THESIS
FOR
DOCTOR OF PHILOSOPHY
UNIVERSITY OF WOLLONGONG, AUSTRALIA
2000
Doubts about the real nature of schizophrenia are long-standing. There are no laboratory tests to confirm diagnoses and it is not certain whether there is consistency in the diagnostic process. Various models have been developed to explain the cause of the symptoms. The dominant explanatory model is based on medical assumptions that the symptoms are pathological and are caused by an illness of the mind or brain. The medical model embraces a wide variety of psychological and biological theories of aetiology but there is no scientific/medical consensus and all the evidence supporting medical theories is equivocal. This apparent confusion gives rise to questions concerning the validity of a medical interpretation. Alternative, non-medical models explain the cause of the symptoms as being either a mystical/spiritual emergency (mystical model) or as social alienation (myth-of-mental-illness model).
When a comparative analysis of the medical, mystical and myth-mental-illness models is undertaken in the light of interest group theory it is apparent that competing interest groups are promoting different explanatory models to achieve political ends. A key determinant of this political struggle involves the selection and emphasis of conflicting human rights imperatives. Human rights are central to the issue of schizophrenia because people who display the symptoms tend to be socially disruptive and, as a result, are frequently hospitalised involuntarily and forcibly treated with drugs that are mentally and physically debilitating.1. INTRODUCTION (pdf-330 kb)
Objectives of the Thesis
Methodology and Underlying Theoretical Perspective of the Thesis
A Brief Description of Schizophrenia
Schizophrenia Controversies
Expanding the Diagnostic Net
The DSM Diagnostic System
Growth of the Mental Health Industry
Social Control, Youth and Unemployment
2. INTEREST GROUPS AND HUMAN RIGHTS (pdf - 340 kb)
Interest Group Theory
Human Rights and Activism
Background to Human Rights
Human Rights, Science and Technology
Human Rights and Psychiatry
Soviet Psychiatry
UN Principles on Mental Illness
The Burdekin Inquiry
3. THE MEDICAL MODEL: SCHIZOPHRENIC SYMPTOMS AS PATHOLOGY (pdf - 370 kb)
Regression Theories
Current Diagnostic Criteria
ICD-10 Diagnostic Criteria for Schizophrenia
DSM IV Diagnostic Criteria for Schizophreni
Origins of descriptive psychopathology for Schizophrenia
Kraepelin and Bleuler
4. THE PSYCHIATRIC DICHOTOMY AND THE PROLIFERATION OF MODELS (pdf - 520 kb)
Biochemical Hypotheses — and Associated Drug Treatments
Atypical Neuroleptics
Other Biochemical Theories
Uncertainties in Schizophrenia Research
Brain Imaging
Scanning For Causes
Infection Theories
Nutrition
Genetic Theories
Theories of an Environmental/Experiential Aetiology
Developmental Theories
Family Environment
Double Bind Theory
Family Stress
Social Stress
5. THE MEDICAL MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES (pdf - 300 kb)
Interest Groups
Campaign to Extend Involuntary Treatment in NSW
Human Rights Imperatives
Right to Treatment
Informed Consent
6. THE MYSTICAL MODEL: SCHIZOPHRENIC SYMPTOMS AS A NATURAL EXTENSION OF CONSCIOUSNESS (pdf - 450 KB)
Background to the Mystical Tradition
Dealing With the Knowledge of Mortality
Attaining Mystical Experience
Mysticism and Psychiatry
Anti-Psychiatry, Laing and the Mystical Model
Jung
John Weir Perry — a Jungian
Mythological Heroes and Schizophrenia
Summary of the Mystical Model
7. THE MYSTICAL MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES (pdf - 340 kb)
Interest Groups
Human Rights Imperatives
The Spirit of Article 18
The Technical Requirements of Article 18
Involuntary Treatment Provisions in New South Wales (NSW), Australia
Incarceration of Alleged Schizophrenics
Hypothetical Mental Patient
Neuroleptic Treatment
Human Rights Report on Freedom of Religion and Belief
8. THE MYTH-OF-MENTAL-ILLNESS MODEL: SCHIZOPHRENIC SYMPTOMS AS MANUFACTURED ARTIFACTS (pdf - 490 kb)
Sub-Type 1: Schizophrenic-as-Cultural-Outsider
Negative Symptoms
Outsider Case Studies
Sub-type 2: Schizophrenic-as-Scapegoat
Sub-Type 3: Schizophrenia-as-Role-Play
9. THE MYTH-OF-MENTAL-ILLNESS MODEL: INTEREST GROUPS AND HUMAN RIGHTS IMPERATIVES (pdf - 380 kb)
Interest Groups
Human Rights Imperatives
Background to the Insanity Plea
Relevant Human Rights
Torture and Cruel Treatment
Neuroleptics, the M-M-I Model and Human Rights
Treatment or Torture
10. EARLY PSYCHOSIS: PREVENTIVE MEDICINE, SCIENTIFC ASSAULT ON MYSTICAL TENDENCIES, OR AN EXTENSION OF SOCIAL CONTROL? (pdf - 520 kb)
Early Psychosis as Preventive Medicine
Early Psychosis Programmes
Case Study — The EPPIC Programme
Critical Analysis of Early Psychosis
Drug Company Influence
CONCLUSION (pdf - 170kb)
BIBLIOGRAPHY (pdf - 480kb)
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