Interpretation of Schizophrenia (book)
Encyclopedia
Interpretation of Schizophrenia (first edition, 1955) is a book written by psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 Silvano Arieti
Silvano Arieti
Silvano Arieti was a psychiatrist regarded in his time as one of the world’s foremost authorities on schizophrenia. He received his M.D. from the University of Pisa but left Italy soon after because of Benito Mussolini's increasingly racial policies...

 that won the 1975 scientific National Book Award
National Book Award
The National Book Awards are a set of American literary awards. Started in 1950, the Awards are presented annually to American authors for literature published in the current year. In 1989 the National Book Foundation, a nonprofit organization which now oversees and manages the National Book...

 in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

. Interpretation of Schizophrenia sets forth demonstrative evidence
Demonstrative evidence
Demonstrative evidence is evidence in the form of a representation of an object. This is, as opposed to, real evidence, testimony, or other forms of evidence used at trial.-Examples:...

 of a psychological etiology
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

 for schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

. In the award winning 1974 edition (ISBN 0-465-03429-2) Arieti expanded the book vastly.

Overview

Interpretation of schizophrenia is a 756-page book divided in 45 chapters. Arieti begins his book stating that it is difficult to define schizophrenia. He asks if schizophrenia is an illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...

 and answers in the negative, since the disorder is not understood in classic Virchowian
Rudolf Virchow
Rudolph Carl Virchow was a German doctor, anthropologist, pathologist, prehistorian, biologist and politician, known for his advancement of public health...

 criterion of cellular pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

. Though those searching for a biological basis
Biological psychiatry
Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics and...

 of schizophrenia far outnumber those undertaking psychological
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

 approaches, Arieti supports the minority view. He believes schizophrenia is an unrealistic way to represent both the self and the world and praises psychiatrist Adolf Meyer
Adolf Meyer (psychiatrist)
Adolf Meyer, M.D., LL.D., , was a Swiss psychiatrist who rose to prominence as the president of the American Psychiatric Association and was one of the most influential figures in psychiatry in the first half of the twentieth century...

 for stressing the importance of psychological factors in the etiology of schizophrenia. Arieti also mentions that Freud felt that in schizophrenia the patient's relationship with people is handicapped (an observation that resembles what presently is called autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...

).

Family etiology

Arieti then describes the psychogenic factors that lead to the disorder. The family environment and psychodynamics in the etiology of psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

 comes under scrutiny. Arieti describes the building of neurotic and psychotic defense mechanisms; the emerging schizoid personality, and fully developed schizophrenia understood as an injury to the inner self
Self (psychology)
The psychology of self is the study of either the cognitive and affective representation of one's identity or the subject of experience. The earliest formulation of the self in modern psychology derived from the distinction between the self as I, the subjective knower, and the self as Me, the...

. Arieti believes that a state of extreme anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

 originating in early childhood
Childhood
Childhood is the age span ranging from birth to adolescence. In developmental psychology, childhood is divided up into the developmental stages of toddlerhood , early childhood , middle childhood , and adolescence .- Age ranges of childhood :The term childhood is non-specific and can imply a...

 produces vulnerability for the whole life of the individual.

A characteristic of Homo sapiens is a prolonged childhood with a consequently extended dependency on adults. This, according to Arieti, "is the basis of the psychodynamics of schizophrenia", a claim that also appears in later writers on child abuse
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...

 such as Alice Miller
Alice Miller (psychologist)
Alice Miller née Rostovski was a psychologist and world renowned author, who is noted for her books on child abuse by their own parents, translated in several languages...

 and Colin Ross
Colin A. Ross
Colin A. Ross is a psychiatrist of Canadian origin and professional training. Ross attended medical school at the University of Alberta, Edmonton, Canada and completed his training in psychiatry at the University of Manitoba, Winnipeg, Canada...

. Arieti reviews the paper by Frieda Fromm-Reichmann
Frieda Fromm-Reichmann
Frieda Fromm-Reichmann was a German psychiatrist and contemporary of Sigmund Freud who emigrated to America during World War II.-Life and work:...

 about the "schizophrenogenic" mother and reaches the tentative conclusion that only 25 percent of the mothers of schizophrenics in his clinical experience fit that image. However, he adds that only in a minority of schizophrenia cases "the child is able to retain the good maternal image". Arieti also mentions the work of Theodore Lidz
Theodore Lidz
Theodore Lidz was an American psychiatrist best known for his articles and books on the causes of schizophrenia and on psychotherapy with schizophrenic patients...

