Schizophrenia Identical Twins; Stanley & Lobotomy Hx

Author: Hanjhs2000

Patty: WAY OVER, WE'RE TALKING. Woman: AH, OKAY. Patty: OR IS THAT THE OTHER GUY? Woman: NO, THIS IS JERRY. Patty: THAT'S THE OTHER GUY WHO'S VERY, VERY, VERY PARANOID. Woman: GOD, HOW ARE WE GOING TO APPROACH HIM AGAIN? THIS IS WHAT WE'RE GOING TO DO. I'm going to stop a little in the front. Patty: UH-HUH. Woman: AND THEN WE GET OUT AND TRY TO PUT THE SANDWICH A FEW FEET BEFORE HE GET THERE TO SEE IF HE PICK IT UP.

Patty: OKAY, WELL, LET'S-- WE GOT TO DO IT BEFORE HE GETS... Well, here... We'll see. Woman: WE'LL GO IN THERE, HOLD IT. Patty: JEEZ, HE LOOKS BAD. Woman: HE'S LOOKING WORSE AND WORSE. Patty: I KNOW, HE LOOKS TERRIBLE.

Woman: AND IT'S SO DIFFICULT TO FIND HIM. HE'S GOING THIS DIRECTION? Patty: YEAH, HE'S GOING THIS DIRECTION. Woman: OKAY, I WANT HIM TO SEE US THROUGH THE FRONT.

Patty: YEAH, BUT WE DON'T WANT TO-- WE WANT TO MAKE IT CLEAR TO HIM... Woman: OKAY, HE'S ON MY SIDE. Patty: ALL RIGHT.DO IT FROM ? Woman: NO. Woman: JERRY? WANT A SANDWICH? ■ HOW ABOUT IF I PUT IT HERE, OKAY? MAYBE HE COME BACK AND TAKE IT. Woman: WHEN A CLIENT THAT I APPROACH IN THE PARK DOESN'T ALLOW ME TO APPROACH THEM FOR YEARS, I UNDERSTAND. I don't take it personal. You tell me if i-- if i encounter you in a park and i get out of the van and i go to you and offer you a sandwich, you tell me if you're going to take the sandwich from me. And you are normal, supposedly.

Schizophrenia Identical Twins; Stanley & Lobotomy Hx

You don't have any problems in your brain that doesn't make you perceive reality different than when a schizophrenic perceive it. Then you tell me how a schizophrenic who is paranoid is going to react when i offer a sandwich. They may think it's poison. They may think i'm coming to kill them.

You never know what can go through the mind of these people. Patty: LOOK AT JERRY COMING BACK. Woman: OH, JERRY'S COMING BACK FOR THE SANDWICH. Patty: ALL RIGHT, GUY.

Woman: GOD. Patty: MAYBE HE'S GOING TO SIT. Woman: YEAH.

Narrator: THERE ARE AT LEAST 150,000 SEVERELY MENTALLY ILL MEN AND WOMEN LIVING IN THE PARKS AND ON THE STREETS OF THIS COUNTRY. Project reachout is a private new york agency that tries to draw some of them in for shelter and treatment. Woman: KEEP A DISTANCE, OKAY? WANT A SANDWICH? SEE YOU LATER. Narrator: LAST YEAR, PATTY MOON AND MARGARETA LOPEZ, ONE OF THREE REACHOUT TEAMS, MADE CONTACT WITH MORE THAN 2,500. Lopez: OKAY. He took the sandwich. Lopez: FIVE! Moon: YOU HAVE SOME DAMN GOOD INSTINCTS.

Lopez: GOD! Moon: HOW DID YOU KNOW TO APPROACH HIM AGAIN? Lopez: I DON'T KNOW, HE WAS TOO-- HE WAS TOO SETTLED THERE, SO QUIET, SO... Moon: LOOK AT, HE'S GOING TO EAT IT EVEN. Either that or he'll throw it.

Lopez: FIRST SANDWICH. Moon: I KNOW, I CAN'T BELIEVE THIS. Narrator: MARGARETA LOPEZ CALLS NEW YORK'S CENTRAL PARK THE LARGEST OPEN PSYCHIATRIC WARD IN THE WORLD. 30% of the nation's homeless suffer severe mental illness, and the most psychotic try to isolate themselves in places like this.

