New Book: "Overcoming Paranoid and Suspicious Thoughts"
There is a new book out in the UK called Overcoming Paranoid and Suspicious Thoughts that focuses on helping people to overcome paranoid and suspicious thoughts. The book is written by Dr. Daniel Freeman who is a senior lecturer in clinical psychology at King's College in London, England. The book uses one of the most well-proven approaches for handling mental health issues - an approach called cognitive behavioral therapy (CBT).
The book seems like it might be a valuable source of information for parents and young adults in families where there has been a history of paranoid schizophrenia, as well as any other people who are showing early signs of paranoia (including excessive worrying, and suspicions).
For parents in families that have a history of mental illness this book could help in the task of training children to think about life situations in a way that reduces their risk of paranoia and potentially schizophrenia (see here for other books related to this topic). The book might even be of value to people who have been diagnosed with schizophrenia, but who are high-functioning and on medications but who still occasionally have paranoid thoughts.
Interestingly, the book touches upon the issue of how people can "learn to think in a paranoid way" by being around other people who think that way (anxiety, suspicions and worry can be viewed as "paranoia lite") . This touches upon the social "environmental factors" that research suggests play a roll in development of schizophrenia, and that may be one reason why children of parents who have schizophrenia may be much more likely to develop schizophrenia (over and above genetics and biological predisposition factors).
Studies have indicated that when babies are adopted from mothers diagnosed with schizophrenia (that is, children with an increased risk of a biological predisposition towards schizophrenia) and are raised in dysfunctional families they have over a 800% higher risk of developing schizophrenia when compared to the similarly pre-disposed children adopted into more calm and "functional" families - which suggests that the social skills and stress-management skills learned in a positive family environment may be a very important protective agent against mental illness.(Source: British Journal of Psychiatry).
Some of the researchers we've talked to are using similar techniques as outlined in this book in therapy for patients at early schizophrenia diagnosis and treatment facilities - and there are annecdotal reports as well as early research study results that suggest this approach can be effective.
The London Times had this to say about the new book:
In Dr Freeman's new book, Overcoming Paranoid and Suspicious Thoughts, he explains that paranoid thoughts stem from the interaction between stress, emotions and how you respond to information and process it. Lack of sleep and street drugs such as cannabis can also be factors. "Anything that causes you to feel different or anxious is likely to lead you to start to explain things in a suspicious way. But it only becomes a problem when you don't think of alternatives, you seek only evidence consistent with your suspicious thoughts."...
Who is most prone? Dr Freeman believes that both nature and nurture play their part in making people vulnerable to harmful paranoid thoughts. "You could be a worrier, but it can also reflect your experiences: if you have been bullied or mugged you're much more likely to see others as hostile and more likely to interpret future situations in terms of suspicious thoughts. There is an emotional component to paranoid thoughts, or you can learn them from suspicious family members who don't trust people. It can be genetic or environmental, though much more likely an interaction of both."
The key to dealing with paranoid thoughts is to distinguish thought from fact, Freeman says. "It's how you react that will determine whether it interferes with your life. Remember that all sorts of experiences are common, that it's a thought not a fact and you don't have to act on it. Talk to people, try not to get caught up in it, be detached, weigh up the evidence for and against, think of alternative explanations and put the experience into context."
These are the principles of cognitive behaviour therapy, and if you can't deal with paranoid thoughts on your own, Freeman recommends seeing a CBT therapist.
Purchase the book on Amazon UK:
, by Daniel Freeman, Jason Freeman and Philippa Garety, is published on July 6 by Robinson Press, £ 9.99 (approximately $18 US)
Are your suspicious thoughts justified? Ask Yourself These Questions:
Would other people think that my suspicions are realistic?
What would my best friend say?
Have I talked to others about my worries?
Is it possible that I have exaggerated the threat?
Is there any indisputable evidence for my suspicions?
Are my worries based on ambiguous events?
Are my worries based on my feelings rather than on indisputable evidence?
Is it likely that I would be singled out above anyone else?
Is there any evidence that runs contrary to my suspicions?
Is it possible that I'm being at all oversensitive?
Do my suspicions persist despite reassurance from others that they are unfounded?
There are no hard-and-fast rules for deciding whether a worry is realistic. But the probability that your fears are unrealistic increases the more you feel that:
No one else fully shares your suspicions.
There is no indisputable evidence to support your worries.
There is evidence against your suspicions.
