Literature Review Of Serious Mental Disorders

The vast majority of findings in the published literature, apart from the studies of early trauma and early development, are either descriptive, or relate to predisposition, or measure what I  believe are the biological results of the disease process. While description, predisposition and biological change pertain to the disease process, they are not proven causative, and exploration has not led to significant prevention. In contrast, the early traumata identified and demonstrated in this text have exceedingly high correlations with disease processes that can surface 20 to 30 years later, and these early traumata can be identified and eliminated or attenuated, making prevention possible.Nonetheless, I review briefly some of the literature pertaining to serious mental disorders

DESCRIPTIVE PSYCHIATRY:

Over the last century a number of descriptive scientists played an important role in the identification, description and categorization of serious mental disorders. Their work drew interest to the field and provided a framework for future study. Aside from its historical value, their work continues in the form of DSM IV, which is an elaboration and extension of the same efforts to categorize mental illness in a way that facilitates study, research, treatment and prevention.

Noteworthy descriptive scientists of the past include Emil Kraepelin, Eugene Bleuler, Gabriel Langfeld and Kurt Schneider. Emil Kraepelin (1856-1926), a German psychiatrist, categorized seriously disturbed individuals into three main groups: dementia praecox [schizophrenia], manic depressive psychosis, and paranoia. His main contribution to the field was his careful description and categorization of serious mental disorders.

Eugene Bleuler (1857-1939), a Swiss psychiatrist, coined the word schizophrenia, and provided the four "A"s of schizophrenia: Associations (looseness of), Autism, Affective disturbance, and Ambivalence. Gabriel Langfeld described schizophreniform psychosis, and Kurt Schneider gave us first rank and second rank Schneiderian symptoms.

From Kraepelin through DSM IV, classification has been largely descriptive. I believe this is because little has been understood about cause. This leaves the process of categorization in its infancy. We find it more helpful to know the age of origin of a disorder than to know that the disorder meets a certain set of diagnostic criteria, and we think that future studies likely will confirm our impression that medications and regions of brain activity are specific to age of origin-not to current diagnostic criteria.

PSYCHOLOGICAL CAUSATION:

Causation has been addressed in many ways, including psychological attempts at explanation. Sigmund Freud came the closest to the theories presented in my work when he described ego disintegration and regression as a return to a state of primary narcissism. The idea of a return to a time when the ego was not yet developed matches closely my findings. I have developed the concepts further, however, describing original trauma, precipitating trauma, the return to a specific time, age and brain site, and adding the connection between psychological mechanism and biological change.

The psychological explanation of regression, attributing it to a return to an earlier time "because" the patient was more comfortable then, is a misunderstanding of the process. While there is a tendency to adapt or "settle in" to the most comfortable aspect of the regressed state, the reason for the regression is survival, and in the case of schizophrenia and other serious disorders, the survival mechanism is maladaptive. My data correlating early traumata with the later development of serious mental illness bares this out.

The most damaging of all attempts to explain the cause of schizophrenia psychologically was the attempt to blame the parent for his or her interaction with the child. The parent often suffers more than the child because of unwarranted feelings of guilt. The attempt to indite the parent was often presented in a way that was cruel and insensitive to the feelings and the needs of the parent, and this effort brought emotional destruction to lives of countless persons who already were in a state of great emotional despair.

Frieda Fromm-Reichmann (Campbell, 1989) was the first to discuss the "schizophrenogenic mother." While she and others were astute in capturing intricate nuances in the relationship, the significant mistake was to identify the unique interaction between the patient and the mother as the cause instead of the result of the disease process. My work clearly makes this distinction: When the patient returns to the infant mind/brain/reality, everyone treats the patient like an infant, and this includes many mental health professionals.

Family support groups evolved as a means of self preservation, and as they grew in number and gained political influence, researchers retreated from exploration of interpersonal causes. The work of G. W. Brown (1966) had identified a strong mathematical correlation between living at home and recurrent hospitalizations, however, and this sparked a search for elements in the home environment to account for relapse. Expressed emotion in the family, referred to as the "EE" factor, was identified as the culprit, and family therapy to lower the EE factor was proven effective in reducing the relapse rate.

According to my findings, this effort does not go far enough. It is like detonating a small charge next to a combat veteran instead of a large one. The absence of an explosion precipitates no flashback at all. Likewise, a zero EE factor, brought about by a complete separation, is immeasurably better than a low EE factor.

This is not an inditement of the parent or an implication that he or she caused the disorder in any way. Even if the parent is exemplary and behaves in the most ideal way, contact can lead to relapse. The mechanism for this is the same as that between an alcoholic and the bottle. The bottle of scotch may be the finest in the world, but after the subject has "crossed the invisible line" and has become alcohol dependent, one sip returns him to the infant-on-the-bottle mind/brain/reality, and he drinks until the belly is full and passes out.

