With advances in medical technology and with many large scale, longitudinal studies now underway, social and biological science have built a convincing case that the varieties of madness subsumed by the label schizophrenia are created, fueled, and sustained by genetic, biochemical and environmental factors. However, with the ever more detailed models of the neurobiological and social systems out of which schizophrenia is born, it is possible to overlook how suffering persons actually experience their symptoms and navigate their way through life.
This book is unique in focusing on the experiences of those who have schizophrenia, and who must make sense of and live with this condition. It explores how schizophrenia disrupts person's experiences of themselves as beings in the world and how that disruption poses enduring barriers to recovery - barriers not reducible to issues of social justice or biology. After presenting a model of how disturbances in self-experience are related to but not identical with symptoms and dysfunction, it looks at the implications for the development of therapies that might provide greater opportunities for recovery.
The book provides a highly readable and humane examination of this common condition.
Reviewer:Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description:This interesting new book has a unique perspective on the pathogenesis of schizophrenia. The thesis is that individuals with schizophrenia are not only subject to the neurobiological factors known to be involved in the pathophysiology, along with social injustices, but that the experiences, both intra and extra-subjective, that schizophrenics go through contribute to the features of the illness and relate to, but are not identical to, the symptoms. Written and edited by two clinicians in the field, the book provides a distinctive viewpoint to the literature on schizophrenia.
Purpose:The purpose of the book, according to the authors, "is to attend to and help articulate the root experiences of persons who suffer from schizophrenia." The authors "hope to discuss some of the disorder's key, first-person dimensions, and in a way that not only avoids dualism, but both illuminates some of schizophrenia's clinical and psychosocial dimensions and provides concrete directions for treatment." Although it is not clear to me that these goals are actually accomplished, the authors present an interesting thesis.
Audience:The targeted audience is clinicians. Those interested in the philosophy of psychiatry would also be interested in the book.
Features:The first chapter summarizes the biological and social justice factors thought to be contributory to schizophrenia. Chapter 2 reviews the sense of self in schizophrenia. Chapter 3 discusses how the self develops as dialogue and self-positions. Chapters 4, 5, and 6 discuss how the alteration in dialogue results in self-diminishment, symptoms, and psychosocial dysfunction. Chapter 7 focuses on how this disruption in dialogue could be a therapeutic target in psychotherapy. The final chapter is a summary of the ideas. The reference section contains the relevant citations from the literature the authors use in the presentation of their thesis.
Assessment:This book presents an inimitable perspective on the pathogenesis of some aspects of schizophrenia. The idea is that manifestations of the illness further the worsening of the illness itself: having schizophrenia makes you more schizophrenic; similarly, having autism makes you more autistic. Maybe, maybe not -- but interesting ideas.