Malcolm Garland -Rethinking Psychosis in the 21st Century – Brief Reflections From the Front Line

THE LETTER 55 & 56 Spring/Summer 2014, pages 75-79.

Based on published research, the views of service users, as well as clinical experience, this paper critiques the concept of schizophrenia. It will highlight: the failure of the emergence of a biological explanation for schizophrenia; the ‘myth’ of antipsychotics; the heterogeneity of ‘psychosis’ in the real world; psychosis as just another form of psychological stress. Our summary view is that schizophrenia is too broad a term to be useful and that there are many patients with this diagnosis being treated with a pharmacological approach rather than a psychological one.  We propose an aetiological/narrative based model of psychosis ‘What happened to you?’ replacing a phenomenological one ‘What is wrong with you?’

Keywords: limit of medical model in psychosis treatment; anti-psychotics-misnomer?; trauma-related aetiology; service user movement

Thank you very much Barry and Patricia for inviting me to speak here today.  I’d like to start with some reflections. I suppose firstly I regret waiting until my greying years to speak openly about what has been sitting with me for a long time.  I regret deriding with all my superior medical arrogance those, including many of you here, who sought to see a greater meaning in all that we suffer, thereby, essentially rubbishing all that was not ‘biology’.  I feel sadness that I have made, and indeed continue to make, many patients suffer with reductionist, ineffective and often coercive treatment.  Finally, I’m fear-ful that my attempts to demolish, in just a few words, an entire world view, hitherto held very firmlyby me, may appear crass and over simplistic, but with that in mind I will proceed.

Comments are closed.