Cover Image: March 2010 Scientific American Magazine See Inside

Living with Schizophrenia

A diagnosis of schizophrenia is not always grounds for despair














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Who is most likely to improve? Researchers have linked a number of factors to better outcomes in patients. These include functioning successfully in their lives before the disease emerged; experiencing severe symptoms suddenly, all at once, rather than little by little; being older when the disease appeared; being female; having a higher IQ; and lacking a family history of the disorder. All these traits and features, however, allow at best modest forecasts of schizophrenia’s prognosis.

Clearly, we have made considerable progress in our understanding of schizophrenia’s course and are more optimistic than we have ever been about the future of those afflicted. Nevertheless, we need even more effective remedies if our aim is to bring patients back to the productive, happy lives they enjoyed before their illness struck—and shattered their sense of self.

Schizophrenia Fictions
Although most people have heard of schizophrenia, many misunderstand the disorder. Here we dispel three widespread misconceptions about this troubling mental illness.

Myth #1: People with schizophrenia have multiple personalities.
Fact: This belief reflects a confusion between schizophrenia and dissociative identity disorder—once called multiple-personality disorder—a controversial diagnosis that is supposedly marked by the coexistence of multiple personalities or personality states within individuals. People with schizophrenia possess only one personality, but that personality has beenshattered, with severe impairments in thinking, emotion and motivation.

Myth #2: All people with schizophrenia are essentially alike.
Fact: People with schizophrenia experience a bewildering variety of symptoms. Some suffer primarily from “positive” symptoms, such as delusions, which are fixed false beliefs—the idea, say, that government agents are following them—and hallucinations, such as hearing voices. In contrast, others mainly have “negative” symptoms, such as social withdrawal and diminished emotional and verbal expression. Still another set of patients experiences cognitive deficits—problems with paying attention, remembering and planning. Many patients’ deficits span all three categories.

Myth #3: Schizophrenia is caused by family attitudes and behaviors.
Fact: In 1948 German psychoanalyst Frieda Fromm-Reichmann introduced the notion of the schizophrenia-inducing mother—one who was hostile and hypercritical—an idea that persisted for decades. Yet research has consistently failed to directly link parenting to the onset of schizophrenia, although numerous investigations suggest that intense familial criticism may hasten its relapse.


This article was originally published with the title Living with Schizophrenia.



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ABOUT THE AUTHOR(S)

SCOTT O. LILIENFELD and HAL ARKOWITZ serve on the board of advisers for Scientific American Mind. Lilienfeld is a psychology professor at Emory University, and Arkowitz is a psychology professor at the University of Arizona.


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  1. 1. Jorie 11:08 AM 2/24/10

    Why was this article printed in the March 2010 issue of Scientific American? There seems to be nothing new here. A rehash of old information seems odd for this magazine. The picture on the cover to bring attention to this article is awful!

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  2. 2. cmb 11:52 AM 2/24/10

    i hadn't heard most of this personally and I'd like to know what the original sources are. would the authors please site some references?

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  3. 3. Nunyabeezwax 01:29 PM 2/24/10

    I agree, the related image sucks. However, my spouse was diagnosed with this disorder about 5 years ago, after drowning and being electrocuted simultaneously in a lake on the 4th of July. At times, he will experience severe auditory hallucinations that will cause all of the other symptoms, described, to domino. I have read my fair share, plus his, on the subject but have never come across the bleak downhill future from which this article is now reporting that some sufferers may recover from.
    I try to motivate him and discuss how much his family needs him and loves him, hoping to get us through the tough times. But...I, for some reason, always thought he would return to his old self some day. I assumed, like depression for some, it could be over someday and we would move on. Half way through the reading, my heart crushed and I broke down in shock. Again at 3/4 and by the end I felt as if my heart was ripped from my chest and my life's future stopped in limbo. Now everything seems questionable, whereas before, I thought there was a destination in sight that we were journeying toward. My husband is only 33 yrs in age and I love him immensely, as do our children.
    He was on meds a few years ago, which was a great relief from the symptoms, then he was off them for a couple of years. It became a severe nightmare as he relapsed. I finally got him back to a doctor, a year ago, and things started off well, Until, the first med stopped helping. He has tried a few different ones since then but none of them are quite cutting it (only some relief) and his doctor seems to be irritated with the unsuccessful results. She says that she can't follow him around all day to see what's making him sad and that he needs to try to figure it out. He is also bipolar and I was not with him, at her office, that day. Otherwise, it might not have been said. I deem her comment inappropriate and felt it was obvious that he would be sad because he has irritating voices screaming at him, in his head, all day. I'm going to imagine that it sucks!, can't she? Thought that link was pretty cut and dry as far as 'obvious' goes.
    He has never been hospitalized for this and he maintains p/t employment, never missing a day. After the first visit or two, to the current doctor, his blood pressure has gone up and remains high.
    Even though it wasn't the intent, the new information I have learned from this article is not good news to me. I know this is great news for some. I can't help but to hope of a better recovery than the one that's described here.

