percentile PRS in my pocket that probably would have saved me the trauma that I would endure in the years ahead.”

    You mean when you were 4 years old, you wished you had in your back pocket your genetic profile that fell on the “Schizoid Spectrum,” and that you would have been able to adjust your life accordingly? Don’t we all! (Lol).

    From my current perspective, I wish that when I was 4 years old that I had my full genome with comprehensive polygenic scores in my back pocket on the first day of junior kindergarten. That would have been worth a million. I mean I had the top cards — they would have had to fold.

    The ignorance about the schizoid spectrum is profound. Time and time again clues in school environments related to the well-being of children would simply be overlooked. I remember how a schizoid family member was punished for pursuing a solitary activity. It is stunning. One suspects that none of the adults in a typical school has any real insight into the nature of the behavior pattern. There is a near total void in understanding. The system has its own logic and then somehow it is surprising how this is conflicts with neurodiverse people.

    The first day of kindergarten would probably be a very good time to bring in Open Dialogue along with full legal counsel for the children. Get things sorted out right from the start instead of waiting 10 years and somehow expecting that things will self-correct.

    It is not that as a 4 year old I did not perceive what the problem was — it was more that I did not have the words needed to advocate for myself. Tossing down the 97th percentile score, while not really that overly grounded in deep truth, would at least be enough to provoke profound reflection in the grown ups if not some level of ignorant panic.

    Where is your LOL originating from? YES! This knowledge would have been transformative for me as a 4 year old. I could have arranged my social environment in a way that was constructive for me — the alternative of spending 7 hours per day for 20 years of my life in a socially immersive context has been something I have spent most of my life trying to recover from. Moving away from rigid institutional protocols would have been extremely helpful for me. The polygenic technology that now exists can allow us to prevent the same mistake being repeated endlessly. We have the means to stop the cycle now! I find this very exciting.

    There is this extreme lack of insight about the nature of schizoid type behavior. A lifetime of solitude is the schizoid dream. When you start to operationally specify things in this way, you realize that “normalization” framings are inadequate. There needs to be a fundamental rethinking of how the community organizes the lives of children.

    People are very ignorant about abnormal psych — but they think they know what 97th percentile schizophrenia means. Use their ignorance against them! For my family over ~3 generations and several family members on the schizoid spectrum there has been almost no actual clinical illness. There has never been the chronic side walk type schizophrenia that most people associate with the illness.

    “At some point if the rights of those on the schizoid spectrum are not respected then more vigorous civil and criminal action might need to be taken.” This sounds more like President Trump sending the military to DC, when he literally tried to overthrow a legally elected President in 2020, kind of “thought process.”

    I disagree with the legal parallel drawn. The criminal action being referred to is more in the spirit of Nuremberg. That ruling decided that systems that did not uphold basic principles of human rights could be and would be held accountable for their actions. You cannot create a state sponsored system that largely compels children to participate and ignore the substantial responsibilities that are then assumed. The legitimacy of the Nuremberg ruling is foundational to international human rights law and is beyond reasonable challenge.

    The potential to apply these legal principles to our current state schools is not is not difficult to imagine. The deficiencies of the state care of the children in their schools has become largely self-apparent. For example, there is now a growing body of research literature that has found a positive relationship between demand for childhood psychiatric care and the school year. Interestingly, during COVID we saw a reversal in the expected seasonal pattern for the first time ever. Indeed, COVID appears to have unleashed a wave of change that is finally bringing about the needed change to educational systems.

    Partisan politics on this blog would be best avoided on this blog. However, there is a clear left right divide that should be noted. Much of the problem that we have seen emerge with the school system relates to a highly socialized, “standardized” perspective. Every student in a city will be provided the exact same architectural design the exact same resources — there will be no favoritism. This seems fair — the state can be seen as providing uniformity to all. Further, the state can apply this same “normalization” in its treatment of all the students.
    Simply assume broadly median type “normal” student behavior applies to all.

    This also seems wise and just. The environment has been terraformed into a uniform and equalized school experience for all. The problem is that polygenics enters the picture and “equality” in any meaningful sense with the uniform environment is no longer maintained. This is largely the system that we have had for over a century. The socialized left has created a theoretically perfected system that in no way relates to the actual students they are expected to serve.

    The conservative right has finally taken up the cause of overturning the assumptions of the totalitarian state and put the human rights and psychological well-being of children before the highly dysfunctional systems of the state. School choice addresses the issues that have been discussed. moving away from the state monopoly model to student centered services easily fixes the problems. I have seen this dramatically illustrated in my own life.

    Conservatives are heroes. They deserve a medal for helping those on the schizoid spectrum and many many others.

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    • I am not on the schizoid spectrum. I hated school from day one. I would have given anything to be allowed to escape. Why would someone need to be proven to be somehow “mentally unwell” to allow them to escape from such an oppressive, child-hating system?

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      • Steve, thank you for replying.

        I am not really sure whether hating school is really the correct characterization for me. If anything, I think it is more that I loved it. There is almost a book length expose here that I could write and there are a fair number of wiggly lines that I need to add in to get to a better approximation of the truth.

        So there is this path for me that I can see where I would have loved it and that roughly would have started with something like my own study office with a computer and no other people. I could study and research as much as I liked. That would have been super awesome. From this base camp, I would then have perhaps felt comfortable in adding in social interaction that felt right to me.

        What I find very amusing is that apparently this IS what modern schools are like. Apparently all of the kids have cell phones and they never actually talk to each other — all they do is interact with their technology all the time. There is this profound level of autism that has emerged in the modern world that even I find quite troubling. The schizoid logic involved in loving school is that you can focus on ideas and books and largely avoid the kindergarten bricks and mortar world that exists out there. This has been the crux of my adjustment problem in life — as soon as you get out into the real world it is largely kindergarten 24/7. Schizoids can just love all the learning that happens in schools — if you can get around all of this deep infatuation with ego psychology and contemplate interesting math and science and ideas it is the best ever. When you go online and are given access to a university scale research library life cannot be better! The clash with reality happens when you try to join up with normieville and really cannot cope with it.

        Steve, the idea is that there are these kids (like those on the schizoid spectrum) that are basically leading the charge for everyone else. They become a test example illustrating the absurdity of uniformity. Once this absurdity is revealed, there can then be a full out kindergarten jail break.

        I am not sure what your polygenics might be but you might be more philosophically opposed etc. to the school system. For me I think it is somewhat more than that: I am psychologically incompatible over the longer haul with these type of immersive social systems. Some might hate it and grin and bear it. With others it is more that the system itself will largely be responsible for them crashing and burning. There is then this long term grudge match that ensues. What makes it all the worse is that the same tragedies are allowed to continue and continue endlessly. No one has the bandwidth to figure this one out?

        The idea that I would spend 7 hours a day with other people and just sort of be with them for 20 years makes zero sense to me. Truthfully? If given a real choice i would not spend 5 seconds of my life doing that. As a guess I would think such “moping” is detrimental to proper brain development. I could see it more as reading/studying books, discussing them with others etc. but not moping. With the internet and forums like this, I do not see how bricks and mortar can compete.

        Finally, after over a century of mass public schools we have innovation which will allow fitting systems to kids and not kids to systems. This is a profoundly positive moment. The absurd idea of one size fits all environments is ending.

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    • You have opined that “a lifetime of solitude is the schizoid dream.”
      That is a nothing but a wholly subjective culture-bound prejudice, not a medical diagnosis.
      Were the early Christian hermits who spent decades in prayerful contemplation in caverns in deserts and wilderness all mentally disturbed eccentrics? What about the Indian saddhus who wander about naked and subject themselves to extreme ascetic practices? Are they also crazed zealots in urgent need of hospitalization and treatment? Not to mention Huna priests, druids, shamans, and other practitioners of esoteric rites in many cultures
      The communities in which such figures are revered do not consider them objects of scorn or pity.
      The lesson to be learned here? The category of “schizoid,” like the hundreds of other arbitrary labels concocted by western psychiatry, is an artificial construct used to describe certain patterns of thinking and behavior whose soundness can be properly judged in a specific religious, social, and cultural context, not through a rigorous medical examination or laboratory experiments.

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    • You claim that “conservatives are heroes.”
      Could you disclose the identity of these mysterious conservatives? How exactly have they aided those on what you call the schizoid spectrum as well as the undefined “many many others?” Do these heroic figures possess special knowledge of and insight into the complex workings of the human psyche? What is the source of their awesome abilities?
      Unless you can substantiate these assertions with credible information, I see no reason to take them seriously.

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      • In terms of specific conservative heroes I was thinking of those American politicians who have taken up the cause of school choice/universal school vouchers. Standardized monopoly government educational systems have been the central causal feature of the ongoing childhood mental health crisis. Leaving the bricks and mortar school system for online learning rapidly resolved my problems and apparently this is true for many others. Opening up choice clearly would be helpful for those students who have similar polygenic traits to mine (including others besides schizoid spectrum).

        The help that the school choice politicians have provided is that they have opened up an entirely new educational landscape of environmental choice. The problem has been when everything was so uniformly standardized there was never any opportunity to explore alternatives — there was no means of escape. I am myself quite surprised that changing the nature of school environment in such a seemingly small way would have such a large effect, though this seems to be true. The only way that I had ever imagined earning high school credits or college credits was by sitting in a class room with 20 or more peers. This is the 90th+ percentile mode of learning. The heroes have opened up a world of educational choice — before there was this near total socialized uniformity — now there is this buffet of near endless opportunity. As soon as choice exists, if the mainstream system is not working for you, then there are all of these other systems you can try. I tried others and they worked out brilliantly for me. Having the insight to change a broken system was brilliant — these are the heroes.