The primary diagnosis is schizophrenia. Paul McHugh, MD, Johns Hopkins Hospital: SCHIZOPHRENIA IS A MAJOR PROBLEM FOR US TO UNDERSTAND AND IT'S BEEN A TOUGH NUT TO CRACK, AND FOR A NUMBER OF REASONS. First of all, we can't sense a central problem in schizophrenia. We can only say, look, all of mental life is devastated by schizophrenia, and we can't point to a central mental function that is at the heart of the problem. That's not true of conditions like mental retardation or dementia or manic-depressive disorder. With each one of them we can say, look, the central problem here is a dilapidation of intelligence, or the central problem here is a dilapidation of mood. In schizophrenia we say the whole mind and the whole capacity of the individual to relate to the world has been shaken and devastated by this illness and we don't understand why. Woman: THIS WAS WHEN THE TWINS WERE A YEAR OLD.

Sharon is on the left and marge is on the right. I look back and they were awfully cute then, and why so much attention was drawn to them when i would take them out in public. It's the kind of thing where i had all the dreams and everything that the typical parent has for their children, and then to see them cut down in such a dramatic way... I guess i'm glad i didn't know then what i know today. Narrator: WHAT AMY MURPHY DIDN'T KNOW THEN WAS THAT ONE OF HER DAUGHTERS, MARGE, WOULD BECOME ACUTELY ILL WITH SCHIZOPHRENIA IN 1982 WHEN SHE WAS A JUNIOR AT COLLEGE.

Nurse: I'M IN THE BACK, BACK HERE, ALL THE WAY IN THE BACK. Narrator: IN 1989, THE MURPHY TWINS AND THEIR MOTHER CAME TO THE NATIONAL INSTITUTES OF MENTAL HEALTH IN WASHINGTON TO BE PART OF A MAJOR STUDY INTO THE ENIGMATIC CAUSES OF SCHIZOPHRENIA. Woman: OH, HI, NICE TO MEET YOU. You must be a grandma too. Amy Murphy: YES, I'M A GRANDMA. Nurse: OKAY, THIS IS FOR THE PROCEDURE THAT DR. Torrey talked to you about... Amy Murphy: MARGE..

Marge, marge, but you're not listening a minute. Marge: OKAY, OKAY, I'LL LISTEN. Amy Murphy: OKAY. REMEMBER WE SAID YOU WERE GOING TO HAVE A NEEDLE IN BOTH ARMS AND THEY'RE GOING TO TAKE THE WHITE BLOOD CELLS OUT? Marge: OKAY, THAT'S WHAT YOU TOLD ME. Amy Murphy: OKAY, THAT'S THE MACHINE THAT IS DOING IT. Marge: YES.

Amy Murphy: SEE, YOU DIDN'T SEE THE MACHINE BEFORE. Amy Murphy: WITH MARGE'S ILLNESS, HER WHOLE PERSONALITY HAS CHANGED. It's like there's a shell... That her body is standing there and it talks and says things, but the girl i knew, the daughter i raised, isn't there.

She... She's gone. Or not quite gone, but almost. Nurse: MARJORIE, THE ONLY THING THAT'S GOING TO BE A LITTLE BIT DIFFERENT ABOUT YOURS IS THAT WE HAVE TO DO A FINGER STICK FIRST... Marge: OKAY. Nurse: ...WHICH WE DON'T HAVE TO DO WITH SHARON BECAUSE WE WERE ABLE TO GET HER BLOOD SAMPLE THE OTHER DAY. Woman: BECAUSE DR. Torrey got into her veins but not yours.

Marge: YEAH. Nurse: AND WE COULDN'T, SO WE JUST HAVE TO DO A FINGER STICK... Amy Murphy: WHEN MARGE GOT SICK, SHARON LOST HER BEST FRIEND. It's hard to describe how twins are, but they've always had each other and they've always shared each other. There's a bond that's so close that it's real hard to break. And when that bond is broken, it's hard to replace. Marge: YEAH.