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  4. 4. gothceltgirl in reply to stew6302 02:05 PM 2/24/10

    WHAT?! My uncle was schizophrenic. I can tell you it does exist.

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  5. 5. jtowber 02:53 PM 2/24/10

    Here is a link to a detailed bibliography of recovery as a key concept and practice in preventing relapse and promoting work socialization and normalcy from serious persistent mental illnesses:
    http://www.yale.edu/PRCH/pdf/ProgramReferences.pdf

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  6. 6. jtowber 02:56 PM 2/24/10

    Here is a bibliography from Yale's recovery initaive:

    http://www.yale.edu/PRCH/pdf/ProgramReferences.pdf

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  7. 7. cmb in reply to jtowber 03:01 PM 2/24/10

    thanks for the bibliography

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  8. 8. karmabites in reply to Nunyabeezwax 03:13 PM 2/24/10

    Your story truly gripped my heart. What your husband needs most is your continued love and support -- and certainly a different physician. I really hope for the best recovery possible for your husband.

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  9. 9. southernchick in reply to Nunyabeezwax 12:09 AM 2/25/10

    I am curious as to what state you live in b/c I *might* be able to give you some valuable info regarding poor communication and 'bedside manner' by the physician in question. Can you email me directly? I'd like to help, plus, I think I might have some info that will help you get back that feeling of hope that you think you've lost.
    Let me help if I can, Please.
    Thanks,
    S

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  10. 10. Nunyabeezwax 11:50 AM 2/25/10

    I welcome any source of hope and helpful information. We are in Texas and my email is nunyabeezwax@att.net. Thank you both!

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  11. 11. ididit 03:12 PM 3/4/10

    lol i be all like talking to myself sometimes do that me im all like tarded?

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  12. 12. CertifiedPsycho 07:25 AM 3/6/10

    I am a female of European descent and I was diagnosed with the disease in my teens. Although I take medication and participate in therapy, I struggled with the symptoms associated with breaks from reality well into my thirties.

    In 1992 I was alone and contemplating the visual and auditory hallucinations that routinely disrupt my thinking and behavior when, in a moment of perceptual clarity, I said out loud "They don't qualify as hallucinations unless I respond to them." As soon as I heard myself say it out loud I knew that I had just had a mind-altering realization.

    From that point on, I would get reality checks from my animals - if they didn't confirm it - I didn't react. Whenever possible I would enter into a meditative state and focus on the light that shone through my eyelids. I'm not sure what I was thinking about as I stared into my eyelids, but after a time my symptoms became less intrusive and it became easier to not respond.

    Since that stellar realization, I have enjoyed a relatively content and secure life. Although I still experience the hallucinations, my thinking patterns have become more consistent and I am functioning at an ever-higher level with each passing year.

    Within ten years my diagnosis was down-graded from Paranoid schizophrenia to schizo-affective disorder. I still experience a higher level of paranoia than most people, but it's not producing the delusional thoughts and alternate realities that it has in the past.

    While it is true that my disorder has improved significantly, during times of extreme stress - emotional and/or physical - I can't override the erratic thought processes and I experience confusion and extreme sensitivity to sound and tactile stimulation. For this reason I continue taking medications so that I'm always at therapeutic levels.

    Although my disorder is disabling (I've never held a job for more than a year), in the last decade I have completed more projects and endeavors than in the entire forty years prior. I'm happier and more productive because I am no longer compelled to respond to aberrant perceptions or delusional thoughts.

    I find it interesting that there are those among us who would complain about an ugly picture or call the information in the article common knowledge, when only 1 percent of the population experiences reality breaks (which are much uglier than the picture, by the way ...). There are many common misconceptions and myths about the disorder, and I appreciate any attempts to dispel them.

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  13. 13. SteveinLongBeach 03:41 PM 3/8/10

    My Dad was a psychiatrist specializing in treatment of schizophrenic patients. Once I remember him calling a former patient of his about 15-20 years after he'd treated her (that'd have been back in the late fifties, when the only drugs available were the first-generation antipsychotics; but his work was always based on establishing a therapeutic bond, with drugs when helpful, but secondary). She was doing fine.

    No recovery? I don't believe it.

    My Dad believed that the insurance industry and the pharmaceuticals had largely killed off not just serious treatment of patients with major mental illness, but even much of clinical training in psychiatry, since the 30 day limit on payment for hospitalization and the overblown claims for new (and more profitable) medications were deeply harmful to the entire enterprise of helping people with the most serious problems, skewing treatment and research alike toward purely neurophysiological concerns and away from treatment of the patient as a human being in the world...

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  14. 14. ssmith04 03:24 PM 3/23/10

    This article accords very closely with my mother's experience of schizophrenia. I'm glad to see more rational examination of schizophrenia, and less hype/mythology.

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  15. 15. Lori 01:35 AM 4/23/10

    What page was the article "Living with Schizophrenia"

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