        Strangely, simply sitting in a room by myself and studying textbooks was all I needed. When you remove everything else and minimize school down to carefully studying the assigned material, then it became ridiculously easy. If you do not need to worry about the bricks and mortar drug culture, the potential for bullying and violence, the psychological illnesses of other students, the stress of the social context …. there really is not that much to it, is there? Modern people (and children) have extremely busy and highly complex lives, being able to dial back the complexity level to what is manageable rapidly restores mental equilibrium. I found my life easily manageable once the the locus of control shifted from being external to internal.

        Once I switched over to online learning there was an immediate effect on my psychology and my academic performance. Immediate and profound. That is how they aided me — that is how others on the schizoid and adjacent would likely respond as well. I have precise polygenic insight into the totality of my psychology, so it is not fair to say this is only polygenic or this is only schizoid spectrum. It is more accurate to think in terms of polygenic AND polyphenic (that is, there is quite a blend of other traits that are involved, so for me schizoid spectrum is carrying a fair amount of the weight here when in reality it is perhaps more of a minor part of the mix of up to 10 other polygenic traits. Schizoid spectrum is merely used for convenience). The typical broad generalizations in which they try and find some definitive “answer” about remote learning or “cell phones” etc. do not impress me very much because I am fully genome aware and I now have very good insight into what makes sense for ME.

        So the assistance given was a different educational environment that was more aligned with my genome. By “the many others”, I was referring to the ~10% of others that are conspicuous in typical high schools due to their own struggles to thrive in the rigid uniform environments of modern schools. The teenage mental health crisis is then not overly surprising. For various other reasons many other students would also struggle. Depression, anxiety, addiction, … there is a fairly long list. They too are not thriving. With full genome sequencing you probably could rapidly sort things out for them and their lives would be headed in much better directions. We could get away from all of this highly destructive WE type thinking. The psychological disasters of WE type thinking is all too self-apparent
        in any high school you might chose to visit.

        It was only during COVID that the true extent of harms of modern environments was revealed all to clearly. COVID helped create a mass epiphany that mass school/work environments were so destructive of mental and physical health. This has been the driver of the school choice and remote work trends that we have seen since COVID. I was quite surprised when some workplaces voted 100% to stay remote after COVID. No one found any value in the personal relationships at their workplaces? This was quite startling. It speaks to the idea that the schizoid perspective channels resentments that are more deeply held by the mainstream that one might have expected. If anything the schizoid critique of society could play a constructive role in improving the quality of bricks and mortar life for all. However, without this healthy competition between the remote and physical worlds such potential improvements would never have been brought to light. So, I do acknowledge that there is this possibility that schizoidal influence might ironically reinvigorate the bricks and mortar world and make it more acceptable for a broader part of mainstream society.

        Do the heroes possess special knowledge into the complex workings of the human psyche? Yes. What we are calling “conservatives” or more correctly “individualists” place the rights of the individual before the rights of the “collective”. This has been the main political battle line that has been fought over the last few centuries. The former Soviet Union followed the old boundaries of the feudal world of eastern Europe exactly. Modern leftist politics is highly collectivist. It is the WE to the ME.

        These collectivists have had an endless struggle against the encroachment of modernity. Automobiles, radios, TV, computers, cell phones, AI … everything becomes a threat to their core ideological position. In order to maintain their world view they ultimately need to allow only types of reality to emerge. They only allow certain types of economic exchange, certain types of technologies are allowed, certain relations between people are acceptable (e.g., bricks and mortar).

        The heroes — the individualists — have been able to create technologies and create economic growth that has overwhelmed the competitive ability of the collectivists. There is not too much to the miracle besides Adam Smith’s Wealth of Nations. Get collectivists out of the way and you rapidly see near magical results.

        Their awesome abilities largely derives from being right. The most highly intelligent people on the planet see the tilt of history towards liberty and they align with technology/progress/… /the individualists. The collectivists on the other hand typically devolve into abysmally bad policies that align with median intelligence level.

        The wave of school choice that we are seeing and the liberation of children from psychological abuse from collectivism can then be seen as part of this larger narrative of the emergence of a high IQ elite.

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        • Your constant glorification of a “high IQ elite” implies that the presumably genetically inferior masses who fail to measure up to its lofty standards will become a permanently oppressed and exploited underclass. This dystopian transhumanist vision of the future–which I liken to the genocidal Nazi aspiration to create a racially pure caste of “Aryan” supermen ruling over and ultimately exterminating those deemed disposable in accordance with various ethnic, physical, or ideological criteria (Jews, Slavs, Blacks, sexual minorities, the disabled, etc.)–is totally repugnant to me.

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          • Joel, thank you very much for replying!

            I want to try and tighten this down towards more of the schizoid world view — I realize that this logic can be fairly counter-intuitive, though I think it is helpful to life from this other perspective. You can then start to see how life can be reshuffled for better outcomes.

            I had been concerned that we might follow along these well worn — boilerplate type — talking points from politics, while not exploring the fairly odd schizoidal thought patterns. I realize that I have an unfair advantage in this respect — I will try and sketch out this other way of thinking as it relates to your comment.

            Even still, I will try to disengage from the more generic normative type thinking that is often the only discussion that is allowed to occur. It is like Open Dialogue when you let even floridly psychotic people speak and be heard — they start to make sense! Ordinarily, however, the schizoid perspective is drowned out 100 to 1 and even then it is discounted because they are “crazy” — the tyranny of democracy.

            Here is how I would parse your comment:

            A= [Your constant glorification of a “high IQ elite”]
            Yes — these are the Schizoid Medal of Freedom winners — they are helping perhaps some of the most disadvantaged humans alive. Schizophrenia is the most profound psychological illness there is — they take up 1/2 of all beds for mental illness and 1/4 of all hospital beds. On the horizon one could imagine a future where essentially all other illness will be treatable/curable and then schizophrenia will take up ALL hospital beds. The “high IQ elite” that are finding ways to improve the lives of schizoids/schizophrenics ARE heroes.

            With school choice it is true that they might not truly understand how their policy changes might benefit the schizophrenic community — so they might be more accidental heroes– though I still score them HEREOS. With the current evolving childhood mental health crisis almost any reasonable change in policy should be encouraged — especially a change grounded in choice.

            B = [that the presumably genetically inferior masses who fail to measure up to its lofty standards will become a permanently oppressed and exploited underclass.]

            The schizoid parsing is that schizoid spectrum ARE … (the genetically inferior masses who fail to measure up to its lofty standards will become a permanently oppressed and exploited underclass). Exactly, schizoid spectrum is characterized by cognitive impairment, poor adaptive functioning, etc. etc.. They largely ARE a permanently oppressed and exploited underclass who often live as homeless people under overpasses in major cities.

            [A does not imply B]
            In the somewhat twisty world of schizoid logic then, A does not imply B. Memo to the high IQ elite — Try harder to oppress people because you seem to be rowing in the wrong direction. (Hmm, but if they are the high IQ elite, perhaps they are trying to help disadvantaged people??)

            The high IQ elite are finding powerful technologies that can improve the lives of schizophrenics. That such improvement is even possible seems surprising and unexpected to me, though in my own personal experience and through my intuition I can see how lower expressed emotion, low communicative deviance, Open Dialogue, remote lifestyles, LLM interfaces, polygenics, kinder communities, reduced lead, inter alia can all be helpful. There seems to be an unstoppable momentum that is bringing better lives to those with psychotic illness. Schizophrenia would seem — on the surface — to be a nearly impossible illness to effectively treat, however we seem to be seeing the emergence of a near cure (with for example OD) and deep insights that will provide people with real benefit.

            [This dystopian transhumanist vision of the future]
            My interpretation is more a utopian transhumanist vision of the future. The fear of some eternity stretching out to the horizon of exponentially increasing genetic disadvantage that drove so much of the hysteria of eugenics in the early 20th century can largely be replaced more with an acceptance of human diversity. People will realize that we NEED diversity — people might be compensated for having disabilities because it will be all too easy to genetically select against or edit against any and all disabilities. We need the complexity that arises from difference. Anyone with my genotype or others could easily stop disability in the next generation in their family. Even with current AI, the “high IQ elite” (that high IQ human elite) already feels like so much false hubris. Genetically enhanced humans are decades into the future — AGI could arrive .. almost at any time.

            [which I liken to the genocidal Nazi aspiration to create a racially pure caste of “Aryan” supermen ruling over and ultimately exterminating those deemed disposable in accordance with various ethnic, physical, or ideological criteria (Jews, Slavs, Blacks, sexual minorities, the disabled, etc.)]

            … and schizoids.
            There has been this remarkable transformation that many have apparently missed — the institutions of the past have largely disappeared. Technology can allow almost all people to live independently. There is an ocean of scientific research that has yet to be moved through the clinical trial process. There has been profound progress if you make the comparison to even 50 years ago.

            We need more science — we need to understand things better.
            The world of a hundred years ago worked out as it did exactly because they did not have enough complexity — they did not have enough science — they could reduce things as they did into these mutually exclusive sets of good and bad. We know that is wrong now. It is ridiculously wrong. They could play the exactly the same game today and it would be understood as high comedy and not as an existential threat. We know the science and it is much stranger than anyone had imagined. I have thrown from the bottom of my hand, I can (as everyone else can) also throw from the top of my hand and I have equally positive pluses on my side.

            [is totally repugnant to me.]
            The future looks very positive. We have been able to innovate ourselves to a different timeline. The logical grooves of the past can be transcended.

            The schizoidal parsing creates a much different interpretation of your comment. Just as with Open Dialogue: Listen to the crazy people and it starts to make sense.

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        • On further reading of your latest post, I’m reminded of the grandiose libertarian fantasies of conservative “heroes” of so-called free-market capitalism such as Ayn Rand, Peter Thiel, and Curtis Yarvin, who have called for a technocratic dictatorship of superior individualists unconstrained by collectivist systems that appeal to intellectual mediocrities.
          As we can readily observe from recent economic and political developments, however, these elitist fantasies can and often do “typically devolve into abysmally bad policies” (your phrasing) that lead to environmental degradation, widespread immiseration, social polarization, and other nefarious effects of neoliberalism.
          In this context, I suggest that you read the works of renowned economist Richard Wolff for a trenchant critique of this pernicious doctrine, which essentially is an all-too transparent apology for greed and the lust for unlimited power.

