Genetic study provides first-ever insight into biological origin of schizophrenia

Jan 27, 2016

A landmark study, based on genetic analysis of nearly 65,000 people, has revealed that a person’s risk of schizophrenia is increased if they inherit specific variants in a gene related to “synaptic pruning” — the elimination of connections between neurons. The findings represent the first time that the origin of this devastating psychiatric disease has been causally linked to specific gene variants and a biological process. They also help explain decades-old observations: synaptic pruning is particularly active during adolescence, which is the typical period of onset for schizophrenia symptoms, and brains of schizophrenic patients tend to show fewer connections between neurons. The gene, called complement component 4 (C4), plays a well-known role in the immune system but has now been shown to also play a key role in brain development and schizophrenia risk. The insight may allow future therapeutic strategies to be directed at the disorder’s roots, rather than just its symptoms.
The study, which appears online in the January 27 issue of Nature, was led by researchers from the Broad Institute’s Stanley Center for Psychiatric Research, Harvard Medical School, and Boston Children’s Hospital. They include senior author Steven McCarroll, director of genetics for the Stanley Center and an associate professor of genetics at Harvard Medical School; Beth Stevens, a neuroscientist and assistant professor of neurology at Boston Children’s Hospital and institute member at the Broad; Michael Carroll, a professor at Harvard Medical School and researcher at Children’s Hospital; and first author Aswin Sekar, an M.D./Ph.D. student at Harvard Medical School.

The study has the potential to reinvigorate translational research on a debilitating disease. Schizophrenia is a devastating psychiatric disorder that afflicts approximately one percent of the population and is characterized by hallucinations, emotional withdrawal, and a decline in cognitive function. These symptoms most frequently begin in patients when they are teenagers or young adults. First described more than 130 years ago, schizophrenia lacks highly effective treatments and has seen few biological or medical breakthroughs over the past half-century. In summer 2014, an international consortium, led by researchers at the Broad Institute’s Stanley Center, identified more than 100 regions in the human genome that carry risk factors for schizophrenia. The newly published study now reports the discovery of the specific gene underlying the strongest of these risk factors and links it to a specific biological process in the brain.

“Since schizophrenia was first described over a century ago, its underlying biology has been a black box, in part because it has been virtually impossible to model the disorder in cells or animals,” said McCarroll. “The human genome is providing a powerful new way in to this disease. Understanding these genetic effects on risk is a way of prying open that black box, peering inside, and starting to see actual biological mechanisms.”

“This study marks a crucial turning point in the fight against mental illness,” said Bruce Cuthbert, acting director of the National Institute of Mental Health. “Because the molecular origins of psychiatric diseases are little-understood, efforts by pharmaceutical companies to pursue new therapeutics are few and far between. This study changes the game. Thanks to this genetic breakthrough we can finally see the potential for clinical tests, early detection, new treatments, and even prevention.”

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34 comments on “Genetic study provides first-ever insight into biological origin of schizophrenia

  • This is thoroughly thrilling. The mechanism of over-enthusiastic adolescent synaptic pruning in the cortex is almost perfect in bringing together a number of existing theories.

    But there are many many other aspects



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  • I too find this very exciting, however I agree that there are a plethora of other aspects, as well many competing theories. It is also very difficult to make objective claims when communicating about a condition that, I feel, needs to be viewed subjectively. In many cases, talk therapy is more effective in treating and managing schizophrenia. Every brain is indeed different. How we develop our associations for positive and negative rewards are also different. There is such a deep complexity that goes into understanding this condition. Extrinsic and intrinsic properties need to be examined. Perhaps their referring to cases where the predominant cause is intrinsic, rather than extrinsic? Perhaps the cases that were able to be helped through talk therapy were the result of extrinsic, rather than intrinsic qualities (or rather the strong influence of extrinsic factors on intrinsic qualities)? Hm..



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  • Thrilling indeed Phil.

    James Watson will be delighted after his efforts to identify a genetic component to schizophrenia. Not only does this lend support to his intuitions, it suggests treatments may emerge to regulate rogue genes, perhaps preventing the disease developing for individuals known to be at risk. Biological therapies may emerge, such as those now being used for IBD sufferers, or MS patients.