CAN YOU MAKE A STATEMENT? Nurse: WHAT KIND OF A STATEMENT AM I SUPPOSED TO MAKE? Marge: I DON'T KNOW. Nurse: OH. e. Fuller Torrey, MD, Twin Study, NIMH: IN THE CASE OF THE MURPHY TWINS, MARGE HAS A MORE SEVERE FORM OF THE DISEASE THAN THE AVERAGE PERSON WITH SCHIZOPHRENIA. Marge is kind of in the same class as my sister, who was hospitalized for many years also.

Schizophrenia is a brain disease; we know that now. WHEN MY SISTER GOT SICK IN THE 1950s, WE DIDN'T KNOW THAT AND THERE WAS A LOT OF CONFUSION ABOUT WHAT SCHIZOPHRENIA WAS. We know now that schizophrenia is a disease like parkinson's disease or alzheimer's disease or multiple sclerosis.

We know that something gets in the brain and changes the chemistry in the brain and causes symptoms, so that the kind of symptoms that people have, and my sister had, are hearing voices, delusional thinking so that you misinterpret what's going on and think that things refer to you that don't refer to you, and the inability to think logically from "a" to "b" to "c". Marge: CAN YOU TAKE THIS OFF, THE NEEDLE OUT? I PRODUCED, YOU KNOW... Nurse: WE HAVE TO LEAVE IT IN NOW FOR A WHILE.

Nurse: WE HAVE TO LEAVE IT IN FOR A FEW MINUTES. Marge: WHAT? FOR BEING A BAD LITTLE GIRL? Nurse: NO, YOU'VE BEEN AN EXCELLENT GIRL. Nurse: MARJORIE? THIS IS THE 40 MINUTES NOW THAT WE WERE TELLING YOU ABOUT FOR THE... Torrey: WHEN WE TAKE BLOOD FROM THE TWINS, AND WE HOOK THEM UP TO THE SPECIAL MACHINE THAT WILL TAKE A SMALL AMOUNT OF BLOOD, BUT WILL TAKE SELECTIVELY THE LYMPHOCYTES THAT WE WANT TO STUDY.

They are the best means for studying the immune system. And we know that many people with schizophrenia have abnormalities in the immune system. Amy Murphy: THIS IS MARJORIE'S, AND THIS ONE'S SHARON'S. Narrator: IN ALL, THERE ARE 17 PAIRS OF IDENTICAL TWINS IN THE STUDY, IDENTICAL IN EVERY WAY, EXCEPT THAT ONE TWIN HAS SCHIZOPHRENIA. Amy Murphy: GUESS AGAIN.

Woman: I'M TRYING TO, I DON'T WANT TO BE WRONG. Amy Murphy: IT'S OKAY IF YOU ARE, THOUGH. Woman: THIS IS SHARON? Amy Murphy: YEAH, YEAH, THAT'S SHARON. Woman: IT'S HARD. It's really hard. Amy Murphy: YEAH. Woman: VERY HARD TO, YEAH, VERY HARD.

Torrey: IDENTICAL TWINS ARE EXTREMELY USEFUL FOR ALL KINDS OF MEDICAL RESEARCH, INCLUDING RESEARCH ON SCHIZOPHRENIA, BECAUSE THEY START WITH THE SAME GENES. They start as basically clones of each other, if you like. And in any disease, including schizophrenia, where genetics are thought to play a role, this is the best way to separate the genetic from the non-genetic aspects of the disease. If it were a purely genetic disease, then whenever one set of identical twins-- whenever one person got the disease, the other one would always get it, because they have the same genes. Daniel Weinberger, MD, Twin Study, NIMH: IN STUDIES OF TWINS THAT HAVE BEEN DONE FOR ABOUT FIVE DECADES NOW, THE LIKELIHOOD THAT IF ONE TWIN HAS THE ILLNESS THE OTHER TWIN WILL HAVE THE ILLNESS IS ONLY ABOUT 50% OR 60%. In other words, half the time the twins are concordant, meaning they both have the illness, and half the time if one has the illness the other one does not have the illness.

