The most interesting fact derived from brain imaging observations is that psychotherapy clearly alters brain chemistry and structure. This is the essence of the article.

The scientists have observed that without the benefit of psychotherapy their is a loss in gray matter. The article suggests that these losses occur with or without neuroleptic drugs. It appears logical that introducing chemicals into the body system that target the brain will result in deterioration of particular brain functions. It also appears plausible that absent altering the mental, emotional, and psychosocial aspects of the human employing psychotherapy that deterioration may also occur.

This is very much consistent with observations that responses to stress accelerates or results in other illnesses such as coronary disease, cancer, etc. It seems entirely realistic that stress responses, neurosis and psychosis would accelerate diseases that affect the brain.

I wish however to be clear in the distinction that neurotic or psychotic behaviors are not brain diseases but are human responses to stress and psychological trauma. In all instances unmanaged stress responses are precipitous and not the disease itself.

Also I’ve seen critiques of studies that compare typicals to atypicals (side effects etc.) pointing out that more often than not participants are given much higher doses of the typicals, so, objectively, scientifically, the results aren’t really comparable. But, of course, these studies aren’t meant that much to really compare than they are meant to make a case for the atypicals…

Getting around researchers paid by drug companies is like being around political spin doctors: you have to step back and try to figure out what the facts were before the spin.

To start with, they say that certain losses of brain tissue have been found “consistently” in patients with schizophrenia: I believe the facts on that are that it has consistently been found that ON AVERAGE people diagnosed with schizophrenia have such losses compared with people not so diagnosed, some diagnosed with schizophrenia do not have those differences, some not diagnosed do have them.

As for the charge that maybe the drugs cause the losses, they tend to point out that there is at least a bit of evidence showing some such losses, on average, in people diagnosed before they start drugs. Such changes are likely caused by things like trauma, stress, and avoidance and withdrawal, which then only get worse after a person is started on drugs – with some exceptions, because sometimes people stress less after getting on antipsychotics and may become more active, so for some, the antipsychotics may be both helping and hurting.

Since they can point to some negative brain differences before starting drugs, and then see more negative differneces after the person is on drugs for awhile, and since lots of money comes from drug companies, they naturally conclude that the drugs are simply failing to stop changes caused by “the illness.” They ignore the studies in monkeys, who don’t have “schizophrenia” but show many of the negative differences just as a result of taking the drugs.

Similarly, most reports will say that the antipsychotics fail to improve “negative symptoms” and will ignore data that the drugs induce negative symptoms in many people who never had them before. (Sometimes they may reduce negative symptoms for some people, to make the story more complex.) Other reports will actually claim that atypicals improve negative symptoms more than typicals do – and will simply cite data showing people on typicals having more negative symptoms than those on atypicals, without even considering the possibility that the typicals are simply CAUSING more negative symptoms than do the atypicals.

I share your curiosity about the exact nature of this “cognitive enhancement therapy” and wonder how the study would have worked had they used something else. One possible positive about the cognitive enhancement therapy was the way they paired people up within it – they may have structured it so that a lot of what was going on was really peer support.

“Progressive loss of gray matter, frontal hypofunction, and decreased white matter integrity have been consistently observed in patients with schizophrenia,” the article quotes one of the researchers. Now, I’m not a neurologist, my knowledge of the anatomy of the brain, respectively of the scientifically correct terms referring to specific areas, is limited, but I do know that major tranquilizers decrease neurotransmitter activity in the frontal lobes, and I think, this is 101-knowledge for any neurologist/psychopharmacologist. Nevertheless, these guys, who ought to know better, attribute “frontal hypofunction” to “schizophrenia”, not to the drugs probably all of their study participants are taking. The article even says: “The resulting deficits do not respond to antipsychotic drugs,… ” WTF?! How could substances that by definition de crease activity in a specific region of the brain ever be expected to, at the same time, also increase activity in these very same regions?? IMO, there’s something really really wrong here. (And I’m sure, a trained neurologist might be able to find a whole lot of additional inconsistencies.)