    An exciting development.



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  • Alyson

    Do you seriously think that schizophrenia can be managed with talk therapy? Are you opposed to psych meds in general? I’m really hoping that you’re not one of those people who have limited experience with mentally ill individuals, especially family members and now intends to give us the opinion that some of our worst psych illnesses can be talked away. Have you grown up with anyone in your family who is schizophrenic? Bipolar? or even just ADD? These people suffer and their families suffer because of their behavior and bizarre thoughts. Why let this continue when there is a pill that can, if not fix it, at least soften the effects of the situation?

    No one thinks that there is a magic pill that can cure mental illness but what those of us who are dealing with mentally ill family members know is that without the pill, there isn’t going to be any “talk therapy” at all! The consequences for untreated mental illness are huge for the individual, the family and for society. These medications allow people to remain in society and not in an institution. They are always recommended to be used in combination with behavior mod counseling and they need strong strategy training for daily life. Without the meds there is no talking to these patients and there could also be an element of danger for the patient and others.

    Please think twice before saying that psych meds are bad. There is plenty of opportunity out there to spend time with these patients in a medical setting or in their own home to see what they go through on a daily basis and equally important, what their parents, siblings and extended families suffer with every single day. Give them their meds and let them and everyone around them have some degree of relief then maybe we can have some talking.



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  • Without the meds there is no talking to these patients

    Exactly so. I have experienced precisely this problem…several times. Once the confabulations start, conventional cognitions and meanings are gone and words have little traction.

    It is worth noting that this synaptic poverty in the cortex is probably not the immediate cause of confabulation but a trigger for it. The synaptic poverty may be the mechanism for impaired retrieval of “conventional wisdom”, semantic memories. Without these to hand, a theory goes, the brain tries to generate or regenerate something to fill the gap. Heuristics like spirits or Goddidit are simple enough to retrieve and generative of replacement knowledge.

    I would be very interested to see how the DNA of the religious and deeply religious stack up around C4.

    Medication like SSRIs are unlikely to restore full access to semantic memory and indeed may have nothing to do with this but may instead have to do with the confabulation caused. (The confabulation, I am proposing is a brain defence mechanism against itself. The deeply primitive energy accountant for brains operates a use it or lose it strategy. Brains are energy costly. Temporary loss of function can be rapidly compounded by the brain disposing of these newly quiet cells, turning concussion into a major brain injury. Dummy activity fends off the much more primitive butchery of apoptosis. All hallucinations appear to flow from reduced brain inputs/access.)



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  • Phil

    the brain tries to generate or regenerate something to fill the gap.

    So disturbing to watch this happening to someone.

    I would be very interested to see how the DNA of the religious and deeply religious stack up around C4.

    Yes, interesting indeed.



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  • Thank you Laurie. I found my self outnumbered on a Guardian forum on this subject a couple of months back.
    I find it disturbing that people are actively campaigning for a “talking cure” for a disease like this. Having witnessed my elder sister suffer for years with this I struggle to think how anybody could think that people can reason their out of a psychosis which leaves their cognitive processes completely disorganized.



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  • mr_DNA

    So sorry for your troubles. I have special sympathy for the siblings of those who suffer from these illnesses.

    I find it difficult to hold my temper when on a regular basis people “explain” that big pharma is taking advantage of us by “overmedicating” kids, etc. I ask them if they have any children themselves who suffer from ADD or even worse afflictions like Bipolar disorder, etc. Did they have to watch them fail academically? Be disliked by their peers? It’s heartbreaking and downright cruel to let the suffering continue when a pill can greatly improve the situation and bring them into focus at least enough to graduate from high school, make friends and give their parents and siblings some peace from the drama and chaos that surrounds them like a cloud.

    There is always an air of sanctimony around these do-gooders. A barely concealed insinuation of bad parenting. Why don’t they walk a mile in someone else’s moccasins? I recommend they volunteer in their local high school’s special needs classroom and watch the unmedicated mentally ill try to get through their day.