Now, this means by definition that genetics cannot be the entire story. We don't understand what the factors are that make it possible for someone to have the gene but not have the illness. But there are many human illnesses like this; this is not unique to schizophrenia. Man: I'D LIKE TO ASK YOU A COUPLE OF PROVERBS. CAN YOU TELL ME WHAT THIS SAYING MEANS? "A ROLLING STONE GATHERS NO MOSS." Marge: I DON'T KNOW, WHAT DO YOU MEAN? Man: WELL, THIS IS A SAYING. This is something people sometimes say. "A ROLLING STONE..." Marge: IS IT A CLICHE? Man: SORT OF, YEAH. Marge: YEAH? Man: "A ROLLING STONE GATHERS NO MOSS." WHAT DOES THAT MEAN TO YOU? Marge: WHAT? IS MOSS LIKE GRASS ON THE GROUND? Man: I THINK IT'S ONE OF THOSE THINGS THAT IT'S WHATEVER YOU THINK IT IS.

Marge: YOU HAVE A ROCK, YOU THINK YOU THROW IT? I DON'T KNOW. Torrey: "A ROLLING STONE GATHERS NO MOSS." Sharon: OKAY, WHAT THAT MEANS TO ME? Torrey: WHAT DOES IT MEAN TO YOU? Sharon: THAT SOMETHING IS MOVING SO FASTHAT IT GATHERS NO EXTRANEOUS MATERIAL. Torrey: OKAY... HOW ABOUT "PEOPLE WHO LIVE IN GLASS HOUSES SHOULDN'T THROW STONES"? Sharon: OR STOW THRONES. Torrey: YOU'VE HEARD THAT ONE? Sharon: YES. OKAY, "PEOPLE IN GLASS HOUSES..." Sharon: THE RELIEF I GOT FROM THE TWIN STUDY WAS, YOU KNOW, JUST INCREDIBLE. Dr. Torrey said out of the first 35 things to worry about in life, getting sick like her ought to be 37 on my list.

People looked at me and said, "you've lost weight." and i hadn't lost any physical weight at all. I'm just kind of the same. But i knew what they were talking about because it was emotional weight that was gone. And people saw it. And people i hadn't seen in years said that, "well, since the twin study, she looks lighter and brighter and so much more relaxed." i wish my life were different and i wish this illness never existed, but it's a part of my life and it is a part of who i am. And that's not going to change. Narrator: SCHIZOPHRENIA STRIKES ONE IN 100. There are different degrees of severity.

But to see the disease at its most severe is to see it untreated. We first met david when he had just come in from the cold to project reachout. ALTHOUGH HE AGREED TO TALK TO OUR PRODUCER, DeWITT SAGE, HE WAS ALSO DEEPLY SUSPICIOUS. David is a paranoid schizophrenic.

David Taggert: THE... I... The... My stomach kind of gives me trouble when i don't have enough sleep. The stomach and the legs are the two things that tend to most prominently go when i don't sleep. Narrator: REACHOUT'S MIKE MASTROGIOVANNI IS DAVID'S CASE WORKER. Mike: OOPS. David: HAPPENS OFTEN.

Mike: WHAT HAPPENED TO THE LENS THERE? David: THEY FELL OFF MY FACE ONE DAY AND THEY'RE GLASS AND THEY WERE COLD, IT WAS COLD, AND SO THEY WERE PROBABLY A LITTLE EXTRA BRITTLE AND BANGO. Mike: BECAUSE THIS HAPPENED SINCE THE LAST TIME I SAW YOU, RIGHT, WHICH WAS JUST... David: WHICH WAS A COUPLE DAYS AGO, YEAH.

It fell and hit the sidewalk and it's glass lens, so... Mike: HAVE YOU CONFIRMED YOUR... YOUR PRESCRIPTION? IS IT THE RIGHT PRESCRIPTION? David: I, UH..

Mike: YOU WERE GOING TO CHECK THAT OUT. David: I HAVEN'T, UH... I... I... I can't answer that at the moment but the reason that i'm going-- that i'm confirm-- i'm going-- i'm setting up so that i can confirm the prescription is having had lenses stolen-- it's all on tape-- having had glasses disappear and then reappear when i squawked. So i definitely must, must, must, must so that i can be safe crossing streets, make sure that i get the correct prescription. And that means all the way from..

All the way from the stage of getting the prescription to actually having the glasses made. And one other thing-- i'd really appreciate it-- in light of what else is on the tape this is going to make sense-- i'd really appreciate it if there's no transmitter imbedded in the frame. Okay. ( laughs ) Mike: I... I would hope that that's not the case. David: LIKE THE ONE-- LIKE THE ONE THAT'S PROBABLY HERE. Anyway, that's fact, folks.

