Sample from Lost in a Mind Field. Pages 12, 23 and 66
A Shrink-Rap Press Book Copyright: Neil Phillips 2010
Negative symptoms
Negative or deficit symptoms involve the absence of something that is normally there
rather than the presence of something strange. They are troublesome and often more
difficult to change than positive symptoms. Negative symptoms involve withdrawal and
often preoccupation with an inner world to such an extent that there is reduced activity
and interest in others.
Withdrawal
The kind of extreme withdrawal that can occur with
schizophrenia can be very painful for family and
friends. It feels like rejection, although it’s really
about the illness turning attention inwards.
There’s little inclination to talk and if
something is said there’s not much to it.
There is often a reluctance to respond to
a question. This leads to an impression of
mental emptiness that is sometimes called
“poverty of thought”. We’ll discuss this in
more detail when we come to the part of the
book about disturbances of thinking.
Even very quiet and withdrawn people
might have rich mental lives which they keep
completely private, thinking mainly about things
unrelated to the external world.
This explains how many people with schizophrenia
can spend weeks at a time having little or
no interaction with the everyday
world without getting bored.
The illness itself can open
up a fascinating and
entertaining mental
world in which fantasy
is far more fascinating
and important than
anything in the real
world.
The problem is that
you can’t switch it off
so everyday tasks such
as washing and eating
are largely neglected and
relationships deteriorate.
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Filtering distractions
It’s thought that trouble filtering out distractions is part of what causes cognitive
difficulties in schizophrenia. Normally things that aren’t immediately relevant barely
intrude into our awareness as we focus on a task. Of course somebody talking noisily
nearby or a jackhammer next door will be distracting but screening out small intrusions,
like a door being closed in another room, is almost effortless so that small intrusions
usually don’t even come into awareness.
If you have schizophrenia the filters that screen out intrusions might not work very well.
The problem is made worse by internal thoughts that become complex hallucinations
or just random hallucinated words or noises. As successfully using our cognitive mental
equipment involves staying steadily on track, following a line of thought, keeping the
ideas you’re working on in mind and attending carefully to accuracy, it’s easy to see how
schizophrenia can interfere with cognition.
If screening external distractions
is unreliable, ordinary tasks
that demand a reasonable
level of concentration
become very difficult.
Stop for just a moment
and listen carefully to
your environment
right now. If you
listen carefully
you will hear all
sorts of distracting
things happening
around you that you didn’t
notice only moments ago.
If you can’t concentrate it’s hard to organise
yourself, plan a project and carry out your plans even
if you have very good ideas and great skill. Workplaces
can be very stressful and bosses unreasonable, impatient and demanding. However, if
distractions and frustrations can be reduced by a quiet work environment and the boss
makes an effort to give clear, calm and thoughtful instructions rather than harassing,
demanding and shouting, many people with schizophrenia can do excellent work or
advanced study.
So, if you have schizophrenia, don’t give up on what you want to do. If it’s hard to find
a job you might well find that there is a local organisation that specialises in helping
people who have a mental illness learn new skills and revive their capacity to work.
Helping others through volunteering will make you feel valued, help you find friends and
give you many new contacts. It’s a very important first step back into paid employment.
23
The brain
The human brain is probably the most complicated thing that we know about and have
to deal with. It has enormous processing power and remarkable flexibility. We do not
yet know how or why human mental development and intellectual capacity began its
very rapid evolution some three million years ago. What we do know is that as the brain
evolved we began to remember the past in fine detail and we began to imagine a future.
Furthermore, we developed sophisticated languages and began to communicate with
a precision and subtlety that no other creature on earth has achieved. Our enhanced
capacity enabled us to build cultures and, ultimately, extraordinary technology.
We’ve paid a price for these advances in mental and cultural life. Our big brains in big
heads make childbirth painful and, for most of history, very dangerous. Our babies are
extremely dependent, far more so than other species. We remain small and immature
long after our nearest relatives are fully grown so that we have time for the huge
education we must have if we are going to survive and multiply in our complex cultural
and technological world.
Because we can remember, we sometimes have
to relive awful things and it’s easy to frighten
ourselves and dread the future. However,
it’s not all old horrors and impending
doom; our big brain also gives us the
gifts of art, music and science. It’s the
only organ that tells jokes and stories,
indulges in nostalgia, experiences
wonder, falls in love and explores
spirituality. This wonderful brain can
also become psychotic. If we want
to understand what happens in the
brain during a psychosis we have
to look carefully at its working parts
and what they do. That’s not an easy
thing to do.
Looking into the brain
We do not as yet have a full
understanding of why and how a
psychosis develops but in recent
years we’ve made rapid progress. The
complexity of the working brain makes
it by far the most difficult part of a human
being to study. Unlike many other bodily
organs, its basic shape and anatomy reveal very little
about how it actually works. In the past, the effects of illness or injury on certain parts
of the brain or stimulating parts of the brain during brain operations were the only ways
of discovering which part did what. Later, electroencephalograms (EEGs) revealed
broad changes in mental activity in the living brain. More recently, amazing scanning
techniques are revealing much, much more.
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