    Even Freud knew that talk therapy was not effective for these categories of mental illness. High intelligence and the ability to process through deep introspection are required for Freudian psychoanalysis.



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  • That’s fantastic; many lives can be improved if that works out well. I’ve lost a brother in law to suicide during a maniacal depression, and seen close up what a damage that can do to the direct family; many lives are severely affected by this.
    Synaptic pruning severs inappropiate axon connections between various area’s in the brain, and is a normal process from birth to adolescence. But a rogue version! Wow.



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  • There is another side to this. Read R.D. Laing, Phil and Laurie. (Of course schizophrenics should be treated with medication, but I don’t think that talking to schizophrenics is necessarily a lost cause. The expression “talk therapy” is a bad one.

    The experience and behavior that gets labeled schizophrenic is a special strategy that a person invents in order to live in an unlivable situation.
    R. D. Laing

    The subtitle that Laing assigned to The Divided Self was, “an existential study in sanity and madness.” It was not an existential study in “psychopathology.” Why this distinction? Are they not the same thing? To answer this, I want to take a look at what Laing set out to accomplish in this study, why he qualifies it as a study that is specifically existential in nature, and how this classic work laid the foundation for everything that Laing would write subsequently.

    As Laing says in the preface to that work, this book is “a study of schizoid and schizophrenic persons,” and its basic goal “is to make madness, and the process of going mad, comprehensible.” At the outset, the diagnostic language Laing employs is readily familiar to every psychiatrist and psychoanalyst who works with this population. Terms such as psychotic, schizoid, schizophrenic, paranoid – all standard nosological entities with which therapists the world over are familiar –proliferate throughout this book. He is speaking their language, so to speak, but the meaning he is assigning to these terms is anything but ordinary. Laing explains that he has never been very skillful in recognizing the diagnostic categories that are standard in every psychiatric diagnostic manual in the world, including the DSM that is used in America. He had trouble recognizing the subtle nuances that are supposed to distinguish, for example, the various types of schizophrenia, of which there are many, or even what distinguishes them from other forms of psychotic process, such as paranoia, or bipolar disorder, previously known as manic-depression.

    None of these terms are written in stone. In fact, they are constantly changing and undergo revision in every new edition of the DSM. So what is Laing saying here? He is not suggesting that he is too stupid to understand the complexity of these entities. Rather, he is suggesting that because there is no agreement in the psychiatric community as to how to recognize these symptoms and the mental illness they are purported to classify, it is impossible to take them seriously. No two practitioners agree on how to diagnose a person, and given the never ending revisions to these categories, practitioners often change their own minds as to how to recognize what it is they are proposing to diagnose and treat. This is hardly the science it is purported to be.

    What did Laing conclude from this disarray in categorization? That there is no such thing as mental illness, or psychopathology, so no wonder there is no agreement as to what “it” is. When a doctor sets out to diagnose a typical medical illness, he customarily looks for physical symptoms in his patient. The color or tone of the skin, dilation of the pupils, body temperature, and so on may indicate an abnormality. Additional tests may be administered that examine the blood or urine, and if that fails to provide conclusive results, perhaps x-rays, CAT scans, EKG’s, heart stress tests, mammograms or prostrate exams – all ways of examining the chemistry or interior of the body – may be utilized in order to hone in on what is malfunctioning. For so-called psychiatric symptoms, however, such tests will be of virtually no use, because no one will locate any of the symptoms of psychopathology inside or on the surface of one’s body. Even an examination of the brain, which is now the darling of neuropsychiatrists and neuropsychoanalysts, will never locate the presence of any form of mental or emotional disturbance that we can label a mental illness.