David: THIS WILL GET LOST ON A CUTTING ROOM FLOOR FOR SURE. I am probably, or possibly, under surveillance by the drug enforcement administration, private investigative officials, and various units of the n.y.p.d. The f.b.i. Once told me that they weren't interested in me, which was kind of refreshing.

WHO KNOWS? DeWitt Sage: DAVID, LET ME ASK-- THE F.B.I., ALL OF THIS INTENSE SURVEILLANCE, COULD THIS BE PART OF AN ILLNESS THAT YOU HAVE? David: NICE TRY. If... When you... When you say, "well, maybe it's just something that i'm thinking of and product of my situation," when it happens 150 times? i mean, let's take an example. Someone might be reading a book and leave it on a telephone booth as he's making a call. Someone might do that and sometimes that book might be a really attractive book or an expensive book or somebody else might have liked that book and that book might not be there when you turn back, say, 30 seconds later.

Okay? and when that happens 30 or 40 times, when sometimes those books are obviously of no conceivable cash value to anybody? when sometimes the books contain your identification documents and your money, which nobody but someone maintaining close surveillance on you could have discovered? see, see, when determining whether something is real or something is not real, it's real simple-- get the facts. Weinberger: SCHIZOPHRENIA HAS TO BE VIEWED AS THE CANCER OF MENTAL ILLNESSES. It is certainly the most profound illness treated by psychiatrists.

Part of the desperation that people felt in treating this profoundly disabling and dramatic illness was reflected in the amazing treatments that were brought to bear on schizophrenia. I mean, there are treatments from surgical treatments where people would, you know, lobotomies, people would do surgery on the brain, but there were surgical treatments on other organs. People used to take out the adrenal glands. Castration at one time was considered to be an effective treatment for schizophrenia. There have been all kinds of medical treatments, there have been all kinds of psychological treatments.

Helen Savarese, Nurse Administrator: LOBOTOMIES TO ME, JUST SEEING THEM... Devastated me. I was a part of it. YOU HAVE TO REMEMBER THAT IN THE EARLY '50s THERE WERE NO Sage: JUSTIN, CAN WE TALK FOR A MINUTE? Justin: SURE. Sage: YOU WANT TO SIT UP? OR DO YOU WANT TO LIE DOWN? Justin: LIE DOWN. Sage: REALLY? Justin: YEAH... Feel comfortable lying down.

Savarese: I REMEMBER ON LOBOTOMIES THEY'D BRING THE PATIENT IN, THE DOCTOR WOULD BE HERE, COMPLETE HEAD SHAVED. They wold take gentian violet and score the head. Novocaine would be injected, and the surgery would begin. The patient was fully awake. I remember as a young student■ fothat matter, i would be standing here, and they would, on the side, with a scalpel, then they would use a little drill. And i remember, oh, it-- to me, especially as a young girl, i mean, this to me was absolutely terrible. They would take a probe and insert. They did not know where they were going, but they were hoping that something would slow down the process of this patient.

Sage: JUSTIN, WHAT KIND OF TREATMENTS HAVE YOU BEEN GIVEN OVER THE YEARS? Justin: AMBULATORY INSULIN, INSULIN COMA, ELECTRIC SHOCK, NEUROSURGERY, AND FINALLY DRUG THERAPY. Sage: AND FINALLY? Justin: DRUG THERAPY. Sage: AND WHEN YOU SAY NEUROSURGERY, WHAT DO YOU MEAN? Justin: BRAIN SURGERY. I HAD A PREFRONTAL LOBOTOMY IN 1952 IN NEW YORK STATE PSYCHIATRIC INSTITUTE AND HOSPITAL, 722 WEST 168th STREET, NEW YORK 22, NEW YORK, PHONE NUMBER, LORRAINE 8-4000. Sage: AS SLOWLY AS YOU CAN, AND AS CLEARLY, WHAT HAPPENED THAT DAY? Justin: THE... The operation? they put me on a stretcher.