, another trauma model author of schizophrenia. Like Lidz, Arieti emphasizes the weakness of the father of the schizophrenic patient in the paternal role. In Arieti's own words:
In the first edition of this book I have described one family constellation [...] when a domineering, nagging and hostile mother, who gives the child no chance to assert himself, is married to a dependent, weak man, who is too weak to help the child [...]. In these families the weak parent [...] becomes antagonistic and hostile
Hostility
Hostility is a form of angry internal rejection or denial in psychology. It is a part of personal construct psychology, developed by George Kelly...

 toward the children because [...] he displaces his anger from the spouse to the children, as the spouse is too strong to be a suitable target.


The roles can be reversed when the domineering spouse is the father. Arieti is convinced that each schizophrenia case is representative of those human situations in which something went extremely wrong. "If we ignore it, we become deaf to a profound message that the patient may try to convey". For example, Arieti states about one of his patients that "his adolescence was a crescendo of frustration, anxiety and injury to self-esteem". Arieti also mentions a catatonic patient who, after introjecting
Introjection
Introjection is a psychoanalytical term with a variety of meanings.Generally, it is regarded as the process where the subject replicates in itself behaviors, attributes or other fragments of the surrounding world, especially of other subjects...

 the mother's engulfing behavior, believed that by moving he could produce havoc. The patient's feelings, according to Arieti, became reminiscent of cosmic powers that may cause the destruction of the universe, so the patient chose immobility. For Arieti, the selectivity of certain motor actions is proof that catatonia
Catatonia
Catatonia is a state of neurogenic motor immobility, and behavioral abnormality manifested by stupor. It was first described in 1874: Die Katatonie oder das Spannungsirresein ....

 is not a biological disease or illness, but rather a disorder of the will.

Inner world of the schizophrenic

In Part three of Interpretation of schizophrenia Arieti describes how in spite of its efforts to stay in reality, the patient's defenses finally succumb. When the patient "cannot change the unbearable situation of himself any longer, he has to change reality". Arieti examines the inner world of the schizophrenic.

When a patient states he is Jesus
Jesus
Jesus of Nazareth , commonly referred to as Jesus Christ or simply as Jesus or Christ, is the central figure of Christianity...

 he is compensating a feeling of extreme humiliation
Humiliation
Humiliation is the abasement of pride, which creates mortification or leads to a state of being humbled or reduced to lowliness or submission. It can be brought about through bullying, intimidation, physical or mental mistreatment or trickery, or by embarrassment if a person is revealed to have...

 at home. The paranoid
Paranoia
Paranoia [] is a thought process believed to be heavily influenced by anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself...

 schizophrenic, Arieti explains, resorts to "teleologic causality" or animism
Animism
Animism refers to the belief that non-human entities are spiritual beings, or at least embody some kind of life-principle....

 to understand the world. He writes that whatever occurs to the patient is interpreted as willed by the parental alters
Dissociative identity disorder
Dissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....

 of the patient. In deterministic or teleologic causality, if Nature
Nature
Nature, in the broadest sense, is equivalent to the natural world, physical world, or material world. "Nature" refers to the phenomena of the physical world, and also to life in general...

's happenings were not willed they simply would not occur. In paranoid projection the schizophrenic takes out from him/herself a disagreeable part of the self onto the world. In Interpretation of schizophrenia Arieti illustrates all of the above theoretical constructions with concrete cases of his clinical experience as a psychiatrist.

Arieti maintains that in every case of schizophrenia that he studied serious family disturbance
Dysfunctional family
A dysfunctional family is a family in which conflict, misbehavior, and often abuse on the part of individual members occur continually and regularly, leading other members to accommodate such actions. Children sometimes grow up in such families with the understanding that such an arrangement is...

 was found. When the patient idealizes the parent the idealized image of the parent is maintained in the patient's mind at the expense of an unbearable self-image. He speculates that psychosis starts only when the malevolent image of the parent is transformed "into a distressing other". The parent or parents alters enter the mind accusing the patient of "bad child" or other equivalent accusations in voices that the adult patient hears
Hearing Voices Movement
Hearing Voices Movement is a philosophical trend in how people who hear voices are viewed. It was begun by Marius Romme, a professor of social psychiatry at the University of Limburg in Maastricht, the Netherlands; and Sandra Escher, a science journalist, who began this work after being challenged...

