Insiders: The Schizophrenias

Among the number of insider accounts of living with the diagnosis of and the symptoms of schizophrenia, I will share my understandings of and reflections on the following significant accounts:

  • “The Collected Schizophrenias” (2019) by Esme Weijun Wang
  • “The Center Cannot Hold” (2007) by Elyn R. Saks
  • “Perceval’s Narrative: A Patient’s Account of His Psychosis, 1830-1832”. (1974) Edited with an Introduction by Gregory Bateson
  • ” Operators and Things: The Inner Life of a Schizophrenic” (1976) by Barbara O’Brien
  • “Two Accounts of a Journey Through Madness” (1978) by Mary Barnes and Joe Burke
  • “A Mingled Yarn: Chronicle of a Troubled Family” (1979) by Bulah Parker
  • “Is There No Place for Me?” (2014) by Susan Sheehan

I venture into my reflections with several caveats and some wariness. Of all mental illnesses, schizophrenia may be the most represented (and misrepresented) and controversial psychotic disorders. There continue be a number of misconceptions about schizophrenia and the long standing debate between the strictly medical diagnosis and some psychosocial/familial interpretations of what might be basic causes of schizophrenia continues to be a controversy. I will discuss this as I move through the sources mentioned above. My plan is to provide some background about the history of diagnosing psychotic illnesses, focusing particularly on schizophrenia, then mention what are currently considered various schizophrenias in the Diagnostic and Statistical Manual (DSM V), and then to move to insider accounts.

For readers who would like to begin investigation of some of the sources I mention, I suggest that you begin reading Esme Weijun Wang’s first essay , “Diagnosis”(p.3) in “The Collected Schizophrenias” (2019). She provides an up-to-date analysis of the different types of schizophrenia diagnoses in the context of her own experience (currently) with schizo-affective bipolar type disorder. I will also begin my probe into the insiders’ stories with her essays.

I will then discuss the classic current account of personal experience with schizophrenia by Elyn R. Saks, “The Center Cannot Hold” (2007). “Percival’s Narrative” is likely the first known insider account, since John Percival kept a journal while he was committed to a mental institution from 1830-1832. I will discuss this account based on Gregory Bateson’s commentary, which will also lead into some discussion about Bateson’s notion of the “Double Bind” and other psycho-social interpretations of the bases of schizophrenia. The classic “Operators and Things” (1976) by Barbara O’Brien may give the reader the best “inside” feel for what happens to the mind and person who has schizophrenia. I will share some or her descriptions of her hallucinations and her journey with schizophrenia.

“Two Accounts of a Journey Through Madness” (1978) by Mary Barnes, who had schizophrenia, and her psychoanalyst, Joe Burke, may be the only insider account which includes both patient and therapist. This document is also unique in it’s approach to treatment which is based on the R.D.Laing and Tavistock Clinic in London concepts of de-stigmatizing schizophrenia. I will discuss this as well.

Buelah Parker was a psychiatrist and psychoanalyst who reports her experience working with a particular American family in “A Mingled Yarn” ((1979). Parker’s framework represents an example of the family systems interpretations of the psycho-social causes of schizophrenia, which I will discuss in the context of Bateson’s “double bind” theory and the family systems/family therapy movement.

“Is There No Place for Me” (2014) is not strictly an “insider” account, because Susan Sheehan is not a patient or therapist. She is a journalist. But her ethnographic approach captures the experiences of Sylvia Frumkin’s insider story of living with schizophrenia with amazing insider documentation. Sheehan practically lived with Sylvia during two years of her mental institution experience.