Then i felt myself being moved into a lighted room. THERE WERE FOUR SURGEONS THERE: Narrator: IN LATE 1949, WHEN STANLEY GROSS WAS LOBOTOMIZED AT PILGRIM STATE, THE TREATMENT WAS SEEN AS A CURE FOR THE MOST EXTREME SCHIZOPHRENIA. Although the operation did subdue violence, it soon became clear that the underlying illness was not affected. Stanley, we had been warned, never discussed his operation. Stanley Gross: NO, HE DIED. I told you about the time i heard a bomb dropping, and boom, boom, and it blew a quite big hole about four foot in the ground. So it was a baby bomb, it was a major bomb. Sage: STANLEY, WHICH PLANET SHOULD HAVE COME DOWN TO ATTACK THE EARTH? Gross: THE PLANET OF THE HEAD-BREAKERS.

Sage: THE PLANET OF THE HEAD-BREAKERS? Gross: YEAH, THEY WERE ONE MILLION MILES UP, SO YOU KNOW IT TAKES ABOUT 2½ DAYS BEFORE THEY CAN LAND, TRAVELING A MILLION MILES AN HOUR. Sage: THE PLANET OF THE HEAD-BREAKERS, AND STANLEY'S SUPPOSED TO BE THE HEAD OF THAT PLANET. Gross: RIGHT, THE LORD. Sage: HOW MANY HEADS HAS STANLEY BROKEN? Stanley: WHAT DO YOU THINK, DO YOU REMEMBER IT? ■ Sage: ANYTHING ELSE YOU WANT TO TELL ME? Stanley: THE WHOLE STORY. YOU SEEN HIM BREAK ANY HEADS AROUND HERE? Sage: DID I SEE THEM BREAK ANY HEADS AROUND HERE? Stanley: DID... DID STANLEY EVER GET TO BREAK ANY HEADS IN PILGRIM? Sage: IN PILGRIM STATE? DID STANLEY EVER BREAK ANY HEADS? NO. Stanley: OKAY, SO THAT'S THE STORY. Sage: BUT LET ME ASK YOU A FUNNY QUESTION.

DID PILGRIM STATE EVER BREAK ANY HEADS? Stanley: I DON'T KNOW. I know this isn't a joke, to wear two holes in your head. And i'll tell you something.

I read on a... On a bulletin that was put up that if a doctor did that anymore, he'd get fined $15,000 and spend ten years in jail. It's against the law to do it now. WHAT DO YOU THINK, A DOCTOR WANTS TO GO TO PRISON FOR TEN YEARS AND PAY $15,000? Narrator: BY THE TIME LOBOTOMIES WERE STOPPED AT PILGRIM STATE IN THE MID-1950s, OVER 30,000 HAD BEEN PERFORMED THROUGHOUT THE UNITED STATES. At that time, this now abandoned building was filled beyond capacity-- a monument to the ineffectiveness of any known treatment for schizophrenia. The desperate search for cause and treatment continued. It further polarized psychiatrists already divided between those who embraced the principles of modern medicine and the promise of antipsychotic drugs and those who held to the more dominant tradition of american psychiatry.

Sigmund freud's couch was never used as a window into the souls of madmen. While his theories revolutionized the way we think about ourselves, he never treated any schizophrenic patient. Freud considered psychoanalysis-- his theory of unconscious drives and conflicts-- inappropriate, impossible for the treatment of schizophrenia. But after freud came to america to deliver a series of lectures in 1909, the practice of american psychiatry would eventually come to be dominated, as nowhere else, by the theories and techniques of psychoanalysis. Not infrequently, freud's followers, in treating schizophrenia, would practice what the founding father never preached.

McHugh: THE IMPORTANT THING TO KNOW ABOUT THE FREUDIAN IDEA IS THAT IT'S FUNDAMENTALLY A SALVATIONIST IDEA. It says that it knows the cause and the trouble built into human nature and human life experience and it has the cure for it. And we americans at least have been-- again and again-- ready to take up, at least temporarily, with a new philosophy, a new doctrine, if we think it's going to make this world, and this life in it, better. That's what psychoanalysis offered to us.

