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The curtain dropped again a few hours later. Both are potential ways to look at the silver lining of a disorder that few would see as having benefits at all. What makes psychosis a condition that seems open to interpretation as an ability rather than an illness? Over the next decade, I would occasionally consider the utility of seeing psychosis as an ability: I could improve my mental health by thinking of schizoaffective disorder as a tool for accessing something useful, as opposed to a terrifying pathology.

Yet I had no idea what this belief would look like in practice. My friend Paige and I first met in through a mutual friend.


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She is a gregarious introvert, and in possession of a magnificent, snorting laugh. Her waist-length hair is often in Pippi Longstocking braids. She unironically describes herself as a pizza-loving witch, and provides mystical services ranging from tarot card reading to mediumship to shamanic journeying. For years she would come over every Tuesday to cowork with me.

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I was also introduced to J. I have yet to meet her in person, but we speak on the phone at times; I turn up the volume to catch her wispy voice through my earbuds. She once described the experience of going to Italy for the first time.

Schizophrenia In America - The Huffington Post

She was overwhelmed, she told me, by the sounds she heard from centuries of Italian life, including a cacophony of ancient voices in fluent Italian. In my friendships with these women, I have tried to imagine whether a psychiatrist would be comfortable venturing a diagnosis based on their seemingly logical sensory experiences—particularly sensory experiences that sound like magic. Although both of them struggle with recurrent depression, neither Paige nor J. This is not so with Bri, who graduated with both a B. Bri became, and still is, my spiritual mentor as well—one with whom I have had monthly calls and exchanged regular emails.

In seeking her out, I was intrigued by the idea of finding a way to make sense of my idiosyncrasies and anxieties.

My first phone conversation with Bri was a paid consultation. I told her about being diagnosed with schizoaffective disorder and my later diagnosis of late-stage Lyme disease.


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  7. After she prodded me about my dream life, I went on to tell her about my history of lucid dreaming, current issues with nightmares and PTSD, seemingly psychic experiences, hallucinations, and delusions. As she explains it, people who are thin-skinned have perceptions that are wide open; they perceive what is happening in the other realm. They have been conditioned, like the rest of us with a [W]estern ego, to identify with the negative bias against the nonrational realm of phenomenology.

    And because they do, they become even more neurotic than would otherwise be the case. During my first call with Bri, she recommended that I try her three-day, self-paced audio-and-workbook course about working with liminality. Exploring the possibilities of the sacred arts brought up the question of medication. Even as I considered that I might be thin-skinned, and therefore privy to otherworldly experiences, at no point was I inclined to quit talk therapy or my regimen of psychopharmacological drugs.

    By learning about the liminal, I was not trying to prolong my psychotic experiences, but attempting to make sense of them. I wanted to create a container for what had happened to me and shove the nastiness into it. It is clear that there are important genetic contributions to the likelihood that someone will develop schizophrenia, with consistent evidence from family, twin, and adoption studies.

    This makes it even more challenging to identify specific genes associated with risk for psychosis. There are also a number of environmental factors that are associated with an increased risk of developing schizophrenia. In addition, complications that occur at the time of birth and which cause hypoxia lack of oxygen are also associated with an increased risk for developing schizophrenia M.

    Children born to older fathers are also at a somewhat increased risk of developing schizophrenia. The likelihood of developing schizophrenia is also higher for kids who grow up in urban settings March et al. Both of these factors may reflect higher social and environmental stress in these settings.

    Recovery stories - Adrian and schizophrenia

    However, together they are beginning to give us clues as the neurodevelopmental factors that may lead someone to be at an increased risk for developing this disease. Cannon et al. However, the counterarguments have been that there is evidence that individuals with high-risk symptoms develop psychosis at a much higher rate than individuals with other types of psychiatric symptoms, and that the inclusion of Attenuated Psychotic Syndrome in Section III will spur important research that might have clinical benefits.

    The currently available treatments for schizophrenia leave much to be desired, and the search for more effective treatments for both the psychotic symptoms of schizophrenia e. The first line of treatment for schizophrenia and other psychotic disorders is the use of antipsychotic medications.

    These are drugs that all share a common feature of being a strong block of the D2 type dopamine receptor. Although these drugs can help reduce hallucinations, delusions, and disorganized speech, they do little to improve cognitive deficits or negative symptoms and can be associated with distressing motor side effects. These drugs have more mixed mechanisms of action in terms of the receptor types that they influence, though most of them also influence D2 receptors. These newer antipsychotics are not necessarily more helpful for schizophrenia but have fewer motor side effects.

    Schizophrenia In America

    The evidence that cognitive deficits also contribute to functional impairment in schizophrenia has led to an increased search for treatments that might enhance cognitive function in schizophrenia. Unfortunately, as of yet, there are no pharmacological treatments that work consistently to improve cognition in schizophrenia, though many new types of drugs are currently under exploration. However, there is a type of psychological intervention, referred to as cognitive remediation, which has shown some evidence of helping cognition and function in schizophrenia.

    In particular, a version of this treatment called Cognitive Enhancement Therapy CET has been shown to improve cognition, functional outcome, social cognition, and to protect against gray matter loss Eack et al. The development of new treatments such as Cognitive Enhancement Therapy provides some hope that we will be able to develop new and better approaches to improving the lives of individuals with this serious mental health condition and potentially even prevent it some day. Browse Content Schizophrenia Spectrum Disorders. Share this module to:. Email Address.