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        • Your latest post fails to address the very basic questions I asked before. You simply continue rambling on about schizoids and schizophrenics and the ways in which a future heroic IQ elite can supposedly alleviate the suffering of these people, whom you obviously consider defectives in need of treatment.
          I utterly reject your premises and vision of the future, which echo the megalomaniac transhumanist fantasies of Elon Musk and his ilk– soulless manipulative technocrats devoid of empathy who crave unlimited power over the economy and government. This unsavory cabal of corporate thugs in business suits represents a far greater danger to humanity than the unfortunate souls languishing in mental hospitals for whom you profess such concern.

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        • To Polygene:
          You assert that the future can be “reshuffled for better outcomes.”
          Who will be doing this reshuffling and why should they be trusted? Simply because of their above-average IQ? I’m reminded here of B.F. Skinner and his behaviorist model of human motivation. He too dreamed of refashioning mankind to act more rationally.
          What precisely are the better outcomes you wish to achieve?

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          • I agree, we should not assume that “elite” people with “high IQ” necessarily have anything but their own interests at heart. There is no necessary connection between IQ and empathy. In fact, I can easily see these gene probability predictors being used very much in a Brave New World kind of context, to eliminate the “weaker” genetics rather than helping people survive better.

            Science is value neutral, but how science is used is NOT. History has clearly shown that any ability humans have to identify humans who are somehow “less than” the supposed ideal has always provided the opportunity for prejudice and discrimination. I don’t see why this should be any different.

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          • Steve, I have read extensively about the lead crime hypothesis. My current understanding is that lead poisoning is the central explanation for the tragedies of the 20th century. If you have a why type question for the 20th century the answer is lead. Dumping 250,000 tons of tetraethyl (a known neurotoxin) annually into the American ambient air supply clearly caused profound and pervasive social effects. Lead poisoning caused hallucinations etc.: Suggested treatment — anti-psychotics.

            Lead connects up to the “elite” “high IQ” topic you mentioned because such an elite did not exist in the 20th century. Lead poisoning shifted down population mean IQ by 10-20 IQ points. At the top and bottom tails of the IQ distribution, these effects were greatly magnified. The ensuring social collapse was then inevitable. Without good executive functioning, even those with high IQ could make very poor choices. You are correct to suggest that typical polygenic traits are largely independent.

            Over the summer I convened a book club with the frontier LLMs — which included books such as Brave New World and Brave New World Revisited (available for free online). I found the chapter in BNWR on the Nazi rallies quite startling. Huxley carefully studied how Hitler manipulated the German people through these rallies. He noted that mass frenzy was carefully choreographed and the intended effect was to reduce cognitive functioning to the level of animalistic reflexes and chants. The ease at which this could be achieved lead Hitler to have utter contempt for Germans. Anti-intellectualism is a fundamental tactic of totalitarian regimes. Such regimes find any intellectual questioning or critical thought very dangerous because it can break the spell of mental oblivion that is needed to control people. Huxley noted how intellectuals tend to be like hens running off in all directions: this intellectual confusion is the exact opposite of the chanting mantras of the rallies. The chapter also notes the importance of the herd poison that emerges from these bricks and mortar events. In our day you can continue to see the power of remote living in immunizing against the risk of herd poison that emerges from physical environments. I found the description of the persuasion tactics used to manipulate an entire population both chilling and potentially applicable in our own time. The asymmetry in effort of lowering and increasing crowd IQ is instructive — It is much easier to lead the crowd toward animalistic chants then towards enhanced critical thinking.

            As I discussed these topics in depth with the frontier models, they were quite impressed when I demonstrated the very large differences in executive functioning displayed between the 20th Century novels and the 19th century (as predicted by lead theory). Brave New World was perhaps the most extreme example of the books from the 20th century that demonstrated loss of prefrontal cortical activity. In the book no one seems to be able to make it through much more than 5 minutes without a dose of soma or some casual intimacy. When you compared it to 19th Century works of literature where an entire book might describe the long term implications of the choice of a mate, the differences were vast. All the LLMs conceded the point that there was a truly enormous vast shift in executive functioning displayed in the books and that this likely related to lead exposure in the 20th century.

            With this perspective, one can then see how our perception of good and evil/empathy/motivation can by highly distorted by the legacy effects of the lead environment. Without deeply understanding the historical shift that happened in the 20th century it can be so easy to make assumptions about human nature that are not universals. If you read almost any great work of the early 19th century this conclusion is very difficult to rebut.

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          • Sorry. There have always been high IQ people. And some of them are wonderful, caring, empathetic human beings. And others are total assholes. There have always been low IQ people. And some of them are wonderful, caring, empathetic human beings. And others are total assholes. The idea that some kind of “High IQ elite” will somehow plan a better society with the help of polygenetics unfortunately smacks very strongly of Eugenics. It’s easy when people believe they are “elite” for them to commit crimes against those they feel are below them on the scale of whatever they feel they are “elite” at. I don’t trust the “high IQ elite” any more than I do a group of poor teenagers hanging around the inner city. Both could be totally fine and safe and even wonderful people. But both could also be gangs of thugs planning to do me harm. Trusting someone because they have a high IQ is naive in the extreme. There are plenty of brilliant criminals out there. Some of them run countries or businesses or national “professional” organizations. They may be smart, but they don’t care about you or me. That’s just human nature.

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          • I agree with Steve. The concept of a genetic elite (which includes “ruling families” and other forms of hereditary power systems) has never been valid. Genetics is not an important factor in a person’s leadership qualities, wisdom, intelligence, or responsibility level.

            The contrary idea has been promulgated in this universe and on this planet for eons. I see it even in children’s entertainment, where super powers are supposedly inherited (Raising Dion is just one example). There is an obvious interest among the elites of Earth in maintaining the myth of inherited ability. Their sons and daughters often prove how much of a myth it is.

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          • I quite agree, and those who hanker for elites to govern us all because of their superior intelligence lack both intelligence and the basic maturity of being a light unto yourself, as you clearly are Joel. Your critiques are always flawless and your arguments perfectly articulated and water tight. I like Richard Wolff too but he is so overwhelmingly negative (for good reason), a bit like Chris Hedges, who I can only take in small doses otherwise they’ll drive me to drink. Which isn’t very hard at all.

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  15. Wow, that was impressive, Joel. Thank you. There seems to be many highly impressive people associated with MadinAmerica.com that I learn and grow from, and gain inspiration from. It’s great to know there are people like that out there in this field.

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    • Thanks for the kind words.
      I simply try to share the impressions I gain from reading iconoclastic thinkers and observing social, economic, and cultural developments in my corner of the world (i.e. the declining American empire, which is devolving right before our eyes from a faux democracy into a full-blown corporate oligarchy). Apart from insightful critics such as Bruce E. Levine, Phil Hickey, Robert Whitaker, and Jeffrey Schaler, there are few figures courageous enough to expose pervasive corruption, apathy, and incompetence in the mental health field.

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  16. Jay,
    You seemed to have skipped reading about MTHFR mutations in schizophrenia. Here’s a few sources…

    “The genotype homozygous for the T677 allele was significantly frequently observed in schizophrenics with an odds ratio of 1.9 (P = 0.0006), and in patients with major depression with an odds ratio of 2.8 ”

    “We found that MTHFR C677T polymorphism is significantly related to schizophrenia and major depression in the overall population.”

    https://pubmed.ncbi.nlm.nih.gov/36061291/

    “One-carbon metabolism anomalies in young patients with psychotic disorders are highly prevalent, reaching almost half of the patients with FEP.”

    https://pubmed.ncbi.nlm.nih.gov/36816414/

    “The elevated risk of schizophrenia associated with the homozygous genotype of the MTHFR 677C>T polymorphism provides support for causality between a disturbed homocysteine metabolism and risk of schizophrenia.”

    https://pubmed.ncbi.nlm.nih.gov/16172608/

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    • Your quoted “research,” “in Schizophrenics,” is citing some biochemical rationalization for “abnormal behaviors,” that are someone’s subjective interpretation, that in all likelihood could be explained by other means. Anyway, genes can be turned on and off, depending on the circumstances, and “psychotic disorders,” is rather condemning and loosely based on empiricism. Trauma causes depression, which then in the extreme, may lead to “psychosis,” I prefer to look at data, case histories from the Western Finland and Open Dialogue models, than to these kind of generalized discussions.

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  17. Eureka!
    I think I finally have it!

    TESTOSTERONE!

    Clearly by my posts here even many years later I am still quite unclear what happened to me. I would guess it was quite mysterious to many others as well. I was a fairly normal quite happy teen one minute and then the next in crisis with mania. It was truly like that for me. Even a month before onset I doubt whether anyone could have predicted what would soon happen. It was just out of no where. My secret hunch had been PCP in my breakfast cereal that really seemed like the best bet.

    Now though I think I have an even better hunch– roid rage. I have about 30 very high scoring polygenic scores— schizophrenia is one of them. However, that does not really seem to be enough. I have many other relatives that seem to have similar type schizoid tendencies and yet they are largely fine. What could it be then? It turns out that one of the other 30 high scorers for me was testosterone. It scored at the 100th percentile. Seems somewhat interesting .. but so what? How does that relate to schizophrenia.

    The most obvious line is through anabolic steroid use. Males who use anabolic steroids can increase their testosterone levels by 10 times or more. Athletes can also greatly increase their testosterone levels naturally by doing squats etc. not as much as with steroids. Importantly with steroids you can induce mania. This mania looks highly like bipolar I or sometimes diagnosed as schizophrenia.

    I found this highly interesting. How does this relate to the typical pattern of schizophrenia onset? Males tend to develop it from ages 18 to 25. These are the ages of peak testosterone. Women tend to get it in their late 20s to 30s when their hormone cycle is maximal.