    Instead, what we can examine is the behavior of the person being diagnosed, whether, for example that person is suffering from delusions or hallucinations, confusion, disorganization, incoherent speech, withdrawal, flights of fancy; or depression, anxiety, dissociation or maladaptation, or perhaps a persistently elevated, expansive, or irritable mood! This list is hardly inclusive, but what all these symptoms have in common is that they refer to experiences that everyone has, at one time or another. Even delusions and hallucinations, the gold standard for schizophrenia, are common in dreams, and not all that uncommon when we are awake. Yet most people who exhibit or experience these so-called symptoms are never subjected to a formal diagnosis or treated for them. So why is it that some people are and some people are not? Why are some people deemed crazy and others sane, when they exhibit the same symptoms?

    These are some of the questions that Laing pondered in The Divided Self, but he never arrived at a satisfactory answer. In matters of the mind, the act of diagnosis can just as often be a political as medical ceremonial. Laing believed that we will never succeed in understanding such phenomena as long as we persist in looking at people from an alienating, and alienated, point of view. It is the way that we look at each other, the way that psychiatrists and psychoanalysts typically look at a patient, that Laing believed is the crux of the problem. The reason Laing calls The Divided Self an existential study instead of, say, a psychiatric, or psychoanalytic, or even psychological study is because the existential lens is a supremely personal way of looking at people; a person to person manner of regarding others and recognizing them, as Harry Stack Sullivan said, as more human than otherwise. This is another way of saying that the person, or patient I am treating, is not a sick person, but a person like me. And it is the fact that he is just like me that makes it possible for me to understand and empathize with him in the first place. – Michael Guy Thompson



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  • P.S. I should have read this more carefully, dammit. Serves me right. I don’t think that Laing (and I have read a number of his books) ever said that there was no such thing as mental illness.
    But perhaps Laing’s unique perspective is adequately represented here in spite of that inaccuracy and others.



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  • Dan, I have a book which I’ve long thought would likely appeal to you, if you can find a copy.

    It’s ‘The Origin of Consciousness in the Breakdown of the Bicameral Mind’, by Julian Jaynes. I enjoyed Laing’s The Divided Self.



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  • Thank you to mr_DNA and LaurieB, for your insightful comments.

    My youngest sister has been afflicted with bipolar disorder for nearly two decades now. Diagnosed when I was part way through an undergraduate psych degree, I explored CBT for my Masters thesis, with a driving ambition to help.

    I endorse your remarks and agree that few could appreciate what a family must endure under these circumstances. My sole goal was to persuade my sister to maintain her treatments, because she was simultaneously diagnosed with relapsing/remitting MS. She cyclically endures manic episodes every 18mths to 2 years. Regrettably nobody has been able to convince her that compliance is essential for both ailments. Our mother, siblings and friends have exhausted our resources to no avail.



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  • Thanks, Len,

    I am a little embarrassed by my hastily posted extract. I have great respect for Laing, but that extract was a lousy introduction to anyone who isn’t familiar with him.
    I do think that Laing had a unique perspective and had a great many valuable things to say – about the role of our environment vis-à-vis schizophrenia, about the politics of the family, about alienation and mystification, and much more. And he was a profound critic of our “inter-human lives” but clearly there is a biological component to schizophrenia and to bi-polar and other mental afflictions.
    My late brother was mentally ill, was bi-polar, as was my maternal grandmother and my aunt. I know all too well what talking to them would have amounted to: zero. (But it’s a compelling notion, something I am hoping may someday bear fruit).
    I hope I don’t sound like Tom fucking Cruise or something.
    I can picture Phil’s comment: “Dan, Laing was an innovative and insightful thinker but he was hopeless when it came to his repudiation of schizophrenia as a disease. We now know…”
    I shall look up that book. Thanks.



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  • A landmark study, based on genetic analysis of nearly 65,000 people,
    has revealed that a person’s risk of schizophrenia is increased if
    they inherit specific variants in a gene related to “synaptic pruning”
    — the elimination of connections between neurons.

    Alyson,

    I just read another “landmark” study a few months ago that said that the potential efficacy of talking to schizophrenics (formerly considered taboo) is now being seriously reconsidered and reevaluated. One study after another, and they often contradict each other. Maybe crazy R. D. Laing was onto something.

    Perhaps medication and therapy can someday be useful, if it isn’t already. (Not sure about whether this combination has been proved useful yet. You say it is. Are you sure? I’ll look into it. I don’t see why it couldn’t be.)

