Schizophrenia- the 100th Anniversary, or, I've Come to Wish You an Unhappy Birthday.

So, this year marks the 100th anniversary of the introduction of the diagnosis of "schizophrenia". According to that ever-abundant source of information, Wikipedia, the term was actually coined by Swiss psychiatrist Eugen Bleuler in 1908. One can only presume, as various mental health charities have marked this year as the 100th anniversary of its usage, that it took a further three years for the term to be used in practice as a diagnostic category. Or is it that Wikipedia have got it wrong. Why, surely that could never be!

Eugen Bleuler, psychiatrist and originator of the term, "schizophrenia". 
The stigma, fear and discrimination surrounding the term is well-known, and this, to my mind, is due in no small part to sheer semantic confusion. Derived from the Greek words "schizein" (which actually sounds a bit Germanic to my ear), meaning "to split", and "phren", meaning "mind", "schizophrenia" roughly translates as "splitting of the mind". This definition of the experiences of those diagnosed with the condition (including yours truly) has perhaps led many to associate it with a dual, or "split", personality, a sort of embodiment of the "Jekyll and Hyde" character type. This, however, was not at all the sort of "splitting" Bleuler was referring to. Rather, he meant the separation of function between personality, thinking, memory and perception.
Anyway, to mark this great occasion, the mental health charity Rethink have launched an independent expert commission on the condition, chaired by Sir Robin Murray, Professor of Psychiatric Research at King's College, London. They have also launched their "wishing schizophrenia an unhappy birthday" campaign, in which people can take part in an on-line petition calling for better treatment for those with the diagnosis which will eventually be sent to the Prime Minister, David Cameron. Rethink seem to say that not much has changed since the term first came into usage. People with the condition are still marginalised, discriminated against, vilified and feared, and to prove it they quote the statistic that those with the condition are said to die twenty years younger than the national average.
Speaking for myself, though, I have to say that I believe things have improved for those of us with this dreaded illness. Mental health services are gradually improving, and even the stigma surrounding the illness, although it is difficult to judge, appears to be waning, rather than getting bigger.
Having said that, debates and problems surrounding the term are many. Experts are divided on whether "schizophrenia" is a useful way to describe the experiences of those so diagnosed. Some want to bin the term completely and replace it with a new one. Stigma remains an issue, whether it be on the wane or not. The efficacy of the long-term use of anti-psychotic drugs is also an ensuing debate. And finally, the big debate over whether schizophrenia is an organic brain condition, or one which should be more associated with societal and environmental factors, rages on.
I, personally, have a long-held dislike of the term, "schizophrenia", if only for the stigma which surrounds it, caused, in no small part, as I have said, by the name itself. But, I'm way past the days of identifying myself solely with that term. Indeed, as time goes on, I feel it has less and less to do with me, although to some I will always be a "diagnosed schizophrenic". Personally, I just prefer to be called by my name, David. I am always disappointed, then, when I hear people say, "Hello, my name is... and I'm a schizophrenic". To have one's identity so bound up with the illness is, to my mind, a great mistake, and a deep disservice to those with the condition. The people I know personally who, like me, have been burdened with this label, are always so much more than that label.
So, to the illness and to the term, I give a big, emphatic V-sign. And, to paraphrase the words of  Morrissey and The Smiths, I wish them both a thoroughly unhappy birthday, and if the term should die, I may feel slightly sad, but I won't cry.   

Comments

bazza said…
Hi David. I suppose it's possible that all terms describing any aspect of mental illness would have a negative connotation for you.
It's incredible how words have the power to hurt. It reminds me of the way black people have had various ways they choose to be labelled. I think if a group of people find a certain term offensive we should all try to avoid using that term.
I think the word 'schizophrenia' is a proper medical term and I feel neutral about it but I respect your feelings about the term.
Any suggestions for a substitute?
Click here for Bazza’s Blog ‘To Discover Ice’
klahanie said…
Dear David,
A most thoughtful and informative posting. Up to your usual high standards.
This will be a brief response because your articulation has said it all.
We have come some ways in reducing the stigma and the labelling.
I once worked for a mental health Charity that tried not to use labels, but referred to those with 'Schizophrenia' as suffering from "hallucinations and delusions". I rather struggled with that.
Anyway, David, to me you are indeed, David. A thoroughly decent chap and good buddy.
With kind wishes, Gary
David said…
Dear bazza,
Thank you for your comment.
I do not find all terms describing mental illness offensive, and I think that, maybe, offensive is the wrong word for the way I feel about the "shizophrenia" label.
What I do object to is being referred to as "a schizophrenic", which I feel reduces one's humanity.
The term is also now such a loaded one, that I feel some change is needed. With so much stigma attached to it, I feel that the word has become directly associted with "split personality", violence, and inability to function or contribute, and who would want to be made out to be like that!
I am glad, bazza, that you remain neutral, and see it as a purely medical term. Unfortunately many do not, for the reason stated above. And, some professionals are arguing that the term has even outlived its medical validity.
Two already suggested alternatives are:- "post-traumatic psychosis" and "dopamine dysregualtion disorder", which I feel would both be preferable to "schizophrenia". Others feel differently, and suggest that the stigma would just follow any new term.
I could write reems on this, bazza, but for now that will have to suffice. These are hotly contested debates, but at least we are beginning to have them.
With Very Best Wishes,
David.
David said…
Dear Gary,
Thank you for your kind words.
I suppose "schizophrenia" is such a complex condition, that any new name we come up with will have some draw-backs, but I think it is worth trying, if only to further reduce the stigma surrounding the illness.
Thanks once again, Gary, my hairy pal.
KInd Regards, your way,
David.
David said…
P.S. Bazza. If you want to read the arguments for a change of name, you could go to the CASL (Campaign for the Abolition of the Schizophrenia Label) website. I'm sure they can outline why "schizophrenia" has outlived its welcome more eloquently than I can.

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