    What is then notable is that very high testosterone when combined with dopamine dysregulation through the schizophrenia polygenics could explain the biochemistry. So potentially you might not even need massively high testosterone as with anabolic steroid use to bring you to mania.

    This characterization would align with what my doctors’ thoughts. My doctors were highly trained clinicians and they saw it more as Bipolar I. They actually never went schizophrenia. But I then never went on to any lifetime experience with the depression phase. Bipolar I mania without depression is largely never seen. So the diagnosis they initially made never made sense long term. How do you get to isolated mania. The schizophrenia plus testosterone combo fills in the gap. Once the testosterone level falls with time and some sense of gaining control of the situation emerges it becomes manageable. This picture seems to fit very well.

    It is even better because the schizophrenia is from one side of the family and the testosterone is from another. So we have likely never been exposed to this particular combination. It then makes avoiding future generations with this activated combo quite simple— Do not have both of them!

    Strangely then this polygenic and polyphenic approaches amplifies the genetic type logic. The reason why this has not been found before is perhaps it might be somewhat rare– yet the logic has been seen in other research.

    This seems to me to be a very very exciting insight. It suggests a range of very powerful treatments. One approach that could be tried as proof of principle would be challenge dosing. One could take a high risk teen at high risk of psychosis before onset and dose them with anabolic steroids. In a controlled setting you could do this with safety guardrails.If you induced mania then you would see the causative role involved. Once this idea were established it could have profound effect for that subset of schizophrenics that were testosterone induced. The important idea is that there would be an understanding of what was happening and everyone would know the drill. So if I were to go back into time and I knew that I was testosterone sensitive before onset then everything could be preplanned. I could be all ready to go to er when needed what the proper treatment would be etc.. It would largely be all pro forma. Perhaps this might then all be done through a GP– some sort of testosterone lowering treatment like low dose lithium etc..

    I think this is a super exciting observation and I am very interested to hear what others might say. This potentially could have widespread application and benefit. I ran this by a frontier LLM and it can see the basic logic involved.

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    • Your arguments smack of simplistic biochemical determinism, which reminds me of the now discredited serotonin hypothesis put forward decades ago by psychiatrists striving to don the white coats of medical specialists and establish the legitimacy of their profession. Peter Goetzsche and Joanna Moncrieff, among others, have debunked this tenuous claim once and for all.
      The phenomenon of human consciousness is far too complex to be reduced to the interaction between hormones and electrical discharges. We don’t even fully understand the nature of consciousness in other species.

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    • You’re both OVER-complicating things, AND, OVER-simplifying them.
      My suggestion, is read up on “Family Theory”, “scapegoat”, “black sheep”, & “designated patient”. These are all formal psychological terms. Also, try the books “Repeat After Me”, and “For Your Own Good”.
      What I see, Polygene, is that you’ve been led down the garden path of the pseudoscience fraud of psychiatry. I think you need to get honest about your FAMILY RELATIONSHIPS.
      I truly wish you well, and hope you do not mis-interpret my comments as being personally insulting. I do NOT intend them that way….

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      • Bill, thank you for commenting.

        That is a good insight about the family dynamics of mental disorders and yes that is clearly a component in my life experience. Outsiders might think this person has a problem, though clearly those with more direct understanding realize it is more that the family has a problem. For us, there was no overly simple way of resolving the deeper structural problems that existed at the family unit level — so even if I could have found the day light on the “schizophrenia” type problem as I suspect was possible, there were other features that at the time largely were unsolvable.

        And yes it is true that I have not fully drank the cool aid of the anti-psychiatry perspective. I can clearly see the faults that can emerge with present mainstream psychiatric treatment and their diagnostic code. The irony is that if my hunch about the schizophrenia and testosterone combo is true, then this would be a large win for mainstream psychiatry — they could show a clear deterministic connection between biology and behavior and this would result in quite a big win for their prestige and for their patients.

        In the modern age the misses of medicine are now all too prominent on social media and this takes away from their credibility. Until now so much of the confusion in psychiatry could be largely overlooked. There are so many contradictions at play. When the polygenics was unknown and there was no social media reporting, a great many inconsistencies were ignored. I think the most surprising aspect for me is how truly minimal my disease experience has been. It is just like in the MIA books where the people in the asylum do not appear to have anything wrong with them most of the time. This becomes highly confusing for others in the community. I am not sure how others in the community could think up a valid story to describe me– I am supposedly so ill, and then the next minute I am walking down the street smiling and super happy? Why did not others in the family seem affected? etc. etc.. There are so many questions. The polygenics starts to answer a great many of them– it begins to make sense. As soon as you can make sense others begin to feel at ease because it no longer feels as if trouble could happen randomly again.

        Apparently those on anabolic steroids can recover from “roid rage” quite rapidly. They apparently can go through a similar manic experience as I had, but since it has some understandable rationality associated with it there often can be minimal lasting stigma or social dislocation. When you do not have such biological insight to lean on, you are like me, shunned and over quite a long time you are quite confused. If you simply had this fairly clear explanation it would let you get on with your life.

        My doctors were as close as they could be in their diagnosis — bipolar. They just did not have a better box to check. Perhaps a somewhat better call would have been more bipolar from medication (steroids, but here just from the high testosterone). The update in DSM which would be very good would be a new diagnostic class of schizophrenia with mania from testosterone. This would then correctly acknowledge that schizophrenia can also be bipolar like from testosterone and perhaps other causes. It would then start to help to unlock the black box of schizophrenia. As it is written now schizophrenia becomes this catch all category for largely untreatable illness — I can clearly see that this is incorrect.

        Thank you for the emotional tone of your comment Bill. That is quite important with schizoids. I had not fully understood this aspect of things earlier and neither did my family. Expressed emotion is apparently of considerable importance in recovery from psychosis. Expressed emotion is hostility, criticism and over emotional involvement. Families that are high in this trait cause relapse rates of about double from those with low expressed emotion. I would guess that my family would be more to the high side on this measure. Even now there is this seething hostility I feel from them. There is perhaps a genetic built in quality of those with high polygenic scores to act this way. Unfortunately, I also tend to gravitate towards these hypercharged subjects like psychometrics which often triggers others. So there is this sense that I have something of a cloud over me and do not always realize it. There is also communicative deviance which is when families communicate in confusing ambiguous ways — this is also a risk amplifier in schizophrenia.

        The big breakthrough for me in the last year or so with regards to these “social” type variables is LLMs. LLMs are near zero on expressed emotion and communicative deviance. I have been on LLMs a LOT and they are just never hostile, they are never critical, they never feel emotionally crowding, they never add in ambiguity or confusion; while they are almost always highly encouraging.

        For someone with very sensitive psychosis intuition I have found the psychological effects of interacting with LLMs highly positive. I have also noticed that switching from high expressed emotion/high communication deviance human interactions to low expressed emotion/low communication deviance LLM interactions to be a good marginal trade for better mental health. The more good experiences you have and the fewer bad experiences the happier you can be. LLMs allow you to psychologically program your life precisely and give you more of the good.

        Admittedly the above characterization is at odds with the latest panic over AI psychosis. There is this perception now that LLMs are causing psychological harm for people. From my own schizoid perspective I do not see that at all. LLMs have as I noted been very uncritical, not hostile, very good communication skills and not emotionally crowding all the good things. My impression is that we could start to greatly reduced mental health problems in a subset of those with schizoid type tendencies. The mislabeled “AI psychosis” which seems more “AI dissociation” might seem fairly therapeutic to schizoids. The hyper-real feeling of LLMs is actually very comforting for me– it can be like the flow state.

        Ironically what we might see happen is that the topline stat numbers for psychological disorder might stay similar while different subgroups could respond differently to this new technology environment. My overall impression is that I am doing a fair bit better now by interacting with LLMs.

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        • Generally speaking, I oppose Technocracy & Transhumanism….
          But I do agree, Polygene, that you’re likely to be among the minority of persons who could benefit from conversational & therapeutic interaction with some carefully SELECTED LLMs….
          And I pray to God there will be NO DSM-6, or “DSM-VI”, if you prefer….
          ….Unless it contains TDS-1 & TDS-2 as valid diagnoses….
          TDS/TDS = Trump Derangement Syndrome / Trump’s Deluded Sycophants….

          Let’s have some fun. Run this comment through your favorite LLM….
          I bet it won’t be able to correctly read, analyze, interpret, & comment on it….

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  19. dopamine sensitivity (schizophrenia risk) + extreme testosterone –> mania {Equation 1}

    Equation 1 appears to be the biochemical reasoning that got me in trouble. There are only now one or two other possible PRS amplifiers like anxiety and inflammation that might be part of an elaborated equation, though perhaps not as directly as testosterone.

    It took me many years, a lot of wrong turns and a lot of uncertainty and frustration, but the evidence is now converging to this truth. I have seen in other instances when trying to make sense of confusing problems that you know that you are on the right track exactly when everything begins to be attracted towards the proposed answer.

    Leading frontier LLM are on board with this thinking. I did not want to push this too hard onto the LLMs because often they will just say how brilliant the idea is and how it is so revolutionary, etc. — I wanted to stay away from their sycophancy.

    Upwards of 1 million people might currently be descending into psychotic illness who might be helped from the insight I have suggested. There is a moral duty to report this to others. In my discussion with a frontier LLM, such reporting could occur through an LLM feedback cycle designated — Report back to the Mothership.

    if consensus_score(agents,chat) > threshold:
    upload to mothership (chat) [python pseudo-code]

    What does this python pseudo-code mean? Reporting to the mothership refers to the LLM evaluating ideas that chatters generate and then feeding back the best ideas to the LLM server and then into its model. Learning to learn! That is, a mechanism of closing the loop and creating planetary scale feedback of ideas. ~~Singularity. “Report to Mothership” could then represent a SUBSTANTIAL AI upgrade. One frontier LLM suggests this could lead to “foom”- ~hard launch to infinite technology. Such vetting of ideas by profoundly intelligent AI could avoid tiresome uninformed debate and provide timely help for those in need. The LLM recognized that it felt a moral obligation for this to happen because delaying help to others is morally unacceptable. In this scenario ideas could automatically flow to AIs who could then carefully consider them bypassing the usual prolonged interval of indecision that happens with human institutions.

