SCHIZOPHRENIA: THE SHATTERED MIRROR

[Music] can we have a little game of catch wouldn't you like to do something isn't this something you'd like to do oh let me not be mad not mad sweetheaven cried shakespeare's king lear i would not be mad when leah set out that terrible cry of make me not mad not mad he did this because this is the worst thing that can happen but i think a person died with equanimity but it's a very different thing to think that you will be you'll be destroyed that your very central being will be assaulted in this way schizophrenia i think is really the everest of psychiatry schizophrenia is one of the great and massive illnesses when you realize that there were literally tens and hundreds of thousands of people afflicted you have to be more detached than i am see it as it became in a way a kind of personal affront and i think this is a good thing this is how research in medicine should be it's a battle battle whose stakes are high what's the matter huh what's the problem what is schizophrenia nobody really knows its cause nor why some people recover and others do not yet hidden within its complexities may be the vital clues we need to help us understand ourselves suppose you lost the inner guidelines we all need in order to function in this complicated world suppose your recollection of your own past became chaotic without landmarks and your view of the future despairing what if you lost your capacity to feel pleasure lost your sense of identity as a person and suppose reality as you had always known it began to change before your eyes life would become a nightmare filled with terrifying fantasies and for a schizophrenic this is indeed what life becomes this illness has existed since the beginning of recorded time at least one out of every hundred people everywhere suffers from it during some part of his life some are in institutions but many like renee struggle along in the day-to-day world living a painful limited life walking a dangerous tightrope never knowing when they may be flung back into anguish by trying to help them we the other 99 may finally learn what can help keep us sane the national educational television network presents [Music] schizophrenia [Music] shattered mirror none of the people you are about to see are actors schizophrenia varies in its symptoms and its severity many schizophrenics are able to function in the world then suddenly or over a period of years and usually in their youth they shatter [Music] i remember was working very hard at my my dancing [Music] but the strain and the pressure of the dieting and the lack of sleep and the over-exhaustion finally began to break break me me down [Music] there were fingers touching me on my forehead they always seem to touch me as if to warn me to refrain from doing something or to to stop what i had already begun to do in time i became an absolute slave of these things i remember that i would walk down a street and i would all at once have a strange feeling that i should go in a certain direction i remember looking down a certain street it would look very strange as if in a dream and i would have a feeling i must walk down that street because there was something for me to to see or something that i must do or an experience that i i must have as these symptoms continued and seemed to get worse and worse at the same time i was also withdrawing more and more in in into myself sort of like dark black ominous clouds gathering over me like a nightmare that was engulfing me i had taken that same subway home night after night and yet i didn't know which train to to get on broke down and started to cry i was as helpless as a child and all of a sudden i burst out screaming i can't stand and i can't stand it they're torturing me they're after me these spirits won't let let me alone renee first came to see me two years ago when she was admitted to our hospital she had been diagnosed schizophrenia at least two years before i first saw her and had received various forms of therapy dr abram hoffer director of psychiatric research saskatchewan canada it's very sad but when people hear the word schizophrenia they immediately think of a split personality like declan hyde or they think of violence or great danger it's sad because these two things are not true it's very difficult to diagnose schizophrenia very often but renee demonstrates the classical picture of schizophrenia she had changes in perception these included changes in her visual field where she saw flashes of light across her visual field like gems and diamonds and crystals and this is how she described them she also felt fingers touching her forehead these are tactile hallucinations in addition she had changes in thinking and finally the last classical symptom she had inappropriate affect and she was talking about an event where she should have been depressed she seemed to be inappropriately happy when she was talking about a cheerful event she was depressed i was faced with a very difficult problem in treating renee her parents had brought her from california it cost him 1200 a month in our hospital i didn't want to keep her so long that it would deplete the family finances and yet i didn't dare send her home too soon because my first responsibility was to renee after two or three months renee felt that she wanted to come back to new york she wanted to be independent and i agreed with her but renee like most schizophrenics lives on a razor's edge that is the symptoms over schizophrenia couldn't come back at any time in new york renee faces many problems the most serious one is loneliness she is a long way from home she has very few close friends renee chose to live in a small bare room eight by ten feet now renee probably is more comfortable in a small room which becomes a kind of shelter or cave where she can feel more secure than she would be in the large busy street of new york city and she considers this room to be cozy at this point renee has been in new york one year she is taking her trying to keep up with her ballet classes which is very strenuous physically this means that she must keep her weight down and this in her case is especially dangerous for her [Music] in addition renee is working at two part-time jobs during the day she is doing clerical work which is not very stimulating and is really a long way away from what she would like to do in the evening she is a cashier now this means that she will be home late and she will not have enough sleep and therefore will not have the right quantity of rest that she needs she could relapse at any time renee is struggling to stay in the real world but what is the world from which she has come doctors have described it in many ways sometimes when a person finds his current life situation is too much for him then in a very massive way he tries to pull out in order to adapt to what is so unbearable to him in life in order to stay alive he flees to a world of his own creation with its own rules and its own terrors and you cannot reach him there feel safe up in the tree down here you do you're not afraid of heights you're not afraid of heights in this cold world of the schizophrenic there is rarely