Rethinking Schizophrenia in the Context of the Person and Their Circumstances: Seven Reasons

Abstract

We know a great deal about schizophrenia, but the current state of the art is one of uncertainty. Researchers are confused, and patients feel misunderstood. This situation has been identified as due largely to the fact that the dominant neurobiological perspective leaves out the person. The aim of the present article is to review and integrate a series of clinical, phenomenological, historical, cultural, epidemiological, developmental, epigenetic, and therapeutic phenomena in support of a suggestion that schizophrenia is above all a disorder of the person rather than of the brain. Specifically, we review seven phenomena, beginning with the conception of schizophrenia as a particular disorder of the self. We continue by looking at its recent origin, as a modern phenomenon, its juvenile onset, related to the formation of the self, the better prognosis in developing countries compared to developed countries, and the high incidence of the disorder among migrants. In the context of these phenomena of a marked socio-cultural nature, we consider the so-called “genetic myth,” according to which schizophrenia would have a genetic origin. On reviewing the current genetic emphasis in the light of epigenetics, it emerges that the environment and behavior recover their prominent role in the vicissitudes of development. The seventh reason, which closes the circle of the argument, concerns the role of interpersonal “chemistry” in recovery of the sense of self.

Whispers, echoes, friends and fears: forms and functions of voice‐hearing in adolescence

“…These participants could then focus on change within the relationship with the voice(s) to enhance their wellbeing. Research with adult voice hearers into voice dialogue (Pérez‐Álvarez, García‐Montes, Vallina‐Fernández & Perona‐Garcelán, 2016), sense‐making in community samples (Iudici, Quarato, & Neri, 2019) and more recently virtual reality therapy (Dellazizzo et al., 2018) have also reflected the importance of helping the individual connect past experiences and relationships with the voices they hear to give the voice context. This may be more complex for distressing voices as they appear to have a less tangible form and fewer functions for young people to identify by themselves, as seen in Table 3.…”

The Four Causes of ADHD: Aristotle in the Classroom

“…559–560). It has already seen in schizophrenia, a clinically well-established disorder ( Pérez-Álvarez et al, 2016 ), unlike ADHD, how larger samples of thousands of patients do not lead to stronger genetic associations ( Ross, 2016 ; Sekar et al, 2016 ).…”

Psychology as a Science of Subject and Comportment, beyond the Mind and Behavior

“…Let us add the “new” conception of schizophrenia as an alteration of the experience itself and of the world, according to the ipseity-disturbance model (Sass 2014 ; see also Pérez-Álvarez et al 2016 ). Beyond the psychotic symptoms, this focus reveals a characteristic alteration of basic subjectivity and way of being-in-the-world, typically prereflexive aspects, implicit, hard for the dominant positivist natural science conception to highlight.…”

“…On the contrary, according to a cultural phenomenological focus, in this case, concentrating on the subject and comportment as the “intentional arch” in the above sense, essential structural aspects of schizophrenia are shown (Sass 2014 ). All we need to do is rethink clinical phenomena in terms of the person and his/her circumstances (Pérez-Álvarez et al 2016 ), including appropriate methods, in this case semi-structured interviews exploring various aspects of subjectivity (Sass et al 2017 ).…”