I wish, they’d do a study comparing this cognitive enhancement therapy (and somehow its “innovative cognitive exercises and psychoeducation” as well as its “weekly homework assignments” has me cringe… ) to trauma-focussed therapy, or something like Soteria or Open Dialog, preferably with participants who don’t take any drugs in the latter group. I bet, they’d be somewhat surprized… (or not, because I think, many of them know, those bastards).

I think you nailed it about the distortions in the NAMI description, and the likely effect on clients. Not too surprising though, given that most of NAMI’s funding comes from drug companies.

The notion that “schizophrenia” is an entirely biological affair took another blow today, as news came out that many of the brain differences that have a greater than average likelihood of being present in someone diagnosed with schizophrenia, can be affected or even reversed by changing environment. See “Brain Changes in Schizophrenia Respond to Non-Drug Therapy” If just a bit of therapy can have this kind of effect on the brain, that means many other sorts of environmental causes are probably having effects as well.

I was amused with the section on schizophrenia. It is not amusing however that the false logic summarized there forms the basis for treatment for individuals diagnosed as having the condition.

NAMI says:

“Schizophrenia is a serious and challenging medical illness…” What classifies it as medical? The term medical versus mental appears to validate a biological origin and justifies a biochemical treatment regime.

“Scientists still do not know the specific causes of schizophrenia, but research has shown that the brains of people with schizophrenia are different from the brains of people without the illness.”

“While there is no cure for schizophrenia, it is a treatable and manageable illness. ”

“Schizophrenia is not caused by bad parenting or personal weakness.”

Hmmmm…If scientists still do not know the specific causes of schizophrenia how can they be certain that it is not caused by bad parenting or personal weakness? How can they declare that there is no cure when people have in fact recovered fully/ been cured?

And, ” Antipsychotics help relieve the positive symptoms of schizophrenia by helping to correct an imbalance in the chemicals that enable brain cells to communicate with each other.” Pure speculation and conjecture I would say.

It’s understandable that any poor soul faced with this level of misinformation can’t help to adopt an apathetic outlook and fall into a predominance of negative symptoms when subjected to their drug induced tranquilized state. What I’ve read there is enough to depress anyone!

Great to hear that you will be doing this important work! People like you, acting and speaking out, is most likely to be the thing that will finally change the system! (That is also the contention of the really important book I’m reading right now, Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?)

To complicate matters further when the original beliefs are skewed further by the mythical belief that someone has schizophrenia, promoted as a brain disease of unknown etiology with no cure, the “problem” grows rather than moving toward being alleviated and the beliefs become more constraining, more resigned, more rigid and hopeless. Neuroleptic drugs aid in consolidating the validity of the diagnosis and its effect on the limited belief system.

Alas what is the individual recovering from then? He or she at best can be recovering from the effects of their limiting beliefs. The solution then is to assist the individual in altering the belief system and helping him or her to discover that what they believe is a matter of choice. How they feel and how they behave is a consequence of the actions they take or do not take, and the results those actions achieve or fail to achieve, inspired by their beliefs. As Harry Stack Sullivan observed it is far easier to act your way into a new way of feeling than to feel your way into a new way of acting.

The problem is the problem is not the problem. Schizophrenia is not the problem. Indeed psychosis is not the problem. The problem, inasmuch as we wish to label it a problem, is the belief system that gave rise, in the presence of environmental stimulus, to a defensive response that resulted in the delusional, hallucinatory, and paranoid thoughts and behaviors in the first place.

We cannot help the individual recover because that person has nothing to recover from. At best we can help the person distinguish their limiting beliefs, how they may have originated, and much more importantly help them understand that these beliefs are myths and that what one believes and how one acts is all within the realm of personal choice. How we act determines whom we are being and how we think and feel.