    First Name. Tone of voice or the sound form of a word then become significant and relevant to content, rather than being demoted or inhibited as part of the context, predicting distractibility and derailment. However, for there to be fluent speech at all, there cannot but be use of grammatical frames — the same ones that any patient with schizophrenia will have used for the first two decades of his life virtually incessantly. But when we investigate the linguistic profile of schizophrenia more closely, we see that what appears to be demarcated grammatically as the topic of conversation is not really treated as that: the patient derails, and topics can shift according to any association made.

    In a similar way, what appears to be a predicate applied to an argument yielding an apparent assertion with a truth value, e. Grammar is used, but it has lost its intrinsic meaning By the s, neuropsychological deficits in the schizophrenia population were well established, involving both general intellectual impairment Liddle and Crow, ; Buhrich et al. None of these cognitive functions, however, are in humans completely independent of language, which integrates them but also expands and transforms them, as compared with their forms in other species and hominins Coolidge and Wynn, In Dibben et al.

    Frith broached new terrain by arguing that a number of positive symptoms could be explained by a specialized form of executive dysfunction implicated in the self-monitoring of willed actions, including acts of thinking. This theory held considerable promise in the domain of alien control symptoms and possibly also AVHs, but its support from imaging studies is less clear McKenna, , p. In particular, in AVHs, contrary to what is predicted by the executive dysfunction theory, there is no de-activation of frontal areas or other areas , but an increased activity in the temporal lobe neocortex, often bilaterally.

    This reversed pattern in comparison to controls suggests, as Plaze et al. As such Frith invoked it to explain disturbances in productive speech in FTD.

    Hence there would be no language dysfunction per se in this syndrome, a view he saw supported by the putative lack of a comprehension deficit in language. However, a comprehension deficit has by now often been reported Kuperberg et al. Nonetheless, ToM deficits in the wider schizophrenia phenotype, irrespective of symptoms, are well established by now Frith and Corcoran, ; Bruene, ; Anselmetti et al. However, we know independently, from both normal and abnormally developing populations, that ToM is highly correlated with language in development Astington and Jenkins, ; DeVilliers and Pyers, ; Hale and Tager-Flusberg, ; deVilliers, ; Newton and deVilliers, ; Paynter and Peterson, Whatever explanatory potential the ToM notion contains, therefore, a linguistic perspective may comprise it independently.

    If the latter was said to be as such a mental or non-linguistic one, it would still have to mirror the grammatical one exactly.

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    The grammatical distinction is available to a mind the moment that argument-taking is an option — which is the moment that there is grammar. A grammar in which there are arguments can make clauses arguments, too, which then are embedded in other clauses. If it does, ToM content ipso facto arises, and no special capacity for representing mental state contents has to be postulated beyond grammar itself, which we need anyhow. Crucially, second-order representations are propositions too: it can clearly be false that Bill believes that John is tall. Such representations are ipso facto part of language, which entails their propositionality for free.

    In sum, invoking impairments in neurocognitive variables primarily known from neurological patients has met with considerable obstacles in schizophrenia. Correlations of variables with these symptoms have proven difficult; the mechanism of symptom formation is unclear; and core variables like ToM are not likely language-independent. This invites factoring language into the cognitive neuropsychiatry of schizophrenia and to develop more fine-grained clinical tests of grammar-based meaning distinctions to re-assess the connection between language and cognition. Our account makes us expect the finding that neuroimaging the brain of persons with FTD in particular, have identified anomalies in classical language-related areas and circuitry Weiss et al.

    Sans-Sansa et al. And Pomarol-Clotet et al. Many studies have reported aberrant patterns in fronto-temporal networks across schizophrenia in response to a range of tasks with linguistic demands Ngan et al. In addition, while normal adults exhibit left-lateralization of neural activity in fronto-temporal regions during language processing Vigneau et al. Angrilli et al. This failure of left hemispheric dominance of phonology appears then to extend to schizophrenia in general, which suggests that linguistic sound processing is to some extent impaired throughout the disease.

    A linguistic model of positive symptoms may cast fresh light on their pathogenesis and underlying neuropsychology. This makes it hard to tackle delusional thought. If thought of the kind we see impaired in positive symptoms is language-mediated inherently, and a disintegration of basic functions of language in the configuration of reference is seen empirically in symptoms, then language could be a key neurocognitive variable to be targeted in understanding symptom formation, therapeutic intervention, and cognitive remediation.

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    Retrieval, and Beyond: A Schizophrenic Way

    The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Thinking is a private matter, whereas language is arguably the most important method we have for communicating with others. Titone et al. Rather, when language is used in an idiosyncratic way, it represents the outcome of a deviant thought process.

    Hallucinations in the schizophrenia group were comparatively the most severe and least visual. The communication in question is crucially linguistic , and in normal conditions, perceiving speech is to perceive both acts of communication and agents behind them, while the reverse is not the case. The third is generic and 3rd personal. The fourth is finitely tensed.

    Patients facing such difficulties are linguistic agents , grappling with linguistic distinctions and seeking to determine what is real. Hinzen and Sheehan , Chap. National Center for Biotechnology Information , U.