I think you’ve got a good point there, and in some ways I agree. The existence or otherwise of ‘schizophrenia’ is a moot point really. There is a well described phenomenon of mental disturbance recognizable across different cultures and historical periods; calling it schizophrenia is really just a convention which is supposed to enable therapists and carers to have a common understanding of what it is – and just as importantly what it is not – we are talking about when we use the word. For example in Denmark before the coining of the word schizophrenia it used to be called “ungdoms sløvsind” which means mental lethargy or bluntness, in youth. This is very descriptive of what the problem is and why indeed it is a problem, because it provides an immediate contrast with the normal state of affairs; youth is the time of our lives when mental alertness, drive, and development of ideas and interests are at their peak. Yes, we’re all different all unique all individuals, yet certain things we all have in common enable each one of us with all our uniqueness, individuality and differences to be woven into the social fabric. To become, at this point in life, disinterested, demotivated, reclusive, anti social, and to just allow friends, family, studies, employment, pastimes, personal standards of care and hygiene to drift away and instead become completely absorbed in some inner world of experience quite impenetrable to onlookers, is abnormal and a legitimate cause for concern. Call it schizophrenia or by any other name, any person so entangled is not going to be able to live an independent life, while in the grip of the spell. I do not see it as failing to adapt so much as being maladaptive. We can quickly agree that society is ‘a mess’ but that, for me, does not make schizophrenia a ‘relevant or understandable response’. The point Kwame McKenzie is making about the epigenetics of the problem, if I understand it correctly, is that while we cannot simply ignore that there must be a genetic involvement in these very serious types of psychosis, the hope might be that human environmental influences (socially engineered) not only might compensate for negative effects of biological disadvantages, they may in fact hold the potential to modify the negative effects themselves at the biological level. This is for me a truly exciting prospect – one I often have tried to grapple with in abstract modes without ever having had the science to be able to articulate it in a way which could be accepted in any academic fraternity. It explains admirably for me why recovery is possible and why for example Open Dialog works. Which – after all – is partly what Whitaker is trying to tell us. There are in many cases alternative possibilities to medication in the treatment of schizophrenia which we – through laziness, ignorance, false economy, ideological dependence on models of treatment behind which there lie strong vested commercial interests, – are not exploiting fully. It is the other part of what he is trying to tell us – when he turns these sage observations on their head and in doing so tries to argue a ridiculous case for schizophrenia being an “epidemic” of medicine induced madness – which alienates me from his campaign, and prevents me from taking him seriously.