I read an interesting article by the same name, "Trauma and Schizophrenia" (Karon 2007). In it Karon states,
"Schizophrenia is a chronic terror syndrome. In World War II there were battlefield traums that always produced classic schizophrenic symptoms. However, if the patients were healthy before the trauma, they spontaneously recovered. The myth of the incurability of schizophrenia led to the belief that these individuals could not be schizophrenic if they recovered. But all schizophrenics are the victims of lives filled with trauma, sometimes subtle but usually obvious. Professionals have tried not to listen. But if one investigates, most of the bad things patients talk about or symbolize in their symtpoms are not delusional, but real traumas. It helps to face the truth."
Karon goes to state, "every soldier who underwent a particular battefield experience developed schizophrenic symptoms."
The soldier was under fire. He was in danger of being killed. He dug a foxhole under fire as quickly as he could, one just barely big enough to get into. He crawled into it and stayed there. He did not eat or drink. He urinated and defecated on himself because there was no other place to urinate or defecate without being killed. If the situation lasted for several days, every single soldier appeared classically schizophrenic when the shooting stopped, and his buddies came up to him.
These soldiers exhibited typical symptoms of schizophrenia including; thought disorder (inability to think logically and clearly), autism (inability to relate to people), inappropriate or no affect (the experience of feelings or emotions, moods), hallucinations (experiencing things which are not actually there), delusions (believing things which are not true) and catatonic symptoms (extreme loss of motor skills).
Because the soldiers recovered they were said that have Schizophreniform Psychosis instead of Schizophrenia because it was believed that Schizophrenia was incurable. However, Karon maintains that these soldiers are just one example of patients who experience extreme traumas and develop schizophrenic symptoms as a result. He defines Schizophrenia as a "chronic terror syndrome" and explains:
"Human beings are intended to be terrified for minutes, possibly for hours, so that emergencies can be dealt with. We are not intended to be terrified for days, weeks, or months. The only physiological findings with respect to persons with schizophrenia that can be replicated are those which are components of terror in non-schizophrenic individuals, or which are side effects of medications. The medications, which are helpful in the short run, are all medications which dampen down affect, including terror."
Karon posits that all symptoms of schizophrenia are "manifestations of terror (e.g. not being able to think clearly, not being comfortable with people), defenses against terror (e.g. avoiding people, obsessive symptoms), or symbolic acts." He adds that the catatonic stupor seen in schizophrenic patients mimics the strategy of playing dead that animals employ when attacked by a predator. This is beautifully described in Peter Levine's book, Waking the Tiger. When an impala being chased by a tiger can no longer run for its life, it will throw itself on the ground and play dead. A predator will not eat meat it has not killed because it might be dead for disease. In this death-like state, the impala is cognitively aware of what is happening, but the body is paralyzed. It does not respond to biting or clawing by the tiger.
Karon cites research by Ciompi in Swirzerland which found that "the 'disease' of schizophrenia does not seem to follow the course of a physiological disease, but rather the order of the social crises in a human being's life experiences." Karon reports that when long-term studies are done, "no improvement has been shown in long-term outcome, with the introduction of modern medication". He cites Harding's study which found that
"50% of schizophrenic patients stop taking their medication against medical advice, and the 30% who fully recovered in the long run were from that 'non-compliant'* 50%. No patient who continued to take their medication indefinitely as required by their psychiatrists had a fully recovery, suggesting either that the healthier patient felt freer to stop against medical advice or that the medications, helpful in the short run, interfere with full recovery."
This is indicative of a human suffering from grief or trauma, not a biological problem. A biological problem should respond to a biological intervention (medication). The medications used to treat Schizophrenia have serious side effects, most of which are very uncomfortable. They are heavy duty tranquilizers which usually damp down all emotions (even happiness) and often leave the patient in an emotional and cognitive straight jacket. This is why many patients choose to discontinue them. The side effects are unpleasant, unless you are so traumatized you temporarily need to be tranquilized in order to collect yourself.
In working with patients with schizophrenia over the past 15 years I too have heard the trauma stories Karon describes and his description of how the medical community deals with those told traumas is entirely accurate.
"These straumas have often been explained away either as delusional (i.e., as if the trauma never occurred), or as being the result of the illness (i.e., as if the patient arranges to be traumatized). Early in my career, when schizophrenic patients described traumatic events, particularly child abuse, I tended to consider them delusional until the evidence forced me to teh conclusion that almost always the traumatic events had really occurred. In those few instances where the traumatic events are not real, they always represenst a real problem that is distorted either in its recall or its description."
The medical community in general seems to be guilty of making Freud's mistake. Freud discovered that the "hysteria" from which many of his female patients suffered was induced by molestation and incest during childhood. However, he began seeing so much of it he could not believe it. He also felt the wrath of accused fathers. As a result, Freud eventually recanted his belief that hysteria was a reaction to sexual abuse and stated he believed it to be a "fantasy" that the father would seduce the daughter rather than an actualilty. This position remained until the rise of the feminist movement in the 1970's and the reawakening in awareness of childhood sexual abuse.
Karon then provides several examples of cases in which psychosis was decreased or eliminated by addressing the trauma(s) and the emotions behind them. An interesting article indeed which provides another explanation for Schizophrenia which bears consideration.
*I've always hated the word "non-compliant" when used for patients who discontinue their medications. Patients are expected to blindly heed the doctor's "orders" while not being allowed any input. If the treatment fails, it is blamed on the patient's refusal to comply, rather than the doctor's misdiagnosis or inappropriate treatment.
Karon, B. P. (2007). Trauma and schizophrenia. Journal of Psychological Trauma, 6(2/3), 127-144.