It is unlikely that you would be singled out.
Your fears persist despite reassurance from others.
Your fears are based on feelings and ambiguous events.
More Information on CBT and Schizophrenia:
Treatment of Schizophrenia via Cognitive Behavioral Therapy
Review of CBT for psychosis - Harvard University Presentation/video
Posted by szadmin at June 27, 2006 08:39 AM
More Information on
Schizophrenia Books, TV, Movies & Plays
I'm not too sure about this. On raw figures paranoid thoughts may well be as common as depression/anxiety but what percentage actually have a level of paranoia that necessitates
treatment versus percentage of people needing treatment for anxiety or depression?
A certain degree of suspiciousness though technically definable as 'paranoia' is within the range of normal human behaviour .
Also there is some doubt as to whether CBT is as good as it's champions claim.
Posted by: Tim at June 27, 2006 11:24 AM
Tim, as the writer of that article confesses cognitive behavioral therapy has been "crowned by the research literature, cognitive therapy has long reigned supreme".
The simple fact is that there is no other broad-based psychotherapy that has been as proven in long term scientific studies to be as effective in treatment of a range of mental health issues - from Depression to OCD. The fact that one doctor "disagrees" with decades of research isn't suprising - there will never be 100% concensus in any field of academic study. And your referenced paper by a doctor is one person's opinion - and all he says is that in his opinion it may not be AS Effective as the proponents say - but he doesn't say it is not effective.
To disregard a well-proven approach to therapy because one doctor out of the majority has other ideas (or annecdotal evidence to the contrary) would be ill-advised.
As far as your comment: "A certain degree of suspiciousness though technically definable as 'paranoia' is within the range of normal human behaviour" - I don't think I agree. Paranoia - by definition - means suspicions over and above the ordinary level of experience.
If the paranoia starts to impact in a significant negative way the social life, or work life, or interpersonal relationships that a person has then most doctors would say that therapy is a good thing to try.
Will CBT work for everyone - probably not. Will CBT work for schizophrenia - its not entirely proven in my view (but I know some researchers would disagree), but given the long and successful track record of CBT - it seems "likely" that the ideas described in this book would be helpful to a lot of people.
Posted by: szadmin at June 27, 2006 12:06 PM
Tim, as the writer of that article confesses cognitive behavioral therapy has been "crowned by the research literature, cognitive therapy has long reigned supreme".
The simple fact is that there is no other broad-based therapy that has been proven in long term scientific studies to be as effective in treatment of a range of mental health issues - from Depression to OCD. The fact that one doctor "disagrees" with decades of research isn't suprising - there will never be 100% concensus in any field of human endeavor.
To disregard a well-proven approach to therapy because one doctor out of 1,000 has other ideas (or annecdotal evidence to the contrary) would be ill-advised.
I am not advocating that CBT should be totally disregarded . I accept it can prove of benefit to some people but do think as the author of the article suggests that the 'emperor is not as fully clothed' as some people suggest.CBT is no doubt a useful therapy but that does not mean we should be intellectual slaves to a hyperbolic adulation of those benefits.
With regards to the '1 in 1,OOO has other ideas' comment i would venture to suggest that that is a dramatic underestimation of those who doubt that CBT is as effective as the hyperbole claims.
It is not debatable i agree that the majority of psychologists and psychiatrists are strong believers in CBT,but the history of psychiatry should make us cautious as to the veracity of majority viewpoints.
As far as your comment: "A certain degree of suspiciousness though technically definable as 'paranoia' is within the range of normal human behaviour" - I don't think I agree. Paranoia - by definition - means something outside of the ordinary level of experience - see this page: http://en.wikipedia.org/wiki/Paranoia#Explanation
If for argument's sake we accept your premise that paranoia is 'outside of the ordinary level of experience' then it has to be said that a sizeable number of examples given by the author(s) do not meet that criteria.
I think it also depends on whether you take a categorical or dimensional attitude as to where normal suspiciousness ends and overt paranoia starts.
If the paranoia starts to impact in a significant negative way the social life, or work life, or interpersonal relationships that a person has then most doctors would say that therapy is a good thing to try.
I have no problem with that line of thinking . However i do think that the author(s) are guilty of casting too large and simplistic a net when it comes to the amount of people who experience such things in a clinically
significant way.
It is one thing to treat people with symptoms at such a level they impair their ability to function effectively in any or all ways,it is quite another to encourage the treatment of symptoms that are not at such a level.