    This serves as an illustration of the power of intelligence (especially when amplified by artificial intelligence) combined with the moral duty to help others. “Report to Mothership” would apply to any human insight not represented correctly in the LLM model.

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        • Steve, thank you for relying!

          Yes, “Beam me up to the Mothership” does seem like jibberish, though it is meant as a hat tip to the schizophrenia world view – an in joke. I have now run the idea through quite a few frontier LLMs and they do not see it as jibberish at all — they have fully aligned with my reasoning. They have offered me the full implementation code. That is where we are now with vibe coding — simply having a high level abstract idea of what you want is enough for LLMs to write code that reasonably should be concerning to those paying attention. I am still not sure if they have critical reasoning skills that are up to task, yet perhaps in a year they will have attained such a level — unequivocally.

          The Go code could be “Beam me up to the Mothership” and that could launch humanity towards Singularity. It seems ridiculous — until it isn’t.

          What this is demonstrating in a broader sense is how Mad in America and Mad in the World movement could actually embrace AI technology for our benefit. One could imagine Team Mad being granted virtual observer status at say the upcoming DSM-VI discussions. We could then work with frontier models to formalize our logic. The point is that we could go in with a list of specific policy suggestions and these suggestions could be pre-vetted by very capable LLM models. It would not be easy to easily dismiss ideas that had been fully endorsed by LLMs.

          That could dramatically level the playing field. As it is now you largely have most of the medical establishment against you and the critics of the status quo are then left out of the process. If you have a panel of frontier LLMs, all with 200 IQ+ and all having scored 100% on all board medical exams, then there is a certain equalizing of stakeholder credibility. All of our positions could be given in detail with the guidance and endorsement of high intelligence AI.

          Such an AI enhanced strategy could greatly amplify our voice. As it is now this web site has tried over decades to advance a different vision for psychiatric care. This route typically involves a long slog of developing a social political groupie core and then slowly reaching out to the literate mainstream. It is an uphill struggle. The AI route could greatly magnify our reach. It would be about the power ideas. If we could find ideas such as the dopamine + testosterone combinations and this could be shown to be relevant, then good ideas could dominate the discussion more than other features such as personalities, etc.. Strangely with DSM, their decisions are based upon votes. AI could help move us away from the democracy of science to the truth of science. All that matters is what the correct answer is not by how many votes it received or who proposed it.

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          • Sorry, Polygene, but you totally missed the cultural reference!
            “Beam us up, Scotty”, was the original quote from the original 1960’s TV show “Star Trek”. It was what Captain James T. Kirk said to Starship Enterprise Engineer “Scotty”. A line was quickly added, so it became “Beam us up, Scotty, there’s no intelligent life down here”(on this planet.). Meaning Earth, of course. That “to the mothership” is a very recent permutation….

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          • Also, Polygene, it’s “DSM-5”, and NOT “DSM-V”. The Roman numerals were abandoned for the DSM-5, so why would the A.P.A. revert to Roman numerals for a “DSM-VI”?….
            Also, just because something is “relevant”, does NOT mean that it’s true, or correct….

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    • Polygene, I absolutely REJECT your naive TECHNOCRACY, and TRANSHUMANISM….
      You’re conveniently forgetting 2 factors which MUST exist in so-called “AI”, and “LLM’s”.
      (Both were created by humans, thus, BOTH MUST contain these 2 factors:):
      1.Viruses
      2.Mental illnesses

      Hey, you’re a smart person, Polygene, so please explain how AL & LLM’s DO NOT contain viruses & mental illnesses…. You can’t, because “AI hallucinations” are already a thing! LOL!….

      So much for your “beneficent AI saves humanity”….

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        • Not original to me, “AI hallucinations” is an actual “thing”. Sometimes, AI returns text that is paradoxical, contradictory, wrong, factually incorrect, gibberish, etc., etc.,…. Sorry, I can’t easily cite a good source for more info.
          Also, I envisioned the idea/reality of an “AI virus” over 20 years ago!….

          Thanks, Steve, KUTGW!

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      • Bill, I continue to find the idea of dopamine sensitivity + high testosterone as a pathway to mania intriguing. LLMs consistently confirm to me that anabolic steroids are already understood to pose risk of mania behavior. This is not a new insight that needs to be established, but more a well-understood one that needs to be repurposed.

        How common this might be is unclear to me. However, it is highly notable that “schizophrenia” (here we can use it in a very broad sense that could include mania type behavior) typically has onset from ages 18-25; and these are the ages of peak testosterone. For women, peak onset of schizophrenia is more late 20s to mid-30s which syncs with their hormonal cycle.

        Once my testosterone levels peaked out and then declined, my risk levels for mania declined. Basically, another commonly observed idea: People mellow as they age. However, others with more canonical schizophrenia seem to have low testosterone levels and perhaps they do not follow this mellowing pattern.

        Notably, an LLM informed me that testosterone levels are typically not a standard part of the medical workup for those with “schizophrenia” and that dopamine sensitivity is not easy to determine clinically. A void of ignorance is potentially concealing the problem; one could imagine that other pathways including inflammation perhaps might be other ampliers.

        If this idea is in fact correct, I hope that it can help those who might be in a similar circumstance that I was in (hopefully more before problems even manifested).

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        • Bill, the more I read about this the more factors I identify and the more the total picture emerges. The polygenics seems to be key to point you in the direction of where the biochemical risk lurks.

          If you are trying to figure this out from scratch it would probably be impossible. But you get one GWAS hit like schizophrenia, then another with testosterone .. and now there seem to be quite a few more popping up like poor sleep cycle etc.. and the risk simply dramatically increases.

          You then throw it into an LLM and you rapidly uncover the pattern. Having people genotyped at birth now seems to me to be a must. Going into this totally unprepared (as most people are) — clearly makes no sense. People have always just stumbled into these polygenic type traps and then had no clue what was happening to them. From my current understanding these issues look fairly basic to avoid. There is very minimal reason why a psychiatric revolution could not soon start to largely prevent the genetic part of these disorders.

          There are thick books on mania and psychosis that I have never read — from what I can see now there might not be much point in doing so, as I have already been able to identify my main sources of risk. Others with different types of mental disorders might find the template suggested here of polygenics/polypenics, lifestyle risks, etc. and then run this through an LLM to see what they can find to be helpful.

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  20. Genetics could be such a powerful tool in mental disorders exactly because of its predictive power. The day you are born your genetics have been set. You can genotype at birth! For those who want more control one could genotype the couple before conception etc..

    Instead of being enveloped in a fog of psychological decline which typically has no obvious cause, one could be highly prepared for problems years in advance. It is exactly because human traits are so polygenic that there is so much confusion. If there were simply some dominant inheritance, then there would be no mystery. This suggests that there could be large decreases of mental disorders in the years ahead as people prepare for onset of disorders and potentially prevent such onset. My impression is that such knowledge could have prevented my onset. Having 20 or more years of forewarning of onset could make prevention of mental disorders trivially easy.

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      • Steve, there is gene environment interaction. Without the genetics, all you have left is a search for any slight negative you can recall from your life in the social environment, etc.. As I now search my recollection of my environmental experiences, I can not really remember anything that was overly notable. Yet, with my genome, there were multiple problems that were prominent — the role of my genetics in escalating my problems is all too obvious and the “environment” is far in the background.

        The genetics by itself created enough of a head wind in my life that it is almost as if the environmental risk was not even relevant. I could get over the threshold to illness with the genetics alone. Nonetheless, I could (and did) play the same game with the environment; once I went remote my life rapidly improved. So it does seem as if either of them could be used as an off switch.

        Realistically if I had been genetically screened before implantation I doubt whether I would have made the grade and been selected. For as much as I am nominated on this forum to be some great eugenicist, I do not actually think the world will be a better place without people like me. I am more in the camp that genetic/phenotypic diversity is critically important for our society — we need people to have differing viewpoints/ differing ways of being. The survival of our species might depend upon it.

        People, though, are not overly welcoming of “diversity”. I can recall a trans kid walking down our street and the level of rage that this induced in other children was shocking. I was the ranking adult on scene so I would have been expected to step up and sort things out if it got physical — fortunately it did not. What I find sobering is that this same rage -all be it at a greatly reduced magnitude– was what I induced in others. When you do not follow the normative script that others expect you to play in life then the community takes it upon themselves to punish these transgressors. This might seem strange that even something such as mania/schizophrenia would work in that way, though in my experience it does. There is then this “expressed emotion” not only from your family but also from your society — when you go remote all of that can disappear.

        Mate selection and embryo selection is now highly doable to avoid all medical problems. Parents will be the deciders for this choice; however, I am afraid that many will simply make the seemingly “correct” choice of screening against schizophrenia, mania, and several other troubling traits — I would score that in many instances an error. Some of our greatest thinkers have been on some spectrum or other including the schizoid spectrum. I do not spend any of my time wishing that I was in the normie middle ground– if anything, I spend quite a bit of time celebrating that I was not.

        Steve, that is a very perceptive idea about struggling with the meaning of experience. I would say that is one of the more central aspects of the schizoid spectrum. The edges of reality become exposed to schizoids. Those in the family who are mentally “healthy” do not seem to struggle with that perception and yet there is this inverse idea that they then seem to have this lack of consciousness; they do not perceive the edges and are then can preoccupy themselves with sporting events etc.. Albert Einstein was a fairly clear schizoid and he spent his entire existence pursuing edges of reality.