My sympathy is with family members who often suffer more than the patient, and every effort is made to protect the parent. There may be ways in which families do share in responsibility for the perpetuation of serious disorders, however, and if so, then it is in their best interest to be aware of these factors and to learn what to do.

Two important psychological factors led to the development of family organizations: 1) strong feelings of guilt (even though unwarranted) as parents were targeted unfairly for the cause of schizophrenia, and 2) powerful psychological defense mechanisms of denial and projection, as family members could not tolerate the pain of feeling guilty. These factors influenced the direction of research for nearly two decades, and a strong desire emerged to find a biological cause or an act of God responsible.

To search for the cause of schizophrenia, with the precondition that the result not precipitate feelings of guilt, is not the scientific method. Nonetheless, we have spoken with numerous mental health researchers who have said they would not dare explore possible influences related to family interactions.

Ironically, while my theories identify psychological traumata, they vindicate the parent from blame because they identify accidental traumatic experiences that happen to occur at crucial stages of development, and about which no one is aware.

Dr Clancy McKenzie is a widely acclaimed authority on the understanding of origins, mechanisms and treatment of schizophrenia. He graduated from the University of Michigan School of Medicine in 1962, and then focused his attention on the study of the human mind. Dr. McKenzie has studied the relationship between trauma and Schizophrenia. Through the years he has dedicated himself to the evaluation, analysis and treatment of trauma and its immediate and long-range effects on behavior and mental health. Learn More: http://www.drmckenzie.com and follow his blog: http://www.drmckenzieblog.com

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Is Science Fiction Writing Necessarily Not Serious Literature?

I love writing. I love writing science fiction. I also love to read.

There, I said it. The horrible truth, out in the open on the first line! Clearly this author knows nothing about suspense. What more could be expected from a science fiction writer?

To be slightly more serious for a second, I do indeed love writing. What I dislike are small minded people who think that writing should only occur in a particular way, in a particular genre, style or voice. For example, "expert book reviewers" who tell me a book is bad because of the author's style, or that science fiction (SF) is puerile.

Apart from the obvious considerations of spelling, grammar and punctuation, an author has a massive degree of freedom in how their thoughts reach the reader. Sometimes even these minimal rules are deliberately broken in order to tell the tale.

Of course, a writer wants his work to be read, but it is also about making an emotional connection with the reader. The form writing takes can be formal, like Dickens, or truly unique and free-flowing as in the case of Joyce's Ulysses. What really matters is the connection or, if you prefer, the emotional communication. If there is no emotional connection then you could just as well be reading a telephone directory. If science fiction writing can effectively form this connection with the reader then how can it be judged as "poor literature"?

How much poorer the world of literature would be without Joyce, Dylan Thomas, Wordsworth or Shakespeare. By the same token how much poorer also if there were no Asimov, Heinlein, Niven or Banks. This loss would surely be most severely felt in the world of ideas.

Science fiction is the world of ideas. It is the result of looking at the world and asking, "What if?"

Sometimes these ideas have changed the world: Star Trek's Communicators, once thought impossible, are now commonplace as mobile phones. On the darker side, the movie Aliens showed us robotic guns, power-assisted exoskeletons and various forms of scanners and image-enhancement technology. All of these things are now quite current and accepted in today's world.

With such power to change the world, should science fiction really be seen as the poor relation to "serious literature"?

Sometimes science fiction is not so much about the gadgets, but more about the sociology. Here SF gives the author the ability to explore a world that is different, yet uncannily like our own. Here too there are many notable works: H.G.Wells and The Time Machine as well as War of the Worlds can both be seen as social commentary. His lesser known short story, Tono-Bungay, satirises the advertising of the day and arguably predicted the atom bomb. Wells is of course just one author, but others could included here such as George Orwell (1984) or Aldous Huxley (Brave New World).

So what of the science fiction of the future?

Increasingly the gap between science fiction and science fact is narrowing. People talk seriously about a technological singularity in our near future, in which artificial intelligence will become a fact. With the current rate of improvement in computer data storage and processing power, who really knows?

Sadly, science fiction has not yet shown us a solution for the problems of today's world, but perhaps the book or movie that hints toward that solution is just around the corner.

Dave Felton is a forty something writer wannabe. Although I write a short stories, blog extensively, post widely on the web and am currently writing another novel, I consider myself a "wannabe" as that first published novel still eludes me. Until that day comes you might want to look up my personal blog at http://djfelton.com

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