One of my main reservations about CBT is the way it can be used to invalidate/play down experiences that are by any sensible appraisal unpleasant or traumatic.
It is one thing to help clients to cope more effectively with unpleasant/traumatic/abusive experiences it is quite another to lazily and spuriously pooh hooh the level of distress experienced by the client.
The first is constructive and therapeutic whilst the second is abusive and negative.
Will CBT work for everyone - probably not. Will CBT work for schizophrenia - its not entirely proven in my view (but I know some researchers would disagree), but given the long and successful track record of CBT - it seems "likely" that the ideas described in this book would be helpful to a lot of people.
I think that it will be easier to appraise the benefits of CBT for schizophrenia with the introduction of drugs that better target the cognitive aspects of the disorder.
Posted by: Tim at June 27, 2006 01:55 PM
I seriously doubt that CBT can remove severe paranoia that occurs in acute psychosis. In fact, I would like to see it proven that it has any effect on it at all. Paranoia is a level of suspicion that goes outside the usual experience of 'suspicion'.
Posted by: slc2 at June 28, 2006 01:11 PM
to clarify, i seriously doubt that cbt can remove paranoia in acute unmedicated psychosis. i spend a great deal of time around unmedicated people - i defy anyone to prove that cbt can handle such a situation. the very thing that makes these situations acute is that nothing other than medication affects the paranoia.
Posted by: slc2 at June 28, 2006 01:13 PM
Hi Susan,
I think most researchers would completely agree with you. There is nothing in the above article or book that I can see suggests that CBT would have any positive impact on a person who is actively psychotic and especially unmedicated - so I don't think that is the issue at discussion.
The point the book makes and that we've expanded upon based on similar recent research reports is that it seems, (nobody is saying its "proven"), that the techniques used in this book might be beneficial in the earliest stages of when symptoms of schizophrenia first start (and this is what some early treatment centers are conveying to us) and also for people who have a relatively mild and well controlled case of schizophrenia. Research remains to confirm this however.
B.
Posted by: szadmin at June 28, 2006 01:44 PM
this is a physical disease process. there is no proof that there is any effective prevention or any way, other than medication, to mitigate the symptoms or the course of the disease. i think that people who are treated more rationally and kindly when they first become ill will do better, but i do not feel that anyone can expect a person with schizophrenia to control their symptoms by 'will power' or by responding to cbt. this disease is a biological process.
slc
Posted by: slc at June 28, 2006 03:53 PM
Susan,
Let me explain by way of analogy. Diabetes and Obesity are "physical disease processes" - are you suggesting that families can do nothing to to prevent children from becoming fat if they have the genes that predispose them to obesity and diabetes?? Do you think that the genes of immigrants from Europe and Asia, etc. changed suddenly when these people moved to the US and started eating high-fat, high sugar meals and stopped exercising as much and become overweight (as 60% of people in the USA are)?
Do you think that the prevention or treatment of prevention of diseases/disorders cannot be achieved by anything other than drugs?
Surely, you can see that there are family actions that parents can take (for example playing outside, participating in sports, avoiding high calorie, low nutrition foods) would likely have a large impact on the rate of diabetes and and obesity.
Now - lets talk about schizophrenia. Schizophrenia is a disorder of the mind / brain. There are many (perhaps a majority of) psychologists and psychiatrists in European countries who practice Cognitive Behavioral Therapy with what they claim are positive results in treating some aspects of schizophrenia - and they have credible research to back them up, done at top European universities.
In fact Harvard University practices CBT for schizophrenia (as do about 7 other advanced academic centers in the USA) and has an online video of a presentation on their approach - perhaps you might want to learn about something you seem to know little about:
http://www.schizophrenia.com/sznews/archives/002705.html
You say that "there is no proof that there is any effective prevention or any way, other than medication, to mitigate the symptoms or the course of the disease" - but there are hundreds of schizophrenia researchers at many of the top universities in the world who disagree with you and have published research that contradicts what you say. What will it take for you to start considering these experts opinions?
We try to cover any and all therapies that have credible research from reputable sources. I'm sorry if you disagree with that approach.
B.