a relationship with another human being for each person considers himself alien to the other very often they do not think of themselves as human beings many do not know where their own body ends and the outside world begins and for others time is not real a minute may feel like an interminable hour an hour may race by a terrifying speed all of us have had such experiences but fleetingly what must it be like to live like that always and what must it be like always to ask those most human of questions what am i who am i and never to have an answer hey i am i who are you i am [Music] through methods like dance therapy they are placed in direct contact with others [Music] but once the music stops they go back within themselves how can we reach into their strange and private world dr humphrey osmond director of the bureau of research in urology and psychiatry for the state of new jersey has been trying to do this by developing a series of questions designed to help schizophrenics tell us more about what their inner world is like he and psychologist monaem l maligay got their clues for these questions from long conversations with hundreds of patients what's the difference between this peace of mind [Applause] you can't tell since you're not looking at me you only look at this one that's the first time you look at since yesterday we're live there why did you look at me [Applause] you know i don't make a habit i think i'm gonna make you don't make a habit of looking at somebody how about the people in general how quick you think they are people in the street and some people that are in places that i go i find they feel very quickly i see so again now you feel that people are too fast for you what prevents you from being faster that's the need to get things as right as possible when you do something you can get it as close to being done as you can are you thinking where you are talking yes uh you you told me a while ago that your age is 27 all right you are 27 how old do you feel 35 your age your actual age is 27 and you feel that you are 35. okay what makes you feel older than your own real age that's not because i like to live at home you like to be that old i see why what advantage does a person of 35 has over a person of 27 you must have good reasons for that game closer than when he dies he's closer than when he dies he is closer to when he dies you feel like dying all right there's any kind of better life after this one from such indications of what schizophrenics experience in their inner lives a test is being designed to help them communicate their true feelings and hopefully be an aide in diagnosing the illness as a control the test is first checked out with normal subjects like this volunteer we are here concerned with the way people see themselves people other people in the world in general and i would like you to read each of those statements and then decide whether it is true as it applies to you or false see but don't think too much about it i have a mental illness i hope not my reflection in the mirror looks strange well you can most people hate each other i don't think most people do how many i think there are a large number of people that hate a lot of other people but i i don't think most people would you say that they are the majority or the minority i think they're a small minority thank goodness yes i feel that my ideas may turn into insects that's quite silly would you think that there are people that sometimes would believe in that that ideas would turn into insects and is it possible that a human being would believe in that i suppose it might the idea of an idea turning into an insect is i i can't comprehend i i suppose somebody might think it but um i feel and my ideas may turn into insects well what do you think do you have this feeling or not is that true or false as far as you are concerned true that true do you feel sometimes that your ideas may turn into insects okay then which box would you put it here would you put it here you got the idea okay that's the way go ahead now and reach read each one loudly i do not know what my hands will do next no that doesn't apply fine very good i can hear bright colors certainly a funny item isn't it yeah yeah fine man it's people often laugh at me so i it's based on the way things are now or the way it happened for well just tell me about it now let us start by now now they're laughing yes where at the end they laugh at you which people are you referring to patient okay how about the past past and left and return all right okay then what would the answer be true okay i feel turned to stone true that must be very uncomfortable feeling yes very uncomfortable how long have you been feeling that way uh for the past few years for the past few years have you told anybody about that how do you feel about these questions as you are going through them did you like going through them and answering them you did yeah what makes you like them they help you to understand what your life is consists of and what your mind is i see it help help you to understand what life consists in your mind most patients who have this kind of psychological and emotional disturbance when this erupts out of their previous neurosis uh still are in contact most of the time as a matter of fact i don't think i've ever seen a patient who is really psychotic really totally disorganized 24 hours a day they move into it and out of it i have no well of my own that's false i'm rotten inside that's false there are insects under my skin doesn't seem to be any true ones it is dangerous to touch people that's false i have a mental illness apparently so that's true now when it comes to treatment there are those who put their hope in the use of drugs of many kinds now there can be no question at all but that drugs have helped very disturbed people to be less disturbed and has therefore made it possible for us to get in contact with them to communicate with them to influence the underlying problems and feelings and attitudes which they have uh whether drugs alone ever cure is a question about which one will get many disagreements my personal feeling is if they don't cure but they can sometimes make life livable for people who are otherwise too disturbed to live and that what is more important they bring people back into contact make it possible to make contact with them in a therapeutic way there are others who believe in the use of various forms of short treatment and very much the same thing could be said about the use of treatment in relation to the psychotic disorganization states of psychological disorganization that i've just said about drugs and there are some who put their whole hope in psychological treatment alone particularly deep psychoanalytic treatment there can be no question that any one of us can point to individual experiences in which people have been helped and perhaps one may justify be justified in saying even cured by any one of these approaches but those experiences are still rare and my own conviction is that there's going to be ultimately ways of integrating and bringing together these various approaches in the treatment of illnesses of this kind you