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Schizophrenics are okay!
Posted by We
15th Feb 2015

Calling it “psychodiversity” rather than mental health reframes the debate

The language in mental health is a constantly evolving phenomenon which doesn't hold true with the underlying concept. This problem has become worse since the political correctness movement grew in mental health.

I'm a person who is more interest in the concepts than the words which describe them but I've had to face the terminology problem which is a constant source of debate in the mental health activism movement. What's the right word?

For example, if I were to use the term “schizophrenic” on a Mind or Rethink Facebook post I would always be criticised by others because the term doesn't fit in with what the the supporters of the two leading mental health charities find acceptable. Their views on language are what's believed by the big mental health charities and the national antistigma programme Tine to Change. In their logic "schizophrenic” is stigmatising language and is, according to the prevailing consensus, unacceptable in public mental health arenas.

Sigh...

I find this very sad. I've had to use terms like “person with schizophrenia” to avoid the automatic criticism from vocal members of the mental health movement who continue to be sucked into the language of the disease model. I have little respect for political correctness if it contributes to a veil against conceptual accuracy like it does it mental health it is tantamount to propaganda. (Don't even get me started on “Afro-Caribbean” which is a politically correct term which lumps together two different cultural origins which are widely geographically apart under one label. To me this is same thing as classing black people "black skinned" whereas separating the two cultures is better.)

To use “schizophrenic” is to call the phenomenon a human type whereas medical model understandings in mental health say they/I have a disease which must be treated. The politically correct position that schizophrenia is an illness is fundamentally stigmatising even though people think it's the right antistigma principle. Any deference to the medical model in the language of mental health continues the normalising paradigm which is inherent to the biomedical model but the sole direction of treatment to change individuals is questionable according to the biopsychosocial model and the social model of disability.

The concept underlying the terms of mental illness and mental health problems is fundamentally negative because it assumes no integrity of being, treatment solely deals with individuals (not social factors) and allows forced treatment . The supposed brain illnesses cause of schizophrenia can be forcibly treated and personal beliefs overridden using “lack of insight” as a medical reason because of the illness model of mental health. The model is seemingly compassionate but has an underlying coercive and oppressive mode of action.

Calling a schizophrenic a thing means they/I can have integrity of being. This is outright dismissed by  medicalisation. Medicalisation is key to mental “health” as a concept and, again, is seemingly compassionate but actually is also oppressive. Schizophrenics can have a right to exist as they are without persecution whereas people with schizophrenia have a disease which is always treated by normalisation and forced treatment can be used. Mental health and illness offer no hope of integrity of psychology or being.

The use of a noun carries the hope that schizophrenics can be as they are without being molested by psychiatry. It is the first step towards schizophrenics being acknowledged as natural psychodiversity (mental difference) and the protections of their rights and liberties. These are taken away, not enshrined, by what the medico-legal framework (the Mental Health Act and other legal instruments which provide doctors powers to remove rights) takes away using the illness model. The oppressive powers are there because of the illness paradigm and are guaranteed by nothing else. The current gold standard of disability rights legislations is the Convention for the Rights of Persons with Disabilities (CRPD) states disability should not be an excuse for force or coercion.

The wide gamut of psychodiversity

“Mental illness” and “mental health problem” kow-tow to the fundamental prejudice against certain psychodiversity which the medicalisation of mental health misconstrues as some sort of scientifically provable disease. It's a social problem not a disease. This is the reframing of the debate which psychodiversity principles allow for and act to destigmatise.

Basically, within a model of psychodiversity there is the hope that schizophrenics can be seen as human beings just like anyone else. They may exhibit unusual behaviour and experience social exclusion/disability but this doesn't mean they're diseased. They're disadvantaged just like any other disadvantaged group but they have the right to be because they're integral to the natural mental or psychological variation of the human race. They're allowed to have integrity of being  or integrity of disability which are all impossible through the medicalisation of schizophrenics.

The illness model takes away from this implicit and explicit statement of freedom and rights which framing it is a form of diversity allows to be enshrined. Psychodiversity is a term with no presumed negative sense whereas calling it a disease which can be forcibly treated to remove certain behavioural expression oppresses psychodiversity and makes no provision for integrity of being in any way. Psychodiversity perceives normalising treatment options are useful things if they're free and fully informed choices but they're not the sole recourse nor are they automatically assumed to be good like in the medical model.

It is a difficult challenge to believe in the natural diversity which schizophrenia represents but it's better to call us schizophrenics because it gives us the chance to be given the right to exist as we are.

Psychodiversity is an equality based term and concept at its very heart. Medicalisation isn't nor can ever be except through demedicalisation which is represents the progress if a rights movement where normal psychodiversity such as homosexuals or single mothers become protected and stop being persecuted by the psychiatric system.

(You can skip the rest if you've got what I'm trying to convey. If I've piqued your interest the rest fills in more of the background to the unusual concept of psychodiversity.)

Another way to understand psychodiversity versus mental illness

Another way to understand what I'm saying using a different way of thinking is to consider the wider body of evidence on schizophrenic behaviours and how psychiatric brain science (pseudoscience) can be conceptualised within psychodiversity principles.

The results of dopamine trials are fundamental to modern psychiatric science of schizophrenia and psychosis. It is fundamental to treatment as well as the idea that schizophrenia is an illness rather than a natural human type.

Ask a psychiatrist and they'll tell you the wonders of dopamine brain research in schizophrenia and how it is all scientific. It's all very persuasive until you find the positive dopamine studies, ones which show there's suppression of other things than hallucinations and negative behaviours associated with schizophrenia the illness.