Posted by: Sz Administrator at June 28, 2006 04:38 PM
I don't disagree with that approach, but that isn't what is happening here.
slc
Posted by: slc2 at June 29, 2006 07:17 AM
by the way, yiou are accusing me of believing a lot of things i don't believe. however, the ideas of prevention need to be based on knowledge of cause, and the flaw is that 'risk factors' do not equal cause, and 'environment' doesn't mean anything close to the meaning you give it, and there are studies out there that show other pov's that are not represented here. i would prefer you offered a broader selection of the current research, and i would also prefer that if someone disagrees with you about prevention and treatment through cbt and other similar methods, that instead of criticizing and insulting that person, you would allow for that pov here.
slc
Posted by: slc at June 29, 2006 07:21 AM
Susan,
What do you think 'environment' means? It would be interesting to know seeing as how you refute sz admin's interpretation of the word.
I would also be interested to know why you so strongly refute the environmental factor when an increasing body of learned researchers have shown that schizophrenia can not be explained by genetics alone.
Torrey in a review of twin studies estimated the pairwise concordance rate for monozygotic twins to be 28% and for fraternal twins to be 6%.
These figures point very strongly to the fact that genetic factors alone do not influence the development of schizophrenia.
Posted by: Tim at June 29, 2006 09:07 AM
Susan,
My view of the causes of schizophrenia are in direct alignment with the National Institutes of Mental Health - who say on their web site "As is the case for many other illnesses, schizophrenia is believed to result from a combination of environmental and genetic factors."
Basically "Genes" are genes, and "environment" is everything else - from womb environment, exposure to toxins, infections (in utero, and after birth), stress (including percieved danger, anxiety), social environment and isolation, nutrition, street drugs, ... - basically everything other than genes. This is the standard definition of "environment" for all the researchers I've ever talked to. It is perhaps broader than the "layman's" definition of environment - but thats how scientists define it.
I'd be very interested in understanding your definition of "environment" - I suspect its much narrower, which is how I used to view it until I started talking to the researchers.
As far as covering broader points of view - we look at the new papers that come out every day and no matter what the view point we cover it if we think it isn't too technical for the audience. All we care about here is moving public understanding forward based on good science - we don't care about the specific POV.
As far as your comment that "risk factors" don't equal causes - you're absolutely correct of course. We don't say that they do.
At the same time - if you avoid the risk factors that you can - most of the researchers we've talked to say that you're probably better off than if you don't.
Time will tell whether any specific risk factor is truly a causal factor - but given the high correlation of many of the risk factors at this stage in the game, avoiding risk factors is not an entirely foolish approach (just as it was known that smoking cigarettes was associated with cancer for many decades before they were "proven" to cause cancer). We try to present all the data as best we can - its up to the individual to make their own decisions.
What I find strange is that you have such a "genes only" approach to schizophrenia - when all the leading research organizations (NIMH, NARSAD, Stanley Medical Research Foundation) all say very clearly that the schizophrenia is like all other disorders - a result of genetic and environmental factors. There really is no disagreement about this in the research community.
B.
Posted by: szadmin at June 29, 2006 09:15 AM
'environment' is very often taken to mean family and early experiences. 'environment' actually means the fetal environment, genes, biochemistry, interactions of viruses and genes, and a large, large number of other things - many of which we probably aren't even aware of yet.
my pov is also directly in line with - most of the nimh's pov. however i have a very different view of research, mostly because i do not try to draw more conclusions from the research than is warranted, and because i read a very,very wide range of studies, many of which contradict eachother.
for example, your concordance study of twins. keep in mind there are other studies which get very different results. up to a factor of 2 times different, and the results are used to back completely different theories. again, the results of a study depend largely on the design of the study. you treat these studies as if these results are etched in stone and are unchanging and unchallengable and prove only one thing. that is just not the case. none of these studies conclusively prove anything, and writers like gottesman have gone out and disproven every currently believed theory about schiz any time they want to.
keep in mind, the nimh is not coming out and saying that you can prevent schiz, nor is it endorsing any products being sold with claims to do so, nor do they say that the cause is environmental, only that it is at this point, going along with a multifactoral model, a model which is always followed any time the heredity patterns of a disease follow a specific pattern - the model STILL does not prove a cause, and without a cause you do not have prevention. please, please look up the definition of 'risk factor', it has nothing to do with cause.
plus, a model is a model, not reality, and every single multifactorial model historically has fallen by the wayside. so will this one.
