Madness becomes normal

四月 11, 1997

Schizophrenic traits may be common in many people

If media coverage of schizophrenia was all you had to go on, you could be forgiven for thinking that all schizophrenics were violent murderers. If so, you might be alarmed at the suggestion that many so-called "normal" people have schizophrenic-like personality traits. But Craig Steel, whose doctoral research tests this idea, thinks that admitting we have more in common with "mad" people could be positively beneficial, as we would come to "understand what might seem like total madness in the context of normality".

"It's a rejection of the idea of schizophrenia as a traditional disease that you either have or you don't," says Steel of his work under David Holmsley at the Institute of Psychiatry in London. "(We see) the symptoms of schizophrenia as a severe manifestation of personality traits that exist within the normal population." According to this view, everyone has some "schizotypy" - schizophrenic-like traits - in positive or negative measure. Using the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE), a personality questionnaire, Steel identifies "high schizoptypes",normal people who answer questions in much the same way as do schizophrenics, and who may be particularly vulnerable to schizophrenia. Steel thinks that there may be underlying similarities in the workings of schizophrenic and high-schizotype brains.

The label "schizophrenia" has been around for more than 100 years, and covers a diverse range of seemingly unrelated symptoms - some psychiatrists think that it may even be several separate diseases. But Holmsley's general model explains the symptoms in terms of a defect in information processing. To make sense of the mass of incoming information that presents itself, most people actively prevent irrelevant information from reaching their consciousness. But the breakdown of this process in the schizophrenic brain results in "information overload". In an effort to understand and interpret this cacophony of sensations, some patients hear stray sounds as "voices", some cannot focus their concentration, while others simply withdraw, unable to cope with the impossible complexity of everyday experience.

Steel has been testing whether high schizotypes also find it difficult to weed out irrelevant information, by trying out various tasks that measure a person's response to an unexpected change. "A lot of these tasks have been used before in cognitive psychology, but I'm adapting them to this clinical setting," he explains.

The results so far look good. High schizotypes, like schizophrenics, seem less affected by expectations built up from past events. In some situations this difference could be positively advantageous, and Steel admits that certain of these personality traits could lend themselves to greater creativity. But he thinks it is wrong to view the schizophrenic as a misunderstood creative genius, as some figures of the 1960s anti-psychiatry movement argued.

While an undergraduate at Cardiff University, studying applied psychology, Steel was influenced by such ideas, including R. D. Laing's suggestion that madness was an experiential trip, a "psychedelic journey", which people should be encouraged to go through. "I've had to modify my views since then, because I've had a lot more personal experience of schizophrenia. You come to realise that these people are actually suffering, and you're in danger of using them as martyrs for your own political agenda."

Steel expects to finish his PhD by September, but will miss the Institute of Psychiatry, which has given him the opportunity to engage in several collaborative projects. He hopes that greater understanding might translate into better therapies, not least by making it "more normal to be abnormal".

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