I found two which showed correlations between altruism and creativity. These are positive attributes which are also part of the schizophrenic type. These were D2 dopamine studies and D2 is a common site for modern (atypical) biological schizophrenia treatments which are clearly suppressing both negative and positive behavioural attributes. To me this evidence was a small glimmer into a concept which says schizophrenics are natural variation and can be of great benefit to humanity but calling it a brain disease rather than a socially constructed thing removes the possibility of valuing schizophrenics.

There's another study of D2 and promiscuousness. There's one on infidelity too. Before the sexual revolution in the latter half of the 20th century these traits were judged socially unacceptable and signs of poor morals. This fundamental stigma still exists today and there are people of prudish persuasions who wouldn't consider it good to associate the schizophrenic type with sexual frivolity and infidelity whereas I can see it as a natural state of being or a positive one at that. I'm sure there's a debate to be had on what's a quality and what's a deficit but the debate would be about morals which people hold at whatever time in human history, not anything like a real disease.

My go-to demedicalised psychodiversity is homosexuality (the disease which is now acceptable) and homosexuals (a type which no longer carries the same social prejudice).  It was demedicalised around the same time as the sexual revolution and is now treated as integral human psychodiversity. This integrity of being is not possible in the illness paradigm. Extensive evidence might be used to say that brain differences are brain deficits and this is fundamental to the medicalisation but the same science applied to schizophrenics today could be adapted to homosexuals to demonstrate homosexuality was still an illness. Homosexuals weren't demedicalised by new scientific evidence. Instead it was a change in psychodiversity norms which recognised homosexuality  was natural and essential human mental difference.

The psychodiversity principle allows for brain differences, behavioural difference and the prognosis of mental illness (a worse quality of life) but doesn't automatically judge difference or unusualness as deficit. This automatic negative assumption which is central to the biomedical model is unscientific and is part of the specious application of science used to enforce temporary social and culture values and norms.

In psychodiversity terms a schizophrenic is assumed to be normal and natural human mental variation because they're a type rather than the product of a disease. As long as people call it “schizophrenia” and anything “health” orientated they take away from the possibility of the normalcy of schizophrenics.

The medical language is fundamentally stigmatising because of the concept it represents whereas the concepts behind the term psychodiversity are not tainted by stigma and are empowering rather than oppressive. Political correctness in mental health defers to what the medical model purports and allows the oppression to continue by inappropriately medicalising certain types of psychodiversity and the fundamental stigma is reinforced by the choice of politically correct terms.

It's still possible to have compassion for schizophrenics and the severe disability those labelled with schizophrenia suffer within the psychodiversity paradigm. It's still possible to want to alter the inequality and worse outcomes which typify schizophrenia more than any other major diagnosis in mental health. It's also possible to say it's wrong to make assumptions about anyone, for example the schizophrenia violence or uselessness prejudice. I think it's possible to forgive the unusual and unacceptable (unacceptable according to temporary norms) behaviours of schizophrenics and include them rather than force them to be normal so they'll fit in or have their personality and being suppressed because it's convenient. This is fundamental antistigma far beyond the diagnostic label stigma and antistigma activities of the politically correct movement in mental health.

As a concept and term psychodiversity has it all. It even conjures up the protection of diversity which in accepted for biological differences like skin colour which we see as natural diversity today, not a disease. It's noteworthy to remind you of Negritude – a medical diagnosis from a few centuries ago which saw black skin as abnormal biology (the doctors were all white) which could be treated like any other medical disease with the aim of giving the patient white skin. Today people with black skin are over-represented in society's underclass but schizophrenics are an underclass all to themselves who experience oppression and inordinate social prejudice, a prejudice so profound because it's universally perjoratised (up until very recently) and normalised through mental health labelling and treatment.

The concept of schizotypy - non-pathological or functional schizophrenia - would be alien to psychiatrists half a century ago which is demonstrated by the Rosenthal experiment where researchers faked their way into American psychiatric hospitals by disclosing (falsely) that they experienced the “hearing voices” hallucination which once typified schizophrenics. It was Professor Marius Romme's paper on the emancipatory approach to hearing voices which first introduced British psychiatry to the idea of coping voice hearers in the early 1990s. Till then the establishment didn't believe in anything like these ideas which were about placing the voice hearing movement on a spectrum with normal rather than something totally alien to human psychodiversity. As integral psychodiversity these voice hearers are part of the normal spectrum but psychiatry has historically seen them as totally abnormal and a sign of mental sickness which has to be normalised.

Need I go on? Psychodiversity and schizophrenic are good. Political correctness and the medical model are bad. These fundamentally stigmatise by allowing forced treatment and only aim to normalise until Time to Change (which was driven by the mental health charities and psychiatry just got on the bandwagon) was conceived and implemented. This is the national  anti-mental health stigma campaign for England and Wales. It leads the world in the direction of targeting mental health prejudice but, sadly, falls foul of the medical language and political correctness problem.

The core of antistigma should be based within psychodiversity principles. The debate is framed under similar logic to the planetary biodiversity movement. Organisations such as the World Wildlife Fund work to protect the full spectrum of biodiversity on this planet. The medical model if applied to planetary biodiversity would lead to the extinction of species and not their preservation.

I am a schizophrenic and that's okay! That's normal. That's essential psychodiversity and I have a right to exist unmolested by forced treatment which aims to normalise me not preserve the uniqueness of diversity which the schizophrenic type represents.

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