Posted by: slc2 at June 29, 2006 02:40 PM
aside from that, when did you decide i am so 'genes only' or that i don't think that different things could possibly contribute to this illness? again, you are accusing me of believing things i simply don't believe. instead of insulting me and criticizing me, why don't you ASK me what i think instead of TELLING me what i think? to say that yiou disagree with me because you're 'on the side that wants to see less schiz in the world' - that is easily the most insulting and vicious thing anyone has said to me in quite a long time, as if by my stance, i want to see more people suffer - what a vicious thing to say to someone. we aren't going to have a decent, mutual dialogue til you knock off that kind of nastiness.
slc
Posted by: slc2 at June 29, 2006 02:46 PM
'environment' is very often taken to mean family and early experiences. 'environment' actually means the fetal environment, genes, biochemistry, interactions of viruses and genes, and a large, large number of other things - many of which we probably aren't even aware of yet.'
Susan, the answer you just gave as to what 'environment' means when researchers talk about 'environmental factors' is so way off the mark as to be quite frankly
ludicrous.
[edited to remove personal comment]
Posted by: Tim at June 29, 2006 03:29 PM
tim, when you post something i don't agree with, i don't call it 'ludicrous'. suffice to say, 'environment' means very different things to different people and 'environment' to a biochemical researcher, for example my sister, means something very different. she said that the way the word 'environmental factors' and 'environment' is used in common speech and in popular discussions is very, very different from how she and her colleagues use the word.
slc
Posted by: slc2 at June 30, 2006 08:12 AM
Susan,
Researchers and publishers of research articles when talking about 'environmental factors' and how they affect mental illness use the meaning as defined in any reputable dictionary.
There is no getting over that fact.
Posted by: Tim at June 30, 2006 01:36 PM
Just for an example, I am a high functioning schizophrenic, and have used cbt for as long as I've been diagnosed. I could say that it has helped understand the situation where the thought arises better, but the overall paranoid thought never goes away. In my mind it simply drops the probability of the idea being true. In most circumstances, the paranoid view is the first realization I have, I just talk myself into working with the view as if it doesn't exist.
Posted by: Ernie at July 7, 2006 08:19 AM
Time will tell whether any specific risk factor is truly a causal factor - but given the high correlation of many of the risk factors at this stage in the game, avoiding risk factors is not an entirely foolish approach (just as it was known that smoking cigarettes was associated with cancer for many decades before they were "proven" to cause cancer). We try to present all the data as best we can - its up to the individual to make their own decisions.
Posted by: at November 23, 2006 02:08 AM
Schizophrenia is embarassing!
Posted by: ZyprexaCop at May 30, 2008 08:39 PM
I'm not too sure about this. On raw figures paranoid thoughts may well be as common as depression/anxiety but what percentage actually have a level of paranoia that necessitates
treatment versus percentage of people needing treatment for anxiety or depression?
A certain degree of suspiciousness though technically definable as 'paranoia' is within the range of normal human behaviour .
Also there is some doubt as to whether CBT is as good as it's champions claim.
Posted by: Tim at June 27, 2006 11:24 AM
Tim, as the writer of that article confesses cognitive behavioral therapy has been "crowned by the research literature, cognitive therapy has long reigned supreme".
The simple fact is that there is no other broad-based psychotherapy that has been as proven in long term scientific studies to be as effective in treatment of a range of mental health issues - from Depression to OCD. The fact that one doctor "disagrees" with decades of research isn't suprising - there will never be 100% concensus in any field of academic study. And your referenced paper by a doctor is one person's opinion - and all he says is that in his opinion it may not be AS Effective as the proponents say - but he doesn't say it is not effective.
To disregard a well-proven approach to therapy because one doctor out of the majority has other ideas (or annecdotal evidence to the contrary) would be ill-advised.
As far as your comment: "A certain degree of suspiciousness though technically definable as 'paranoia' is within the range of normal human behaviour" - I don't think I agree. Paranoia - by definition - means suspicions over and above the ordinary level of experience.
If the paranoia starts to impact in a significant negative way the social life, or work life, or interpersonal relationships that a person has then most doctors would say that therapy is a good thing to try.
Will CBT work for everyone - probably not. Will CBT work for schizophrenia - its not entirely proven in my view (but I know some researchers would disagree), but given the long and successful track record of CBT - it seems "likely" that the ideas described in this book would be helpful to a lot of people.
Posted by: szadmin at June 27, 2006 12:06 PM
Tim, as the writer of that article confesses cognitive behavioral therapy has been "crowned by the research literature, cognitive therapy has long reigned supreme".