    The title says: “Origin of schizophrenia.” But as I have asked before, what is the cause behind the cause? I will say this, and accept the consequences: neuroscientists are, for the most part, myopic, arrogant, and suffer from a prodigious lack of imagination and understanding. There are, I assume, many exceptions. (Phil, did you hear that?) Pretty soon we will all be undergoing surgery as infants to prevent the onset of schizophrenia, just like some patients today elect to have their colon removed if colon cancer is in the family. The latter is sensible; the former (scenario) will accomplish nothing; another illness, and a worse one, will replace it. Schizophrenia has a biological component; of that there is no doubt. — But it is also a symptom of environmental and psychological factors. That is my hunch, and I suspect that I may be partially correct, as opposed to entirely incorrect.

    I am a strong believer in medication for schizophrenics (and other mental afflictions), Laurie. I am not saying that it can’t be treated in this way.

    -Dan the fool (on the hill)

    P.S. “Cancer is a defense against schizophrenia. Schizophrenia is a defense against cancer.”
    – Mailer



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  • rightly said.
    I am a trainee neurologist in Germany and we have to do one year clinical psychiatry as well and I have had my year.. It´s absolutely undoable to talk to somebody who is acutely psychotic.. unfortunately (?) we cannot forcefully medicate these patients (only in an acute psychosis where they might hurt themselves or others are we allowed to forcefully medicate.. which is a good Thing in These cases). and this is what makes therapy so difficult in these patients. a lot of them don´t really see why they should take medication on a daily Basis, and even if they do start initially, they tend to stop after a while, because they feel fine.
    talking to a psychotic person and hoping it will help them is more than wishfull thinking.. it´s more like a psychosis of the therapist to think it will benefit the patient, because it won´t.
    when they are not psychotic, there may well be a basis for cognitive therapy, but this will not cure them of having another psychotic event.



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  • ´Even an examination of the brain, which is now the darling of neuropsychiatrists and neuropsychoanalysts, will never locate the presence of any form of mental or emotional disturbance that we can label a mental illness.´

    for the same reason we cannot locate ones personality/ soul in one location of the brain.. it´s how the brain internally (dis)communicates which gives rise to personality and mental defects.



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  • it´s probably more evolved in, rather than being evolved out. because of the intricate way in which our brain works and has evolved in this way and the way in which we as humans care for each other, these absurdities have risen in the brain and have been given the chance to live on.. if we did not care for these individuals, they would be killed by anything and everything. as Phil states: these individuals don´t just only hallucinate, but their brains make odd connections, we normal individuals wouldn´t come up with. they are highly creative, but sadly also psychotic..
    and maybe the first shamans may have been psychotics who see things others don´t, but many shamanistic ritual is instigated by the use of very psychoactive drugs… even you and I would hallucinate on these drugs (which I by the way have done a couple of times..)



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  • R.D.Laings book “Knots” really raised his profile to my generation. As much as anything it became a source book for playwrights (ideal for you!) especially creating domestic dramas. It was, itself a work of art.

    For me it became a major reason to believe we can better negotiate in mild illness with others given the insights into the self causing “knots” we make for ourselves as we misread others and impute wrongly their intentions.

    Laing wanted to believe something grander, that he’d discovered the roots of illness. In fact he was a discoverer and geographer of the lower slopes of illness and that this was where we mostly live. He mistook himself and his value.

    Profound ignorance of the why and how of schizophrenia has led to the less than useful earlier definitions as we try and determine what of the plethora possible symptoms are the strong indicators of any singular illness. Now DSMV contains elements that are hypotheses as much as anything to alert care givers and provide more detailed feedback data.

    Trying to parse symptoms into being indicators of a “singular illness” will be increasingly aided by the neurological insights into mechanism making hypotheses with the added validating virtue of being predictive.

    In early DSMs (two or three) Autism was described as a childhood onset schizophrenia because of an overlap of (symtpoms) behaviours. This revealed mechanism in the article would have put a stop to this crude theory and a lot of irrelevant and damaging treatments avoided.

