According to Wisdom Card.com, “Statistics show that approximately 2.4 million Americans have schizophrenia. Schizophrenia generally first appears in men when they are in their late teens or early 20s. In women it normally appears in their 20’s or early 30s.” To help understand the signs of schizophrenia and what type of help is available, I have interviewed Marriage and Family Therapist Intern Larry Langford.
Tell me a little bit about yourself.
“I am a Marriage and Family Therapist Intern, with an M.S. in Marriage and Family Therapy from California State University'”Fresno and a Ph.D. in English from Rice University, Houston. Although I see patients at a substance abuse rehabilitation facility and at a shelter for abused and at-risk adolescents, my work with schizophrenics occurs primarily in a private practice setting, Sequoia Psychotherapy Center, Inc., Fresno, California. This center is one of the few in the country that offers psychotherapeutic services for many disorders, without resorting to the use of psychotropic medications. Many patients want treatment but worry about being forced to take medications. We offer them an alternative.”
What is schizophrenia?
“Schizophrenia can best be thought of as a coping mechanism for the fear that occurs when the boundaries of one’s self-image begin to give way. Reality has become so terrifying and stressful that a break takes place and a new reality comes into being, often one that is still frightening and grandiose in terms of its delusions and hallucinations but nonetheless more understandable to the patient and thus more tolerable. Because the boundary between the conscious and unconscious becomes more permeable, being schizophrenic is like dreaming while one is awake but without the understanding that the contents of the unconscious have broken to the surface. Schizophrenics live in a waking world defined by dream logic, but nonetheless completely real and threatening to them. First and foremost, therefore, being schizophrenic means living in terror, chronic terror that one’s sense of self is in danger of being annihilated and that only the creation of a new reality can prevent that from happening.”
What are the signs and symptoms of schizophrenia?
“Since schizophrenia is a withdrawal from reality, this withdrawal can manifest itself in many ways and to varying degrees. However it does manifest, it will usually do so in the form of thought and affect disorders. As the schizophrenic withdraws into his new reality, thought disorders in the form of delusions and hallucinations will usually occur, with the former often being persecutory and the latter auditory. The patient will speak of complex and far-reaching conspiracies to destroy him and possibly the world, and he will hear voices that are often unrelenting in their criticism of him. All of which leaves him angry and frightened. Accompanying these delusions and hallucinations is an emotional withdrawal, a loss of a sense of connection with others. This affect disorder often entails an emotional flattening, so that the patient shows little emotional response or seems to have little emotional investment in anything. When speaking with schizophrenics, one senses their disconnection from the world the rest of us share.”
“If the withdrawal from reality continues, then the patient’s behavior might become increasingly disorganized or even catatonic. As they become absorbed in their new reality, schizophrenics lose interest in this one. They may stop taking care of basic needs, appearance, and personal hygiene. Even performing the simplest tasks might be beyond them. Their speech can become so disorganized that what they say makes no sense to others. And in the most extreme cases, they may become catatonic and stop moving and talking altogether. We must remember, however, that they do not become so because they are “crazy” or because some chemical in their brain is out of balance but because they are terrified to the point that they believe only complete silence and immobility will protect them.”
What type of impact does schizophrenia have on a person’s life?
“The impact of schizophrenia on a person’s life depends upon the extent and severity of the symptoms. While some schizophrenics I see are highly disorganized in their behavior, and occasionally near catatonic, others are able to function at a fairly high level. They get themselves to appointments, attend school, or engage in activities such as meditation or Tai Chi. None of them, however, hold jobs or live independently of the care of others. Some are cared for by their families or are wards of the state. Not infrequently, I see schizophrenics who have resorted to substance abuse to deal with their issues, which, of course, only aggravates the difficulties they face.”
“All of which is to say that schizophrenia is a debilitating and severely limiting disorder. The withdrawal into a separate world increasingly narrows the life of the schizophrenic, leaving him feeling alone, frightened, and without hope. The task of the psychotherapist is to support and connect with them in a way that restores hope and enables them to find a path back to the reality from which they have fled.”
What type of help is available for someone who has schizophrenia?
“Pharmaceutical companies offer a wide range of psychotropic medications to deal with the symptoms of schizophrenia. For many psychotherapists, these medications are the first line of defense in dealing with the disorder. However, I prefer the use of psychotherapy, which is a way of treating the patient through a relationship rather than through altering the chemicals in the brain. Don’t misunderstand me. Psychotropic medications often work insofar as they can reduce schizophrenic symptoms, but they don’t address the causes of the disorder, and those causes always lie in the quality of the relationships the patient has with others. Psychotherapy addresses that issue.”
“In the worst cases, hospitalization may be required, but when that is not necessary, or financially infeasible, there are a number of outpatient milieus available to schizophrenics, including individual therapy, family therapy, group therapy, behavioral therapy, art and activity therapy, rehabilitation counseling, and special education programs. Contacting a number of psychotherapists and asking them about their approach to treatment is always a good first step in accessing these services, as is contacting a physician or the local mental health services.”
What advice would you like to leave someone who has a relative with schizophrenia?
“Relatives of schizophrenics are the unsung heroes in the treatment of this disorder because they usually bear its full burden. Although they don’t suffer the symptoms, they must live with them every day, and in addition to the heartbreak of watching a love one afflicted with the disorder, they must somehow try to maintain a semblance of normality and order in their own lives. To care for a relative with schizophrenia is often lonely, frustrating, and exhausting. My advice to them is that, as much as possible, get help. Don’t go it alone, if you don’t have to, because there are a lot of services and a lot of professionals willing to give you assistance. Take care of yourself, too. If schizophrenia has taken over the life of a loved one, don’t let it take over yours, as well. Your own psychotherapy might be of great benefit, but at the very least, give yourself time to relax and enjoy life, otherwise you will find yourself emotionally drained and discouraged. There must be care for the caretakers.”
Thank you Larry for doing the interview on schizophrenia. For more information on Larry Langford or his work you can check out his website on www.larrylangfordtherapy.com.
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