Surviving Schizophrenia, 7th Edition: A Family Manual by E Fuller Torrey
My rating: 5 of 5 stars
I was recommended this book by a friend and I just hope that by recommending it, I also act as that friend to strangers on the net. It is without doubt an excellent book. I don’t know this, but I am guessing that people in this field regard it as a holy book.
Why should you read this book?
Is someone around you (friends/family or you yourself) behaving in a different than usual manner. To be specific, are they experiencing- difficulty in concentrating, anxiety, restlessness and more importantly the typical symptom of the disease- auditory/visual hallucinations? If yes, they must be taken to a psychiatrist (not to be confused with a psychotherapist). If the diagnosis by the practitioner is psychosis (schizophrenia/bipolar disorder or somewhere on that scale), you should definitely read this book.
Even if answers to both the above questions is no, you can continue to read the book out of curiosity (and awareness) or if you are a psychiatrist, psychotherapist or a medical practitioner.
What does the book cover?
It starts by describing what the patient feels (this develops the required empathy in often frustrated family and friends), defining schizophrenia (what is and what is not schizophrenia) and pondering upon the causes (which are not yet clear). It then moves on to treatment (including selecting a psychiatrist, discussion on medication and therapy), rehabilitation services (what they should look like and examples from around the world) and concludes with tips for the patients and their family in the form of commonly asked questions, solutions to major problems faced by them etc.
The first few chapters give multiple examples of how a schizophrenia patient behaves and lists out the symptoms used to identify the illness (as per different medical bodies around the world). He also warns here that in early stages of schizophrenia a person may be experiencing things that are not visible to their family. They may be hearing voices (auditory hallucinations) for weeks or months before family members become aware of it.
An excerpt of what a schizophrenic patient felt like – “The walk of a stranger on the street could be a sign to me which I must interpret. Every face in the windows of a passing streetcar would be engraved on my mind, all of them concentrating on me and trying to pass me some sort of message.”
Next, the book also talks about the probable causes of schizophrenia and discusses various theories that were in vogue at different points of time from the 18th century to the present. Dr Fuller was one of the first to tell the world that it is not an illness that can be merely treated by talking to the patient or through therapy. He goes on to discredit some popular cause theories like childhood trauma or depression due to family/marital discord. It is an illness that affects specific parts of the brain and also needs medication.
The next few chapters talk about the medication, the types of antipsychotics and ways of administering them to patients. Another fact the book discussed was that around 50% of such patients suffer from Anosognosia or an inability to know that their brain is not functioning normally. In such cases, the patient is adamant that they are perfectly fine (they could be thinking that you are part of the conspiracy to label them mad or to kill them!) and would refuse to take medications. There are workarounds should such situations arise, as are discussed in the book.
An excerpt from the book, mentioning what might happen if you try to logically counter the delusions – “If you are walking with such a person and try to reason him/her past these delusions, your efforts will probably be futile…..Reasoning with people about their delusions is like trying to bail out the ocean with a bucket.”
The chapters at the end discuss what medical care, rehabilitation service and community environment should look like for patients. The book discusses consequences of leaving patients untreated and homeless, for the society. It might result in increased crime rate (schizophrenia patients are at high risk of being victims or perpetrators). Justice and policing systems around the world have a history of making erroneous judgements by either over compensating for the perpetrator’s mental illness or by not considering it.
Some successful examples of collaborations between civic, police, and medical fraternity are also mentioned in the book. I wonder whether such services and support exist in India. Sample an excerpt-“The Mental Health Support Team consists of 10–12 specially selected officers and detectives, many of whom have relatives with a serious mental illness, whose only job is to respond to mental illness-related police calls. Team members wear civilian clothing and drive unmarked cars to minimize the stigma associated with their calls.”
The one thing this book will give to the reader is hope and I believe that is crucial for friends, family and patients. Dr Fuller (whose own sister was a schizophrenia patient) drives home the point (by quoting studies from across the world) that most patients can lead fulfilling lives with proper medication and support. With proper treatment the disease may be compared to diabetes, where the patient might have to take medications for the remainder of their life, but can lead normal lives.
Another parting excerpt – “If the brain was so simple we could understand it, we would be so simple that we couldn’t.”
Note: If you want to discuss anything about the book or topic (or even need any kind of help), just drop in a mail at firstname.lastname@example.org or comment below the post
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