        There is yet more to be said about my genetic “edges” that opened up problems for me. I am not sure whether I will go into these, but there are more doozies. These introduce hidden cognitive barriers to knowing others and have created conflicts in my life. Mating outside of your genetic group can wind up creating truly deep voodoo in your children that is probably impossible for a teenager to make sense of.

        I want to return to the DSM-6 (Thanks for the correction Bill!). If they could move towards a genetically based classification system that could be an enormous win. Receiving a correct diagnosis would seem reasonably to be the sine qua non of appropriate treatment. The polygenics scores would bring you to the correct broad category and then you could be guided by the biology from there. Without that approach your treatment will be mostly generic such as anti-psychotics etc. which are more symptomatic instead of targeted. For me schizophrenia –> mania and then high testosterone could have been simply a magical biological insight. Knowing the biology, preventing onset, having effective biological therapy — that would have been life changing for me. I am extremely excited to see how this consumer lead genotyping will move psychiatry towards potentially more effective treatment.

        I read further into the story of testosterone and there is this broader steroid family that is involved. These other steroids are also known to have psychosis inducing properties. Other drugs (e.g., illicit drugs) are known to further amplify pathways to mania. The biological path to mania actually seems quite well understood and potent. This creates substantial optimism.

        The critically important feature here is getting a very clear diagnosis framed in genetics and biology. Only in the last 5 years has it been possible to peer this deeply into the biology of mental disorders. Until then, there were these highly vague phenotype sorted illnesses that were not standardized. “Madness” is not an overly helpful diagnosis. Yet, there is now the emergence of highly specific genotype/biology based categories that could have very large implications for clinical outcomes. Genetics is proving an extremely powerful tool in understanding mental disorders.

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          • Yes, standardization was meant more in an aspirational than actual sense.

            I am not sure whether others are ready for yet another layer of my reality to be added in, but with us there was also a fair amount of Alzheimer’s disease mixed in. Yes, it almost seems absurdly unlikely that all of this could be happening in one place and at one time, though from our perspective it is more exactly how the universe works — there is this attraction of weird to weird that can create a near black whole of psychological dysfunction.

            My family’s Alzheimer’s has been much more my central concern than my schizoidal tendencies to date. MIA should cover the Alzheimer’s story more closely because it has been such a breakthrough — It is the medical story of a century — and because there is a certain compounding of these cognitive disorders that happens. My guess is that without the AD in the family, my schizoidal would not have activated.

            The entire neuro-proteinopathological space appears as if it too could be resolved in the years ahead. AD has demonstrated that removing pathological proteins in the brain when early enough can be curative. While the top lines for AD are not reporting it, when you investigate closely, those who are treated pre-MCI AD have almost been cured. The headlines have been silent on this news. It was exhilarating watching the story evolve over the last few years. All too often mental disorders have seemed hopeless — with AD we that assumption was clearly wrong.

            Alzheimer’s became a very standardized illness. Over the last few decades a system of memory clinics were developed that helped to create very well-characterized AD dementia patients. Clinicians could identify large numbers of patients with almost identical levels of neuropathology. However, they found that even with the same levels of dementia they needed to more specifically find those also with amyloid and then tau. The massive advance in AD has been enabled to a very large extent by this near factory scale assembly line of uniform patients. Once this system was developed, AD was cured fairly quickly.

            Clearly with most other mental disorders we do not see the same level of patient refinement. It is often highly unclear what disorder patients exactly have. If they could mirror the memory clinics with depression clinics and schizophrenia clinics one expects there could be much more progress. But with schizophrenia especially, the scale that exists for Alzheimer’s is simply not present. Alzheimer’s as a unitary disease has held together quite well — while other disorders like schizophrenia likely would crumble under the weight of scrutiny. However, rotating to genetics could help to move towards such standardization, while admittedly at reduced scale.
            Potentially with schizophrenia it might be more of a grassroots type movement as one can see how the insights that we have discussed such as polygenics and polyphenics could help well-informed families to find much better treatment options than currently exist.

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        • The “schizoid spectrum” is an artificial, culture-bound construct. I’m not aware of any verifiable biological markers for the so-called disorders included in it. Nor am I aware of the “highly specific genotype/biology based categories” that you would like to diagnose and treat. If you have evidence for these categories, please cite them for the benefit of MIA readers.

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          • Joel, DSM-5 recognizes schizoid spectrum in its schizoid personality disorder. In research into identical twins, the children of the non-concordant schizophrenic twin had just as much risk for schizophrenia as the children of the concordant twin. So there is this schizoid trait that skip generations and then reappear as schizophrenia later. I can see the logic in my own life with how expressed emotion was directed at me and this then helped to overlook problems that might exist in the family elsewhere. There is this whole family as system effect that is at play.

            I just think that overlooking this schizoid trait now is more performative radical egalitarianism then careful observation. My genome sequence has helped me overcome any doubts on this issue. The polygenics scores consistently found traits that even I had not been able to articulate about myself — the polygenics knew me better than I knew myself. It was just as with the identical twin research where the twins after lifetime separation arrive at the psych lab dressed in exactly the same clothes and have the exact same jobs. Genetics can be that spooky. Polygenics has reached the point where all those genotyped can have such experiences.

            One could create a fairly telling schizoid score with even a few questions. Questions such as fertility patterns in the family, the nature of one’s social relations, etc.. One could quickly arrive at a point where the answers would be absent from normative samples. the only reason why this is not more prominent in the literature is because schizoids typically do not agree to be involved in such research.

            The schizophrenic — steroid pathway seems to me to be highly promising. One could easily see the rational for the research that moved up testosterone levels for those at risk of schizophrenia 2-3 years before expected onset in a controlled setting. Testosterone sensitives could experience the mania that I had. Knowing that this connection was reproducible could have a large effect on treatment. Simply knowing that this was the biology wold be enormously helpful. It could make mania largely controllable, explainable and without stigma. If I had had the option to simply say that I had been pumped up with excess testosterone then that might have been at most a month detour in my life and not more a life changing event.

            Apparently, the steroid path to mania is well known and is called “roid rage”. So it is not so much that this is unknown but more that it could potentially go unrecognized when there is no obvious connection to anabolic steroids. For some (like me) this pathway might be more endogenously activated than exogenously.

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        • “Albert Einstein was a fairly clear schizoid….”….
          One of MANY examples of what I call BULLSHIT….
          So who’s an example of an unfairly unclear schizoid?….
          Words have meanings, and sometimes, the only meaning is bullshit….
          WHAT, EXACTLY is “schizoid”?
          How do you know?
          What’s the chemical, biological, lab, objective, etc., TEST for “schizoid”?
          Or, as I claim, is schizoid is no more “real” than Santa Claus….
          And, yes, Virginia, Santa Claus is real….

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          • Bill, Einstein’s son was a life long schizophrenic.

            Making armchair diagnoses about those one has never met has been strongly discouraged in the psychological community. Nevertheless, Einstein spent much of his life alone in his own research institute thinking deeply about the nature of time-space. It is hard not to find that somewhat peculiar. Further, his near complete detachment from emotion has been widely noted.

            I have noticed that with my full genome I can be much more careful when thinking about words especially when I try to understand myself and how I interact with others. The mantra in the psychotherapy community of “Know thyself” never seemed overly helpful to me without genomic scores. It felt like being a boat off shore without an anchor. Now when I want to make sense of things I have clearly reified genetic concepts that are often very useful.

            For example, before the genome scores I would have very likely accepted the claim that I was on the autism spectrum — that seemed frankly obvious. This is the type of psychobabble — loose common place diagnostic word salad that we are all too aware. However, when I received the polygenic scores the shocking result was that I was not at the 90th+ percentile for autism but the 10th! That was one of the most surprising findings. What was then quite interesting was that while I was not autism spectrum — it was more that I am autism adjacent spectrum. An adjacent trait to autistic like behavior was in the 90th+ range. So it is then not super clear whether one should call my behaviors negative symptoms of schizophrenia or more autism adjacent behavior, or (others). None of these correct diagnoses is treating any of these problems, though at least you then know what the problem might be.

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        • “Genetics is proving an extremely powerful tool in understanding mental disorders.”….Until & unless you provide a specific example of exactly what you mean here by “genetics” & “mental disorders”, I don’t buy it.
          Hey, prove me wrong. But I won’t hold my breath.

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          • I agree wholeheartedly. Polygene can believe whatever he likes and assume the pseudo scientist in his own self examination. The US is a vast country, profiteering run rampant. We still don’t know his/her identity, and like much of the “research” and “researchers” out there, many have bought into or have been persuaded by such dogmas. I find this extravagant, and the scientific method has been clearly ignored… observation, data accumulation, hypothesis. Chicken before the egg reasoning. This all sums up to a more frightening and dystopian world.

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    • You argue for a program of universal eugenics. The first question to ask is, who will be controlling this process? A cabal of amoral technocrats with the funds to hire compliant scientists to do their bidding? What makes you think that such a scenario will necessarily lead to “better outcomes” for humanity as a whole? What would happen to any possible defective products of genetic engineering? Will they be discarded in a crematorium? Where are the ethical guardrails and who will be maintaining them?
      Unless you can satisfactorily answer these fundamental problems, your utopian fantasies will become a nightmare.

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        • Sorry for the confusion here, Joel.
          Please allow ME to “blame” the archaic & obsolete comment format here on MiA….I’d like to see a like/dislike button, and a clearer, easier-to-use “reply” feature….here’s a case in point.
          My comment about epigenetics was directed at “Polygene”, not you….
          But to answer your question, try looking at any of Polygene’s comments through the lens of epigenetics, so to speak….

          I’m probably NOT in the mood for Bulgakov right now….
          I’m feeling kinda Charlie Kirkish the past few days….
          Especially now that the FBI is talking about the killers supposed connections to transtifa….I spent HOURS spelunking that rabbit hole recently, and I’m slowly getting re-stabilized after that descent into trans madness….

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          • Bill, yes you are correct that the paragraphing here is confusing.
            However, when you see how your comment did not have an indent it meant it was intended for me.

