On psychotic disorders and violence
We are all aware of the seeming increase in the frequency of attacks by persons who were later diagnosed as having a serious psychotic condition (e.g., schizophrenia, bipolar disorder, depression and…). In fact, the woman who tried to crash the gate of the White House was probably suffering from post partum depression. Most of the others we have heard about were suffering from schizophrenia – which about 2 percent of the population has or will get.
When someone has a psychotic condition simply stated, they are “out of touch with reality.” Hallmark symptoms can include: delusions (a pattern of cognitions which are not congruent with the world); hallucinations (sensory input that, though seems real, is not – this can involve hearing voices which no one else can hear, seeing things that are not there; commands which only they can hear; even feeling that they are being touched and the sense of smell or taste…).
So, to them all these symptoms are considered to be real! Why are so few being treated? Stigmatization of mental disorders. And, the very symptoms precluded the insight that something is very wrong.
It must be remembered that when a psychotic person hears the hallucination: “Kill so and so,” it is as clear as you reading this line. It appears to be quite real.
From before a half-century ago, such people were involuntarily committed to “state hospitals” – often far away from family and friends – isolated. There were almost no viable treatments and these hospitals were more like dungeons. What to do?
President John F. Kennedy had a sister, Rosemarie, who suffered from some psychiatric condition – though it is not clear as to which diagnosis was appropriate. Her father, Joe, had her committed to a hospital and with little in the way of ameliorative efforts, she was given a lobotomy, which exacerbated her mental state. She remained there until her death about 10 years ago.
So, JFK had a keen interest in the treatment of those so afflicted. He proposed the closing of the state hospitals (see the 1948 film “The Snake Pit” for a quite realistic view of the conditions that one found in these “bedlams”). But, in part due to his assassination, the community program never went into effect, so a far worse situation has evolved: Half of those who are deemed to be psychotic are sent to jails and prisons.
However, there is at least one good development: the introduction of drugs, which helped many (they are called psychotropics and include anti-psychotics Thorazine, Haldol, Lithium, as well as antidepressants, like Prozac…).
How about violence? Actually, people with a psychotic condition commit this kind of behavior at about the same rate as “normal.” Most simply don’t have it together enough to attack anyone. The reason people believe the canard of say, schizophrenia and violence is due to the media always “highlighting” the psychiatric disorder when an event occurs.
One of the most prominent psychiatrists in the U. S. is Dr. E. Fuller Torrey. He has an especial interest in schizophrenia because his sister has suffered from this disorder since her teenage years. In his many books, articles and appearances he implores our nation to become cognizant of mental illness, lessen the stigma, and stop putting these people in prisons and revamp the system so persons so afflicted can get the available help in suitable venues and conditions.
David Chowes, PCV
David Chowes worked as a clinical psychologist at Creedmoor Psychiatric Center and taught at Baruch College/CUNY for 25 years.