The simple fact is that there is no other broad-based therapy that has been proven in long term scientific studies to be as effective in treatment of a range of mental health issues - from Depression to OCD. The fact that one doctor "disagrees" with decades of research isn't suprising - there will never be 100% concensus in any field of human endeavor.
To disregard a well-proven approach to therapy because one doctor out of 1,000 has other ideas (or annecdotal evidence to the contrary) would be ill-advised.
I am not advocating that CBT should be totally disregarded . I accept it can prove of benefit to some people but do think as the author of the article suggests that the 'emperor is not as fully clothed' as some people suggest.CBT is no doubt a useful therapy but that does not mean we should be intellectual slaves to a hyperbolic adulation of those benefits.
With regards to the '1 in 1,OOO has other ideas' comment i would venture to suggest that that is a dramatic underestimation of those who doubt that CBT is as effective as the hyperbole claims.
It is not debatable i agree that the majority of psychologists and psychiatrists are strong believers in CBT,but the history of psychiatry should make us cautious as to the veracity of majority viewpoints.
As far as your comment: "A certain degree of suspiciousness though technically definable as 'paranoia' is within the range of normal human behaviour" - I don't think I agree. Paranoia - by definition - means something outside of the ordinary level of experience - see this page: http://en.wikipedia.org/wiki/Paranoia#Explanation
If for argument's sake we accept your premise that paranoia is 'outside of the ordinary level of experience' then it has to be said that a sizeable number of examples given by the author(s) do not meet that criteria.
I think it also depends on whether you take a categorical or dimensional attitude as to where normal suspiciousness ends and overt paranoia starts.
If the paranoia starts to impact in a significant negative way the social life, or work life, or interpersonal relationships that a person has then most doctors would say that therapy is a good thing to try.
I have no problem with that line of thinking . However i do think that the author(s) are guilty of casting too large and simplistic a net when it comes to the amount of people who experience such things in a clinically
significant way.
It is one thing to treat people with symptoms at such a level they impair their ability to function effectively in any or all ways,it is quite another to encourage the treatment of symptoms that are not at such a level.
One of my main reservations about CBT is the way it can be used to invalidate/play down experiences that are by any sensible appraisal unpleasant or traumatic.
It is one thing to help clients to cope more effectively with unpleasant/traumatic/abusive experiences it is quite another to lazily and spuriously pooh hooh the level of distress experienced by the client.
The first is constructive and therapeutic whilst the second is abusive and negative.
Will CBT work for everyone - probably not. Will CBT work for schizophrenia - its not entirely proven in my view (but I know some researchers would disagree), but given the long and successful track record of CBT - it seems "likely" that the ideas described in this book would be helpful to a lot of people.
I think that it will be easier to appraise the benefits of CBT for schizophrenia with the introduction of drugs that better target the cognitive aspects of the disorder.
Posted by: Tim at June 27, 2006 01:55 PM
I seriously doubt that CBT can remove severe paranoia that occurs in acute psychosis. In fact, I would like to see it proven that it has any effect on it at all. Paranoia is a level of suspicion that goes outside the usual experience of 'suspicion'.
Posted by: slc2 at June 28, 2006 01:11 PM
to clarify, i seriously doubt that cbt can remove paranoia in acute unmedicated psychosis. i spend a great deal of time around unmedicated people - i defy anyone to prove that cbt can handle such a situation. the very thing that makes these situations acute is that nothing other than medication affects the paranoia.
Posted by: slc2 at June 28, 2006 01:13 PM
Hi Susan,
I think most researchers would completely agree with you. There is nothing in the above article or book that I can see suggests that CBT would have any positive impact on a person who is actively psychotic and especially unmedicated - so I don't think that is the issue at discussion.
The point the book makes and that we've expanded upon based on similar recent research reports is that it seems, (nobody is saying its "proven"), that the techniques used in this book might be beneficial in the earliest stages of when symptoms of schizophrenia first start (and this is what some early treatment centers are conveying to us) and also for people who have a relatively mild and well controlled case of schizophrenia. Research remains to confirm this however.
B.