It's a shame that it didn't work out, really. Torrey: I THINK PSYCHOANALYTIC TREATMENT FOR SCHIZOPHRENIA IS NOT ONLY NOT HELPFUL, I THINK IT'S QUITE HARMFUL. And the reason is, because it implies very clearly that the reason that the person is sick is because of the way theyere treated in childhood, because of what happened with their mother, because of what happened with their father or their baby sister or whatever it is. We know that has nothing to do with it. I mean, when you talk about someone with polio would you ask them, "gee, how did you feel when your little sister was born?" if someone comes in with alzheimer's disease or multiple sclerosis, you don't say, "how did your mother treat you when you were little?" it's that silly. And yet we still do that in some cases. Narrator: TODAY, THE STRUGGLE BETWEEN OPPOSING FACTIONS IN PSYCHIATRY IS LARGELY RESOLVED.

There's wide agreement that schizophrenia is a disease and that psychoanalysis is an inappropriate treatment, although no one disputes the important role of supportive talking therapy. But old ideas die hard. Some training institutes still teach that schizophrenia sometimes springs from the traumas of childhood.

We asked Dr. Phyllis meadow for an example. Meadow: WE ABSOLUTELY KNOW WHAT CAUSES SCHIZOPHRENIA, AND I WISH MORE PEOPLE WOULD JUST STUDY SCHIZOPHREA IN DEPTH AND LEARN ABOUT IT. For example, the child comes into the world already frustrated. He's just been born, which is a terrible experience. And the only thing that woos him towards the life drives is the relationship with the breast.

He doesn't have a relationship with the mother, but he has a relationship with the breast. It's never there every time you want it, but it's there enough of the time. I think some analysts refer to that as good-enough mothering. That is, the child can feel magical, omnipotent, he can call up the breast and within a few minutes he'll hear the noise of the breast approaching, something to indicate that the breast is forthcoming. He'll have a fantasy in his mind of a breast, and it will usually trickle milk-- if he's healthy. If he's very unhealthy, he'll roll over, feel apathetic and feel there's no breast, there's no fantasy and there's no way to get anything he needs. And that is what leads to pathology.

Sometimes it leads to death. But that would certainly lead to schizophrenia. Nininger: HI, DAVID. David: GOOD MORNING, DR.

Nininger. I'd shake your hand, but... Nininger: THAT'S ALL RIGHT. Have a seat. WE'RE IN A DIFFERENT ROOM THIS MORNING.■ Narrator: THIS IS DAVID'S SECOND MEETING WITH DR. Jim nininger, a reachout volunteer psychiatrist who tries to treat schizophrenia with a combination of supportive talking therapy and medications. He believes both are necessary. Nininger: SO, UM..

David: SO, I NEED TO SAY, I NEED TO SAY AT THE FIRST OF THIS, DON'T MIND ME-- CALL IT MY PARANOIA OR MY CAREFULNESS-- ANYWAY, THAT ANYTHING WHICH HAS BEEN TAPED PRIOR TO THIS ON THIS DATE OF... What was yesterday's date, so i know today's? tuesday, october 24... Was taped when, to my knowledge, the camera was not running. Therefore, i have not consented to its taping.

Okay, that being said, the camera's now running and this stuff's all good. Okay, anyway, don't mind me-- i was a political science major. Anyway, you know... Nininger: IT'S BEEN A COUPLE WEEKS SINCE WE MET. CAN YOU BRING ME UP TO DATE ON HOW YOU'VE BEEN SINCE THEN? David: MY WEEKENDS HAVE BEEN FINE, MY WEEKNIGHTS HAVE BEEN HELLISH. Nininger: IN THE WEEKENDS YOU HAVE A PLACE TO STAY, AND DURING THE WEEK YOU DON'T, RIGHT? David: THAT'S CORRECT. And during the week, i lately have been inhabiting subway stations and parks. Nininger: DOES THAT GET YOU DEPRESSED, TO HAVE TO LIVE THERE? David: SURE IT DOES.

AND I WONDER, YOU KNOW, I SORT OF THINK, WELL, I'M DEPRESSED, MAYBE I NEED AN ANTIDEPRESSANT-- BUT WHO WOULDN'T BE? Nininger: LET ME ASK YOU THIS. How have you been sleeping?.

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Schizophrenia Identical Twins; Stanley & Lobotomy Hx

Patty: WAY OVER, WE'RE TALKING. Woman: AH, OKAY. Patty: OR IS THAT THE OTHER GUY? Woman: NO, THIS IS JERRY. Patty: THAT'S THE OTHER GUY WHO'S VERY, VERY, VERY PARANOID.…

By: Hanjhs2000