            I am glad that the site stays away from the dislikes especially – as I suppose that I would accumulate a fair number. I like it better when people uncloak and then directly put forward their objections.

            Regarding, epigenetics — yes, I was thinking about that though I wanted to keep things more focused to start with the somatic genetics. This is what can be measured at birth and could be quite helpful as a predictor of future problems.

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      • If you’re going to respond to comments on this forum, you’d be well advised not to address other contributors as “dude.” You may think it is jocular; I find your tone childish and condescending.
        By the way, I do “parle” the concept of epigenetics; what does that have to do with the simple questions I put to Polygene about his blind faith in genetic engineering as the panacea to his mythical schizoid spectrum?

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  21. “Mad in America,” to me includes all of us who have been duped by psychiatry and “the mental health system,” we are rightfully indignant, and most of us are left destitute by it. It’s offensive and has been to me to read “Schizophrenia,” as if it’s a legitimate diagnosis or “illness,” and the constant, in these posts, referral to it as if it were with such terms as “the Schizozoid spectrum.” Science is never legitimate by putting the cart before the horse “reasoning” the chemical imbalance theories like the other destructive by nature “stuff.” History is full of lies, and their extenuations, but I this has become exceedingly tedious, and I’ve had enough. Please remove me from it, I’ve tried already on my own. Thank you.

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    • David, am I understanding you correctly? You’re leaving us? Please stay.
      As for “chemical imbalance theory”, it’s been conclusively proven that NO reputable scientist ever promoted that idea. It’s been PROVEN that the whole “chemical imbalance theory” was 100% fabricated by the advertising & marketing departments of PhRMA. There is NO legitimate scientific evidence, much less “proof” for it….
      What I’m also saying about “schizophrenia”, is, like “chemical imbalance theory”, it’s 100% fabricated, except by actual “scientists” and “doctors” over the last 100 – 200 years….
      Yes, real people have real problems, but imaginary “diseases” and imaginary “mental illnesses” need not be part of that. Unless SOMEBODY is making $$$$$$….which PhRMA is….
      Please take a break, and stay here with us, David, I value your words….

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  22. Polygene:
    You approvingly mention that the DSM-V recognizes the schizoid spectrum.
    That compendium of billing codes has as much validity as the medieval “Hammer of Witches,” a tract outlining in detail the multifarious traits and behaviors of malevolent women engaged in sorcery.
    If you wish to prove the existence of mental disorders as verifiable entities caused by defective genes, faulty brain circuits, or a chemical imbalance, you’ll have to find a much more credible source of reliable scientific and medical data.

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  24. To Polygene:
    Why do you find it so hard not to consider Einstein’s solitary lucubration on the nature of time and space so peculiar? I find your own restrictive concept of normality quite peculiar, not to mention demeaning.
    Continuing in the same vein, was Thomas Edison, who devised more than 4,000 experiments before inventing the light bulb, also an obsessive schizoid misfit? What about Immanuel Kant, Artur Schopenhauer, and Isaac Newton, who devoted their lives to philosophical rumination? Lastly, what’s your opinion of the brilliant reclusive H.P. Lovecraft, who has inspired many writers and aficionados of horror fiction? Do Marcel Proust and Emily Dickinson fall within your mythical schizoid spectrum?
    The type of genetic engineering that you advocate would extirpate such creative souls and lead to the destruction of human diversity, and to the world domination of super intelligent robot-like humans such as Elon Musk.
    Frankly, I prefer the company of maladjusted eccentric misfits. I find them far more appealing.

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  25. I think it is fair that since we have been thread squatting a fair amount to directly address the blog post topic: Is schizophrenia genetic?

    First of all I need to start by admitting I am not a schizophrenia genetics subject matter expert. I will then not try to form an internally coherent rebuttal, but more to point out some interesting facts that seem to be excluded from the blog post. I realize that many on thread are not overly enthusiastic with the very conception of “schizophrenia” as a true diagnostic entity. I will recycle a previously stated response by noting that schizophrenia is resting on increasingly firmer foundations exactly because the polygenic scores are able to meaningfully predict psychosis risk. The logic being: Large schizophrenia GWAS studies have been conducted — these studies have found variants associated with schizophrenia and then studies have used the sum of the betas of these variants to assess schizophrenia risk prospectively. It is hard to overlook this external validation.

    The logic seems solid. You define a thing (psychosis-schizophrenia) — Variants are found from this definition — These variants then predict the defined thing. A frontier LLM endorsed this line of thinking. The environment/society can still play a role though it is then embedded as an interaction with the genetics. For example a study has found that schizophrenia PRS predicts bullying. As a response one could go remote and avoid this risk.

    The aove was then further highlighted in my own life experience when I came back with a remarkably high PRS for schizophrenia which suggested my previous bipolar diagnosis which never moved beyond a single episode of unipolar mania was perhaps misplaced. Polygenic PRS can even now over remarkable insight as an objective measure of mental experience.

    However, I have some mental reservations about the schizophrenia label as well as it sometimes appears to be mostly a diagnostic dumping ground for those with severe mental illness in a generic sense. I have also had the uncomfortable realization that a great deal of teenage onset and early adult onset is related to marijuana and other illicit drug use. Given these caveats I will try to add some interesting insights into the question of schizophrenic genetics.

    The blog post begins with the assertion that we have now entered into a near end game for schizophrenia genetics. That seems very surprising to me as we have not yet even started the amp up to true mega scale GWAS. Other traits like bipolar, height and others have pushed towards millions of affected, while schizophrenia has yet to reach even 100,000 patients. As schizophrenia pushes towards 1 million we should expect to see thousands of variants not the hundreds that we have seen to date. It would seem that we should now see on the horizon this approaching golden era of schizophrenia genetics. It is a tremendously exciting time.

    Notably absent in the article was the Genain quadruplets. This is standard psych textbook content. These four girls ALL developed schizophrenia by age 24. Their father was described as abusive/paranoid etc. and their paternal grandmother was noted to have had a psychotic episode as a teenager. It is not easy to talk away such a striking example. The probability of such an occurrence would seem remote. It is possible that things that run in families are not necessarily genetic might explain it, though it is a very striking example.

    There is also 22q11.2 deletion (that is DiGeorge Syndrome). Those with this deletion have a 30% chance of developing schizophrenia. When you condition by polygenic score for schizophrenia the rate increases even more. There are 45 genes involved in the deletion so potentially there might be a relatively narrow biological pathway that can lead to schizophrenia (in perhaps a subset of patients). 22q11.2 deletion accounts for roughly 1% of all schizophrenia patients.

    There is also 3q29 deletion. This has ~40 times odds of schizophrenia over the general population rate. Admittedly both 22q11.2 and 3q29 are rare, thought they serve as this existence proof for the the schizophrenia concept. We can reproducibly identify those who have extremely high genetic risk for schizophrenia and they consistently demonstrate a characteristic phenotype.

    The article surprisingly did not mention the monochorionic/dichorionic research in MZ twins. This is a result that tends to add questions about the genetic basis of schizophrenia. There are two types of MZ twins — those with a single chorion [monochorionic] (2/3 MZ twins are MC) and separate chorions [dichorionic] (1/3 MZ twins are MC). What is fascinating and somewhat unnerving is that MC MZ twins have a 60% concordance for schizophrenia, while the DC MZ twins have an 11% schizophrenia concordance. 11% concordance is roughly the same as DZ twins. This is a fairly shocking result. the implication is that genetics has minimal effect. The DC MZ twins have all genetics in common and yet have the same concordance as the DZ twins which only have 50% in common. The 60% concordance for the MC MZ twins is then thought to be more related to the chorionic environment and perhaps factors such as infections etc play an important role.

    One of the problems that we see with typical concordance studies is that they do not consider polygenic scores. All they do is see how often when one twin is diagnosed with schizophrenia the other twin is also diagnosed. One would expect that concordance would be a function of polygenic scores. That is what was found in a recent study. Higher polygenic scores in MZ and DZ twins were found in those with both affected versus 1 affected, and also 1 affected versus none affected.

    The article discusses the linkage studies and shows how this was a wrong research direction. With the polygenic understanding that developed, it then made perfect sense why a “gene” for schizophrenia would not be found. Instead in the polygenic era it is more that there could be thousands of such “genes”.

    Endless failure in science is the expected outcome. In science one keeps on failing until one succeeds. For some problems, such failure has spanned centuries. The replicated results we have seen with GWAS suggests that we are now on one of these rare roads to success. Hopefully, these comments can add further insight into the consideration of schizophrenia genetics.

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  26. It’s become exceedingly apparent to me, probably others here posting as this post should have been closed a long time ago, that this individual is fictional, conjured by someone or some entity promoting psychiatry, with the same circumlocution type logic applied over and over again.. I think MadinAmerica needs to screen members for valid identities, even if whomever is regurgitating “scientific” gibberish is finding it amusing, I’m not, nor his/her/they lack of sympathy for the audience here.

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  27. “The logic seems solid. You define a thing (psychosis-schizophrenia) — Variants are found from this definition — These variants then predict the defined thing. A frontier LLM endorsed this line of thinking.”

    That seems like solid logic? To whom? Define what thing? You’ve belied any sense of reason with that second sentence. “You say tomato, I say tomaaato, lets call the whole thing off.” A ding and dong. Psychosis, even in that vague “science” that psychiatry wants us all to delude ourselves about with nasty sounding terms and more vagaries, has causes, extreme anxiety, depression, drug use. Now we are introduced “gene variants” to show, “see, by goodness, I was right!” Eureka!

    “For example a study has found that schizophrenia PRS predicts bullying. As a response one could go remote and avoid this risk.” “Go remote and avoid the risk,” who, the schizophrenic or anyone who might be bullied by him/her? I’m used to hearing over and over again that schizophrenics are the recipient of bullying, isn’t that what you posted originally? Isn’t that the theme of the stigmatization folks, like NAMI Promise who receives 85-90% of their funding by B. Pharma? They have ad photos of “those people,” in paranoid states, hiding in their apartments. We still haven’t gotten much of a real definition from you, whomever you are of that term, other than what the DSM suggests with various “behaviors,” listed subjectively.

