Robert Berezin M.D.

The Theater of the Brain

A commentary on Talk Therapy Found to Ease Schizophrenia

It took 7 years for this conclusion?

Posted Oct 20, 2015

A commentary on Talk Therapy Found to Ease Schizophrenia, by Benedict Carey, Oct. 20, 2015

Honestly, it doesn’t really take a 7-year study to know that talking to a patient is a revolutionary idea. Of course, we need psychotherapy; of course we need input from the community; medications may be relevant, but antipsychotics are not the treatment, but an aid to help diminish the terror. Schizophrenia is a human problem. People with schizophrenia are people. We need to make a relationship and deal with the psychotic character in psychotherapy. We need to treat the whole person. We have lost our way in believing that schizophrenia is some bio-neurological disorder.

Although, in schizophrenia, the self and its plays are fragmented, consciousness continues its ongoing process of playwriting. Consequently, the cortical imagination now writes new plays that are anchored in this limbic rage/terror experience. Disrupted plays of a fragmented self and terror-filled feeling and otherworldly plots are written and inhabited. The feeling of these plays are captured by words like awe, dread, or horror. This leads to the delusions, hallucinations, and bizarre behavior.  Schizophrenia has, as its foremost feature, the rupture of the self. This reflects the fact that its pre-psychotic character world is in fact problematic, hollow, and not sustainable. It is a false self, like a cardboard cutout. The eruption of the psychosis is a built-in inevitability. The fragmentation is not anchored in the Authentic-Being and always becomes unmanageable. The resultant terror/rage is the worst and most unbearably frightening state of all potential human experience.

There are a number of remarkable stories where people overcome and manage their schizophrenia and live wonderful, difficult, and productive lives. Unfortunately they are the exception. In today’s world, it is our moral obligation to treat people who really need it, and so many are ignored. This will require a renewed effort to understand the complex issues of living a life that has some damage, but is no less valuable. We must take care of people who cannot help themselves; people who are isolated; to provide what cannot be done independently; and to have places of refuge where people can go to periodically heal, and come back out again for a productive life. There are a number of places out there that struggle to provide this environment, but nowhere near enough. For a full human life we do not need a medical model, but a human one.