Posted by: szadmin at June 28, 2006 01:44 PM
this is a physical disease process. there is no proof that there is any effective prevention or any way, other than medication, to mitigate the symptoms or the course of the disease. i think that people who are treated more rationally and kindly when they first become ill will do better, but i do not feel that anyone can expect a person with schizophrenia to control their symptoms by 'will power' or by responding to cbt. this disease is a biological process.
slc
Posted by: slc at June 28, 2006 03:53 PM
Susan,
Let me explain by way of analogy. Diabetes and Obesity are "physical disease processes" - are you suggesting that families can do nothing to to prevent children from becoming fat if they have the genes that predispose them to obesity and diabetes?? Do you think that the genes of immigrants from Europe and Asia, etc. changed suddenly when these people moved to the US and started eating high-fat, high sugar meals and stopped exercising as much and become overweight (as 60% of people in the USA are)?
Do you think that the prevention or treatment of prevention of diseases/disorders cannot be achieved by anything other than drugs?
Surely, you can see that there are family actions that parents can take (for example playing outside, participating in sports, avoiding high calorie, low nutrition foods) would likely have a large impact on the rate of diabetes and and obesity.
Now - lets talk about schizophrenia. Schizophrenia is a disorder of the mind / brain. There are many (perhaps a majority of) psychologists and psychiatrists in European countries who practice Cognitive Behavioral Therapy with what they claim are positive results in treating some aspects of schizophrenia - and they have credible research to back them up, done at top European universities.
In fact Harvard University practices CBT for schizophrenia (as do about 7 other advanced academic centers in the USA) and has an online video of a presentation on their approach - perhaps you might want to learn about something you seem to know little about:
http://www.schizophrenia.com/sznews/archives/002705.html
You say that "there is no proof that there is any effective prevention or any way, other than medication, to mitigate the symptoms or the course of the disease" - but there are hundreds of schizophrenia researchers at many of the top universities in the world who disagree with you and have published research that contradicts what you say. What will it take for you to start considering these experts opinions?
We try to cover any and all therapies that have credible research from reputable sources. I'm sorry if you disagree with that approach.
B.
Posted by: Sz Administrator at June 28, 2006 04:38 PM
I don't disagree with that approach, but that isn't what is happening here.
slc
Posted by: slc2 at June 29, 2006 07:17 AM
by the way, yiou are accusing me of believing a lot of things i don't believe. however, the ideas of prevention need to be based on knowledge of cause, and the flaw is that 'risk factors' do not equal cause, and 'environment' doesn't mean anything close to the meaning you give it, and there are studies out there that show other pov's that are not represented here. i would prefer you offered a broader selection of the current research, and i would also prefer that if someone disagrees with you about prevention and treatment through cbt and other similar methods, that instead of criticizing and insulting that person, you would allow for that pov here.
slc
Posted by: slc at June 29, 2006 07:21 AM
Susan,
What do you think 'environment' means? It would be interesting to know seeing as how you refute sz admin's interpretation of the word.
I would also be interested to know why you so strongly refute the environmental factor when an increasing body of learned researchers have shown that schizophrenia can not be explained by genetics alone.
Torrey in a review of twin studies estimated the pairwise concordance rate for monozygotic twins to be 28% and for fraternal twins to be 6%.
These figures point very strongly to the fact that genetic factors alone do not influence the development of schizophrenia.
Posted by: Tim at June 29, 2006 09:07 AM
Susan,
My view of the causes of schizophrenia are in direct alignment with the National Institutes of Mental Health - who say on their web site "As is the case for many other illnesses, schizophrenia is believed to result from a combination of environmental and genetic factors."
Basically "Genes" are genes, and "environment" is everything else - from womb environment, exposure to toxins, infections (in utero, and after birth), stress (including percieved danger, anxiety), social environment and isolation, nutrition, street drugs, ... - basically everything other than genes. This is the standard definition of "environment" for all the researchers I've ever talked to. It is perhaps broader than the "layman's" definition of environment - but thats how scientists define it.
I'd be very interested in understanding your definition of "environment" - I suspect its much narrower, which is how I used to view it until I started talking to the researchers.
As far as covering broader points of view - we look at the new papers that come out every day and no matter what the view point we cover it if we think it isn't too technical for the audience. All we care about here is moving public understanding forward based on good science - we don't care about the specific POV.
As far as your comment that "risk factors" don't equal causes - you're absolutely correct of course. We don't say that they do.
At the same time - if you avoid the risk factors that you can - most of the researchers we've talked to say that you're probably better off than if you don't.
Time will tell whether any specific risk factor is truly a causal factor - but given the high correlation of many of the risk factors at this stage in the game, avoiding risk factors is not an entirely foolish approach (just as it was known that smoking cigarettes was associated with cancer for many decades before they were "proven" to cause cancer). We try to present all the data as best we can - its up to the individual to make their own decisions.
