SCHIZOPHRENIA: Schizophrenia and the Need-Fear Dilemma.
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Abstract
denying that the work is one of the numerous studies of mental illness and the family, thereby denying the specific implications of the title. Behind the double-talk is double-think. They say there is no such fact as schizophrenia : †̃¿ . . . we regard it as a palpable error . . . to take it to be a fact. Nor do we assume its existence. Nor do we adopt it as a hypo thesis. We propose no model ofit. . . . Our question is: are the experience and behaviour that psychiatrists take as symptoms and signs of schizophrenia more socially intelligible than has come to be supposed?' To formulate this question involves a hypothesis regarding schizophrenia, and the evidence that is gathered and reported is relevant, and is intended to be relevant, to a particular model. A series of eleven case demonstrations then succeed one another, with little pause for discussion. Schizo phrenic women are confronted with their relatives and the interviewer. Verbatim records, mainly from tape, show that patients and relatives are at cross purposes, misunderstand one another, sometimes accuse one another of faults in love or understanding. These misunderstandings are interpreted as related to one or more of the psychotic symptoms; but no effort is made to specify how the misunderstanding caused the symptom, or to suggest a way of testing the hypothesized cause-effect link. The authors apparently wish to be taken for serious students (though of what it is not easy to say, since they do not accept madness, sanity and schizophrenia as meaningful terms); but they are unwilling to accept the obligations of serious students. The technique of display chosen for the case demonstrations reminds one of the cinema. Cuttings from tape-recordings show us mere glimpses of these families; and the aim seems to be to influence us by a process of cumulative suggestion. These snippets are selected for an ulterior purpose, but not as the elements of a valid contribution to descriptive psychiatry. The attempt at persuasion by such means is familiar in the world of advertising, and is generally tolerated on the large and the small screen; when presented under the guise of a contribution to know ledge, it is irrelevant and looks disingenuous. ELIoT SLATER.