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The Predictable Signs And Symptoms
Alterations of the senses
These changes range from enhancement in the early stages of schizophrenic breakdown to a blunting of sensations in the later stages, e.g., pain. The patient may experience flooding of the mind by sensory stimuli or thoughts. Some patients develop excessive religious preoccupation and have "peak experiences."
Inability to synthesize and to respond
- also known as "thought disorder"
The patient's difficulty in synthesizing visual and auditory stimuli results in inappropriate responses which hamper interpersonal relations. The altered synthesis produces thought patterns characterized by impaired logic, loose associations, blocking, ambivalence in responses and actions, neologisms, and "word salad."
Altered sense of self
Due to the inability to synthesize and to sort visual and tactile stimuli, which enable us to differentiate our bodies from the external world of objects and persons, the schizophrenic person experiences distortions and confusion regarding the boundaries between his/her self and other people or things. Body parts may be experienced as dissociated or detached, with lives of their own. Or the person may be confused about his/her sexual characteristics.
As an outgrowth of body boundary distortions, sensory overacuteness, faulty synthesis of incoming stimuli and inappropriate responses, the schizophrenic person experiences:
Delusions
These are basically false ideas which the patient believes to be true, but which cannot be or are not validated by members of his/her culture and to which he adheres in the face of reason. Delusions are also the product of a person's culture, experienced as a logical and coherent pattern, and can only be evaluated in this context. Two common kinds are:
paranoid delusions, characterized by a belief that one is being watched, followed, controlled, persecuted, attacked (when frightening enough, they may precipitate an attack in self- defense) and
grandiose delusions, centered on the belief that one is an exalted figure, often political or religious, and that the patient can exert mind control over others.Hallucinations
Hallucinations can be auditory (the most common kind), visual, or auditory-visual combined. They may originate in a stimulus, but are a gross distortion of sensory overacuteness - even to the point of representing something that is not there or was not said.
Changes in emotions
The earliest changes are fluctuations and exaggerations in feelings. Guilt and fear often predominate. The emotions expressed may be inappropriate, laughter at death, crying over a joke, or they may be flattened, thus impairing empathy with another or others. The physical result is apathy, slowness in movement, lack of drive, often thought to be drug effects, but in actuality a product of the disease itself. Mentally, the person may exhibit poverty of thought and speech; emotionally, he becomes detached from objects and people.
Changes in behavior
- secondary signs
Withdrawal is one of the major changes. It is a defensive maneuver to slow down sensory inputs and allow time to integrate them or to avoid the horror of other symptoms. Behavior becomes ritualistic, with posturing, gesturing, parroting what others say. Repetitious movements may develop - tics, tremors, tongue movements, and sucking. These movements are, in some cases, side effects of antipsychotic medications. However, they were also observed before such medications were available and, in some cases, were caused by the disease itself.The apparent "craziness" in everything a schizophrenic person sees and does has its roots in the disordered brain function that produces erroneous sensory data and disordered thinking. Given the disordered brain function as a starting point, many schizophrenic persons are heroic in their attempts to keep a mental equilibrium. And the proper response of those who care about the unfortunate persons with this disease is patience and understanding.
What Schizophrenia Is
A medical model definition
"Schizophrenia is a brain disease, now definitely known to be such. It is a real scientific and biological entity as clearly as diabetes, multiple sclerosis, and cancer are scientific and biological entities. It exhibits symptoms of brain disease, symptoms which include impairment in thinking, delusions, hallucinations, changes in emotions, and changes in behavior. And, like cancer, it probably has more than one cause. Thus, though we speak of schizophrenia and cancer in the singular, we really understand them as being in the plural; there are probably several kinds of schizophrenia of the brain just as there are several different kinds of cancer of the brain." (pg.2)
Early warning signs
Thought patterns became illogical.
The sense of body boundaries deteriorates.
The person experiences auditory hallucinations.
Emotions become grossly inappropriate or flattened.
The person feels that his/her thoughts are controlled by others, are not his own at all, or that he can control the thoughts of others.
Michael Siglag administered the Hood and Morris questionnaire to seventy-five schizophrenic adult inpatients. He describes the research in "Schizophrenic and Mystical Experiences: Similarities and Differences" (Siglag, 1987). Participants were chosen from a cross- section of socioeconomic status, ethnic groups and religious orientations (p.2). Among their initial hypothesis was a prediction that one-third of the questioned schizophrenics would respond positively to having had a mystical experience; in addition, those who respond positively will score equal to or greater than "schizophrenic subjects who do not claim mystical experience, on the questionnaire's factors measure experience of unity, affect, time/space distortion, and noesis.
Siglag tells us that 52% of the schizophrenic respondents reported having a mystical experience, "supporting the idea that the schizophrenic population perceive themselves as having mystical experience at least as often as individuals in nonschizophrenic populations" (p.4). In addition they scored significantly above those schizophrenic that did not report a mystical experience as hypothesized. Data analysis lead Siglag to the following conclusions:
"Schizophrenic individuals who claim to have had a mystical experience are similar to other schizophrenic individuals in that they:
1. do not feel any greater control over their experiences than other schizophrenics;
2. do not experience a greater since of coping ability than other schizophrenics;
3. do not experience any more improvement in their relationships than other schizophrenics;
4. experience terror, fear, depression, and a sense of insecurity.
Schizophrenic individuals who claim to have had a mystical experience differ from other schizophrenic individuals in that they:
1. are more likely to have experienced a sense of unity, oneness, or connectedness in the world;
2. report more of a range of affective experiences, and are more likely to have experienced joyful, peaceful states of consciousness;
3. are more likely to report time-space distortions;
4. experience more of a sense of sacredness or holiness;
5. are more likely to see their experiences as valid and meaningful than other schizophrenics" (pp.10- 11).
Siglag explains the implications of such findings; if it could be determined which patients were involved in the mystical process as well as the psychosis, therapy could be directed at integration of the "knowledge" acquired - utilizing the growth-potential of the mystical experience.