    Close enough for you, Dan?



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  • To Phil:

    Perfect. Please don’t read (unless you must) my comment to Alyson below. As you know I am mercurial, and often vituperative: I made an irresponsible remark about “neuroscience” which I regret (although I did qualify it). Apart from that it’s a fine comment, as usual.



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  • I’ve had plenty of trouble over the meds situation with my mom. She’s bipolar and I always know we’re in for a psychotic break when I surreptitiously check her pill minder box and find the pills scrambled up, extra pills or missing pills or pills cut in half, quarters, etc. I start to watch her more closely and inevitably she begins to detach from reality. In that phase there’s nothing I can do. When I strongly encourage her to take the meds she becomes overtly suspicious of me and I never have success at that point.

    After that it’s just a waiting game until she has sufficiently lost contact with reality that I can (legally) swing into action. Then I call the ambulance and the beefy guys haul her out kicking and screaming and zoom us straight into the emergency room. Staff socks her with two mega injections. One, enough sedative to put a bull elephant into la la land and second, the anti psychotic drug Haldol. They keep her over night there and this is how it has played out several times in the past. Last time it happened, the next morning I showed up to deal with the situation and she’s dressed, sitting on the edge of the bed looking spiffy. I said, “Mom, what’s going on?! Are you ok?” She answered, “Of course I’m ok! I’ve been waiting for you to get here and take me home. What took you so long!” wtf… And she’s absolutely fine and dandy and off we went.

    Not that my anecdotal story counts for much except that I want it to show how our connection to reality is held by a thin thread. That drug Haldol is a complete effing “miracle” of science! In just a matter of several hours it brings people back from the brink of insanity and there is no need to say even one word of therapy to make it happen.

    This is why I have no patience whatsoever for these oblivious dreamers who think we need to delve into long extended therapies when an injection of any number of meds solves the problem right here, right now. If it was your mother who couldn’t tell the difference between a store mannequin and a real live child, what would you do? Talk therapy or the big ole shot of haldol? You will do anything to get your hands on that medication my friend. That’s what I know.

    Dan

    After all of this I must honestly say this: Fuck R. D. Laing and his divided self. I need results and I need them now! 😉



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  • Laurie,

    I wish there were some way…and btw, I just wanted to put in a plug for Laing; I’ve always admired him…I wish there was some way you could get in touch with my mother. She went through the exact same thing or a very similar thing with her mother (late-onset bi-polar with psychotic features). It was very difficult.

    My mother could help you! I know it! Haldol. That rings a bell. My grandfather would grind up his wife’s meds and put it in her food. What about lithium, that family? That did wonders for her and my aunt (who was rampantly psychotic as a result of bi-polar and is now fine. Hard to figure out. No meds now.)

    Maybe you can go that question mark thing and ask them if they’d be willing to let me get you in touch with her, and how that would work. She would not be talking to you as a client, although she has a wealth of experience, professional and personal, which she can draw from – but as a person. (in other words this would not involve any transfer of money. God no!!)

    (You can also ask her your question about adversity and whether it can be overcome.)

    I sense that you are going through something very difficult and awful, and I’d like to be of service. There’s no one quite like my mother.— Razor sharp, extremely sensitive, and a great problem solver. A touch eccentric but we all have our imperfections.

    You friend from a distance,

    Dan



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  • Shamans were mainly herbalists (To treat illnesses) who knew their mushrooms very well 🙂 Mainly, these shamans had to navigate between the spirit world and the leader of the tribe. They were usually smart people, who were politically pretty savvy. Hallucinations due to psychosis do not normally produce great ideas (Mostly fear and paranoia); hallucination due to psilocybene can offer deeper insight in all sorts of connections in nature and people. Highly creative ideas are usually found in the autistics, bordering on genius/madness.



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  • P.P.S. I just re-read your comment. Perhaps my suggestion was unwarranted. It sounds like you have the situation pretty much under control, no? Sorry if I misconstrued.
    But it would be nice if the two of you could talk.
    My late brother refused to take his meds when he was in and out of psychosis. It was infuriating as hell. Sometimes I was able to get him to take it, and it was like night and day.