What I find strange is that you have such a "genes only" approach to schizophrenia - when all the leading research organizations (NIMH, NARSAD, Stanley Medical Research Foundation) all say very clearly that the schizophrenia is like all other disorders - a result of genetic and environmental factors. There really is no disagreement about this in the research community.
B.
Posted by: szadmin at June 29, 2006 09:15 AM
'environment' is very often taken to mean family and early experiences. 'environment' actually means the fetal environment, genes, biochemistry, interactions of viruses and genes, and a large, large number of other things - many of which we probably aren't even aware of yet.
my pov is also directly in line with - most of the nimh's pov. however i have a very different view of research, mostly because i do not try to draw more conclusions from the research than is warranted, and because i read a very,very wide range of studies, many of which contradict eachother.
for example, your concordance study of twins. keep in mind there are other studies which get very different results. up to a factor of 2 times different, and the results are used to back completely different theories. again, the results of a study depend largely on the design of the study. you treat these studies as if these results are etched in stone and are unchanging and unchallengable and prove only one thing. that is just not the case. none of these studies conclusively prove anything, and writers like gottesman have gone out and disproven every currently believed theory about schiz any time they want to.
keep in mind, the nimh is not coming out and saying that you can prevent schiz, nor is it endorsing any products being sold with claims to do so, nor do they say that the cause is environmental, only that it is at this point, going along with a multifactoral model, a model which is always followed any time the heredity patterns of a disease follow a specific pattern - the model STILL does not prove a cause, and without a cause you do not have prevention. please, please look up the definition of 'risk factor', it has nothing to do with cause.
plus, a model is a model, not reality, and every single multifactorial model historically has fallen by the wayside. so will this one.
Posted by: slc2 at June 29, 2006 02:40 PM
aside from that, when did you decide i am so 'genes only' or that i don't think that different things could possibly contribute to this illness? again, you are accusing me of believing things i simply don't believe. instead of insulting me and criticizing me, why don't you ASK me what i think instead of TELLING me what i think? to say that yiou disagree with me because you're 'on the side that wants to see less schiz in the world' - that is easily the most insulting and vicious thing anyone has said to me in quite a long time, as if by my stance, i want to see more people suffer - what a vicious thing to say to someone. we aren't going to have a decent, mutual dialogue til you knock off that kind of nastiness.
slc
Posted by: slc2 at June 29, 2006 02:46 PM
'environment' is very often taken to mean family and early experiences. 'environment' actually means the fetal environment, genes, biochemistry, interactions of viruses and genes, and a large, large number of other things - many of which we probably aren't even aware of yet.'
Susan, the answer you just gave as to what 'environment' means when researchers talk about 'environmental factors' is so way off the mark as to be quite frankly
ludicrous.
[edited to remove personal comment]
Posted by: Tim at June 29, 2006 03:29 PM
tim, when you post something i don't agree with, i don't call it 'ludicrous'. suffice to say, 'environment' means very different things to different people and 'environment' to a biochemical researcher, for example my sister, means something very different. she said that the way the word 'environmental factors' and 'environment' is used in common speech and in popular discussions is very, very different from how she and her colleagues use the word.
slc
Posted by: slc2 at June 30, 2006 08:12 AM
Susan,
Researchers and publishers of research articles when talking about 'environmental factors' and how they affect mental illness use the meaning as defined in any reputable dictionary.
There is no getting over that fact.
Posted by: Tim at June 30, 2006 01:36 PM
Just for an example, I am a high functioning schizophrenic, and have used cbt for as long as I've been diagnosed. I could say that it has helped understand the situation where the thought arises better, but the overall paranoid thought never goes away. In my mind it simply drops the probability of the idea being true. In most circumstances, the paranoid view is the first realization I have, I just talk myself into working with the view as if it doesn't exist.
Posted by: Ernie at July 7, 2006 08:19 AM
Time will tell whether any specific risk factor is truly a causal factor - but given the high correlation of many of the risk factors at this stage in the game, avoiding risk factors is not an entirely foolish approach (just as it was known that smoking cigarettes was associated with cancer for many decades before they were "proven" to cause cancer). We try to present all the data as best we can - its up to the individual to make their own decisions.
Posted by: at November 23, 2006 02:08 AM
Schizophrenia is embarassing!
Posted by: ZyprexaCop at May 30, 2008 08:39 PM