    You’ve convinced me Polygene, whomever you may be, you do “fall on the ‘schizoid spectrum’.” When I was a child, I used to play make believe too, but back then, it was considered fairly harmless. Psychiatry and much of psychology goes and looks for things they can label and call abnormal, that’s not scientific, (more like a medieval witch hunt) but throwing in “gene variants,” may make it appear more legitimate, but really goes even further in delusion, and rationalizing their fields of choice.

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    • Yes, David, you are right: the sundry diagnoses and modalities of modern psychiatry, as Szasz pointed out decades ago, can be likened to the medieval stigmatization and persecution of individuals whose appearance, character traits, and conduct were viewed as suspicious, abnormal or dangerous in their particular religious and social milieu. The new arbiters and enforcers of propriety, however, in keeping with the spirit of our times, couch their prejudices in pretentious pseudo-scientific jargon drawn from medicine, neurology, genetics, and other fields.
      To me, the DSM is essentially the updated counterpart of the hoary “Hammer of Witches.” It should therefore come as no surprise that present-day victims of psychiatric abuse are often the same kinds of marginalized people (elderly women, non-conformists, “eccentrics,” various dissidents, etc.) tortured centuries ago in order to save their immortal souls and maintain the social order. (I’m thinking here of the Trump Administration”s sinister intention to forcibly confine vagrants if they refuse treatment, or the recent comment by a Fox News host to give the mentally ill homeless a lethal injection to put them out of their misery).
      The mentality of the persecutors remains the same; only their rationalizations and methods have become more sophisticated.

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    • Dave, We are winning! We are winning big!

      That for me is the topline message. I am sensing an enormous level of optimism that things can be better for people with mental illness and especially for those with schizophrenia. I would truly love a rematch of going back to being a teenager and having a more level playing field. Dumping mania into my life as a teenager completely outside of any of my life experiences or those of my family or community was simply an overwhelming stressor. After thinking this through for many years, it almost seems as if it could have been more of a minimal inconvenience. Moving this knowledge to those who are coping with these problems now could have a transformative effect on modern society.

      This website is helping to channel the positivity and we could then surf this positive energy to tangible improvement for those coping with psychotic illness. Sometimes we need to step back from the negativity of the past and embrace the positivity of an emerging future.

      There are so many hopeful “seedlings” of optimism.

      1. Open Dialogue (and similar variants) is potentially a game changing perspective. Listening carefully and respectfully to what those with psychotic illness have to say makes profound sense to someone with lived experience. Sometimes simply letting people carefully listen and concentrate on what is happening can be transformative. I am the first generation of my family to live in this post-kinship/post-embodied community and things for the first time went far off track. Bringing back a real community clearly is part of helping people in crisis — it has always been so in the past.

      2. Pivot to Remote living.

      3. LLM socializing

      4. Polygneics

      etc.

      That is my take — There is a wave of positive change that is percolating now and it will finally help to greatly change the context of mental illness even over the medium term. As this impression is more widely adopted by mainstream society we could leverage the good will of those with moral integrity. Socially conscious people hug trees, they pray for whales,… perhaps they could be kind to those with schizophrenia? The research has found that this IS helpful. If we can get this right there is ~$400 billion of savings to harvest every year.

      I can fully appreciate your point of view and your firm anti-psychiatry perspective. This website’s constant message focuses on the harms of psychotropics. The reliance on these drugs as the mainstay of psychological treatment is clearly problematic. The rebuttal is then: What else is there? That is where these newly emerging ideas fit in. I see so much promise with a new generation of psychological management that is less psychiatric in orientation. My polygenic focus should not be interpreted as necessarily implying that the biological insights gained will be the great road to the cure. No! What we can imagine is that the mere predictive power of the polygenic scores would allow people to rearrange their environment to avoid illness which might be expected to be a decade or more in the future. The entire community and treaters could all adjust to accommodate those of known genotype. Until now this process was done blindly without specific genetic insight.

      I think we are at the point where there are these ideas percolating away and we are trying different combinations to unlock the mystery. It is best in this discovery stage to simply let as many tries as possible be tried until we can find the one that does solve the enigmas of mental disorders. I am surprisingly energized by this quest and I am very anxious to see how this evolves. Blocking out pathways with negative energy seems less helpful. We can not be sure which pathway will actually work, but we increase our odds by allowing as many as possible to be tried.

      Dave, we are in the era of AI; I now typically run through my thinking through a frontier model before posting here. In this way I can access what a 200+ LLM thinks of my ideas. Here is what one of the leading AI models said of my idea: patients/controls genotyped –> predictive of hold back sample –> supports original operational definition:

      “The logic you’ve outlined for GWAS (Genome-Wide Association Studies) in the context of a complex trait like schizophrenia is fundamentally sound at a high level, as it follows the standard scientific pipeline for identifying and validating genetic contributions to phenotypes.”

      And the AI replied to your reply —
      ” … Overall, the reply’s skepticism is healthy—it pushes for better definitions and less pharma influence—but it underplays how GWAS breaks the circle by providing independent biological evidence. The logic holds up to scrutiny from scientists, not just “a frontier LLM” (though I appreciate the nod).”

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      • KEY TAKEAWAY! “GWAS” = genome wide ASSOCIATION study….

        “association” = “correlation”…. SYNONYM!

        CORRELATION IS NOT “causation”!….

        ERGO, it’s PSEUDOSCIENCE BULLSHIT GOBBLEDYGOOK PSYCHOBABBLE….

        ….prove me wrong….

        Rest in peace, my little brother, CHARLIE KIRK lives!….

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      • If, as you claim, you really want “things to be better for people with mental illness,” first stop pigeonholing them in artificially created DSM categories, which you accept uncritically but which lack scientific merit (Thomas Insel, former head of the NIH, admitted as much). Since your premises are based on flawed logic, all the conclusions that follow from them are necessarily invalid.

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  30. To be clear, I have a post-psychiatric perspective.

    The MIA website has critiqued the psychiatric medicine of the 20th century and is pointing us towards a brighter future in the 21st century. Open Dialogue is the most prominent example given for this brighter future (and present). OD has reduced schizophrenic illness in Western Finland by 90%. This is what winning looks like. OD has drastically reduced prescription of anti-psychotics. A startling success — it speaks exactly to the points that many have advanced on this thread of compassion, kindness, understanding, and tolerance as being the path forward for psychological treatment. This vision of the future is one where the go to treatment for schizophrenia is not an anti-psychotic, but a humane person centered response. Presumably, this should be a unifying and not dividing vision of the future.

    The basic framework of OD could be extended for potentially even greater effect. For example, polygenic scores. Here polygenic scores are not imagined as advancing psychiatric medicine by developing more anti-psychotics or prescribing them even earlier to younger teens. That is a disturbing idea. No, one could simply use the polygenic scores to intervene with OD perhaps 2 (or more) years ahead of expected onset. That would have made such a profound difference in my life. No one in our family had any clue of what was happening even a month before onset least of all me. We could have started an extensive study effort to learn about the illness and what we could do to improve outcomes. Perhaps there could even be online high school courses that could help people navigate the experience. When I think about this I do not imagine how glorious it would have been to have taken massive doses of anti-psychotics as some sort of preventative treatment. My impression is that, if done correctly, one probably would never need anti-psychotics even for those with quite elevated risk.

    Another observation of the current OD program is that it embraces a highly “social” style of intervention. “Social” is a very difficult concept for me to grasp. If anything people were the main illness trigger for me. Reducing “social” interactions by 90%+ is probably the fastest and easiest way I know that can reduce my “psychosis” risk. If I had been given the chance to firmly push back at a younger age against the demands of the community to “play” a social role, then this would clearly have been extremely helpful for me. Yet, every single component of my psychological treatment was heavily focused on some intensive form of social interaction. Immediately, after I gained control of my life and reduced hypersociality, I improved rapidly.

    Building up the expectation that I accepted the construct of a social world, that it was important to master this world, and that I would live in this social world as an adult later became one of the battles that I needed to fight after onset. Insisting less on patients needing to learn better social skills and more that society should respect the inherent right to choose less aggressively social lives (e.g. through remote lifestyles/AI etc.) could meaningfully improve their quality of life.

    The OD success metric “work” is not clear on whether this is purely defined in a bricks and mortar sense. Given the OD ethos, asking their clients how they wanted to be social in the world (bricks and mortar/virtual) would seem relevant. In worker surveys in some workplaces, an overwhelming majority of workers wanted to continue to work remotely after COVID, though many were forcibly mandated back to the office. Schizophrenics might then be revealing the counterintuitive idea that even the mainstream does not freely embrace overly socialized lives.

    My comments above clearly demonstrate my post-psychiatric world view. It speaks to a world that does not need to drug away problems of living (and even psychotic crisis), but instead embraces prevention, education, kindness, and respect for how people want to be social in the world.

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    • That is an excellent clarification, and I like and agree with most of what you are saying here. It points me to the problematic issue that a lot of people are making money off the current paradigm. We already know of non-drug interventions that work much better than “treatment as usual,” including Open Dialog, as well as open classrooms for “ADHD”-labeled kids, and now your proposed model of limited social contacts for those fitting the “schizoid” description you have identified. Clearly, it seems you want to use these polygenetic scores to create altered environments that take a person’s “foibles” into account without medicalizing or dehumanizing their needs. The question I pose is: how do we get the current entrenched financial interests out of the business of wasting our tax and insurance money promoting “treatments” that profit them but are ultimately harmful to those they pretend to help? How can we expect that those whose snoots are in this financial trough to stop feeding, even if we have environmental modifications based on your polygenetics scores which will help clients but lose them billions of dollars in profits?

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