Chapter

Suspicions of schizophrenia

Eric Matthews

in Reconceiving Schizophrenia

Published on behalf of Oxford University Press

Published in print November 2006 | ISBN: 9780198526131
Published online February 2013 | e-ISBN: 9780191754340 | DOI: http://dx.doi.org/10.1093/med/9780198526131.003.0016

Series: International Perspectives in Philosophy & Psychiatry

Suspicions of schizophrenia

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Nevertheless, there is also a tradition of scepticism about the concept of schizophrenia. And since schizophrenia, as just argued, can be regarded as a paradigm of the medicalized concept of mental illness, the most interesting of these suspicions also tend to be directed towards what they describe as the ‘medical model’ in general: they are an expression of the movement often called ‘anti-psychiatry’. The anti-psychiatric movement is usually associated with a rather romantic rebellion against the modern world of science and technology. Some of its claims might well be regarded by working psychiatrists, busily engaged in attempting to provide therapy for the intense misery of mental disorder, as a mere trivialization of serious human problems. It is tempting therefore to dismiss it as a facile rebellion of the counter-culture against scientific medicine. This chapter, however, is written in the conviction that such a dismissal is too easy. I shall argue that we should not accept all the anti-psychiatrists’ conclusions, and certainly should not abandon the practice of psychiatry as a science-based branch of medicine. But I shall try to show how, by their use of ideas and arguments drawn from philosophy, anti-psychiatrists draw our attention to some features of schizophrenia that are neglected in purely neuropsychiatric models. Their deficiencies lie, in my view, in the inadequacy of their grasp of this philosophical framework and the way it can be applied to the questions with which they are concerned. My aim in this chapter is to see how their work looks when it is based on a more adequate philosophical analysis, derived from the work of the French phenomenologist, Maurice Merleau-Ponty; in particular his concept of human beings as embodied subjects. This, I shall argue, will make it possible to extract the genuine insight from the rather confused romanticism that often surrounds it, and to show how it implies, not the rejection of any kind of medical model of schizophrenia, but a reinterpretation of what such a model involves.

For various reasons, I shall concentrate on two such critics, Thomas Szasz and R.D. Laing. One reason is that they are two of the best known representatives of the anti-psychiatric movement. In a sense, they define what is meant by that term. Furthermore, they are or were practising psychiatrists themselves. But the most important reason is that their critique of schizophrenia is also a critique of the more general concept of mental illness, and hence necessarily requires the philosophical framework spoken of above. Other critics of schizophrenia (and of the concept of mental illness in general), such as Michel Foucault (Foucault 1965) or Mary Boyle (Boyle 2002), direct their attack at external factors, such as the power structures of the society in which psychiatry functions or the desire of psychiatrists to gain the status of medical scientists. Szasz and Laing, by contrast, go to what seems to me the heart of the matter; namely, to the way in which we should respond to the people we call ‘schizophrenics’, and recognize that reflection on that issue is essentially philosophical in character. For this reason, what they have to say has a very concrete bearing on the actual practice of psychiatry and on the nature of its contribution to human welfare. My approach will be, first, to critically examine each of these thinkers in turn in their own terms, and then to present Merleau-Ponty's philosophical framework and to re-examine their work in the light of it.

Chapter.  10484 words. 

Subjects: Psychiatry

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