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  • Dan
    I’m very sure that your mom and I have much in common. I knew it the minute I read her book. Rest assured that just knowing that someone else has come through troubling times is great support for those in the thick of it. We have a few extremely challenging characters in my family but there are others who are strongly supportive. Strangely, I’ve noticed that some of the challenging characters are often the first ones on the job when certain others tumble into the ditch. Some of these bipolars have a tremendous force of personality and I’ve seen them use it for good and for bad.

    In the end I’m always aware of the fact that there are others out there with much worse problems than what I’m dealing with. Much worse.

    I do usually have the situation under control as long as it’s only one person at a time going off the rails. If they all go bonkers at the same time I’m definitely on the next plane out of here! 😀



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  • Rightly said. Who are you addressing?
    Cognitive behavioral therapy is overrated, imo. I take it you look down upon psychoanalysis. I look down on CBT. You have to get down to causes and conditions. CBT is for basket cases only. I’ve been to a few sessions. Never again.
    No one is suggesting talking to rampantly psychotic patients. Nor is anyone suggesting that medication isn’t necessary.
    Read R.D. Laing and Wittgenstein.
    “Psychosis” covers a lot of territory. It is a concept with blurred edges.
    “Even delusions and hallucinations, the gold standard for schizophrenia, are common in dreams, and not all that uncommon when we are awake.”
    Not all schizophrenics are psychotic you know.
    I think you can talk to some of them with good results.



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  • Clarification: CBT can be useful in some instances, as you said.
    I don’t think it should be used on patients who are able to look at themselves, have an observing ego, and have insight.
    Severe OCD might be helped by it. Not sure.



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  • “(Sarcasm) Ah. It’s how the brain communicates, you see. It’s not how the person communicates! Even though, we have no direct evidence that the brain is communicating in one way or another internally, do we?” —A friend



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  • No, you can’t cure it, Mr. DNA! But you can certainly talk to schizophrenics, engage in some form of talk therapy with positive results. Jesus, they’re human beings, and if they are on meds and stable you can be a support to them and listen to them. I have a schizophrenic first cousin who calls me regularly. I am not a psychologist but I know these talks make her feel better. And sometimes she is remarkably lucid. (She often says I am Jesus Christ, so not only is she lucid a times, she is also remarkably appreciative of my fine qualities.)
    No one is talking about a cure; but they are not inhuman. They have feelings, minds, hearts– just like you and me.
    Too much rigidity. Can’t cure them so don’t talk to them. Bad attitude.



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  • Thank you Anti-theist preacher, much obliged.

    In my experience CBT has been somewhat useful but only as you say, when the subject is well. Unlike LaurieB we’ve never been able to monitor my kid sister’s compliance, but I (uniquely in our family) can recognise her prodromal symptoms. I can warn others that trouble is imminent and on each occasion I’ve been correct. Talking then becomes utterly futile and shortly afterwards she will provocatively announce her non-compliance, proudly bragging that that she doesn’t need them. Reliably within a week or so somebody has had to call for an ambulance or the police. Unlike LaurieB’s mum though, she is usually sectioned for a week or more as neuroleptics are titrated for effect.

    [Edited by moderator to bring within Terms of Use.]



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  • Mr. Walsh:

    Hey, Len, CBT works best on the very sick, but not too sick. I don’t think it’s the best form of treatment for patients who have insight and self-awareness. My opinion only. I could be dead wrong.

    I could do without the patronizing comments, but you can say what you like.

    Have a good day.

    I have a lot of mental illness in my family, am no amateur in that regard, and have no crazy notions. I was merely pointing out that talking to schizophrenics in a humane way can be, in some if not many instances, helpful. Not a cure, but a worthwhile thing to do, I think. One has to be careful, of course.

    I know that psychosis has to be treated with neuroleptics and other medications. Duh.

    What did I say that was unsound? I’d like to know. Help me out instead of putting me down.

    Regards,
    Dan the ignorant moron



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