.

Since the 1980s, and into the beginnings of 21st century, biological psychiatric
Biological psychiatry
Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics and...

 models of schizophrenia almost completely took over the psychiatric
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

 profession. Current research into the disorder focuses on neurobiology. Psychological approaches to schizophrenia like Arieti's are a rarity in the profession, although this structurally created circumstance neglects the obvious connection between psychological phenomena and neurotransmitter
Neurotransmitter
Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...

 levels, which can be changed through certain practices, like Yoga
Yoga
Yoga is a physical, mental, and spiritual discipline, originating in ancient India. The goal of yoga, or of the person practicing yoga, is the attainment of a state of perfect spiritual insight and tranquility while meditating on Supersoul...

, meditation
Meditation
Meditation is any form of a family of practices in which practitioners train their minds or self-induce a mode of consciousness to realize some benefit....

, hyperventilation
Hyperventilation
Hyperventilation or overbreathing is the state of breathing faster or deeper than normal, causing excessive expulsion of circulating carbon dioxide. It can result from a psychological state such as a panic attack, from a physiological condition such as metabolic acidosis, can be brought about by...

, sensory deprivation
Sensory deprivation
Sensory deprivation or perceptual isolation is the deliberate reduction or removal of stimuli from one or more of the senses. Simple devices such as blindfolds or hoods and earmuffs can cut off sight and hearing respectively, while more complex devices can also cut off the sense of smell, touch,...

, sleep deprivation
Sleep deprivation
Sleep deprivation is the condition of not having enough sleep; it can be either chronic or acute. A chronic sleep-restricted state can cause fatigue, daytime sleepiness, clumsiness and weight loss or weight gain. It adversely affects the brain and cognitive function. Few studies have compared the...

, among others.

List of chapters

Part One: The manifest Symptomatology and Other Basic Notions. Chapter 1 The basic questions. Chapter 2 Historical review of the concept of schizophrenia. Chapter 3 The manifest symptomatology. Chapter 4 The diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...

 and prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...

 of schizophrenia.

Part Two: The Psychodynamics of Schizophrenia. Chapter 5 First period: early childhood and family. Chapter 6 Second period: late childhood. Chapter 7 Third period: adolescence and early adulthood. Chapter 8 Fourth period: the psychosis. Chapter 9 Patients studied through family members. Chapter 10 Study of catatonic patients. Chapter 11 Study of paranoid patients. Chapter 12 Study of hebephrenic patients. Chapter 13 Postpartum schizophrenic psychosis. Chapter 14 Adverted schizophrenia: relation between psychosis and psychoneurosis.

Part Three: The World of Schizophrenia: A Psychostructural Approach. Chapter 15 The break with reality. Chapter 16 The cognitive transformation. Chapter 17 Disorders of gesture
Gesture
A gesture is a form of non-verbal communication in which visible bodily actions communicate particular messages, either in place of speech or together and in parallel with spoken words. Gestures include movement of the hands, face, or other parts of the body...

, action and volition
Volition
Volition may refer to:*Volition , the cognitive process by which an individual decides on and commits to a particular course of action...

. Chapter 18 Changes in the body image. Chapter 19 The retreat from society. Chapter 20 Creative activities of schizophrenic patients: visual art, poetry, wit. Chapter 21 Emotional change and expansion of human experience.

Part Four: A Longitudinal View of Schizophrenia. Chapter 22 The first or initial stage. Chapter 23 The second or advanced stage. Chapter 24 The third or preterminal stage. Chapter 25. The fourth or terminal stage. Chapter 26 Recapitulation and interpretation of schizophrenic regression.

Part Five: The Somatic and Psychosomatic Aspects of Schizophrenia. Chapter 27 Heredity and constitution in schizophrenia. Chapter 28 The biochemistry of schizophrenia. Chapter 29 Endocrine and cardiovascular changes in schizophrenia. Chapter 30 The central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

 in schizophrenia.

Part Six: Transcultural Aspects and Prevention of Schizophrenia. Chapter 31 Epidemiology
Epidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...

 of schizophrenia. Chapter 32 Transcultural studies of schizophrenia. Chapter 33 The prevention of schizophrenia.

Part Seven: Psychotherapy and Schizophrenia. Chapter 34 The choice of treatment. Chapter 35 The psychotherapeutic
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...

 approach to schizophrenia: a historical survey. Chapter 36 Establishment of relatedness. Chapter 37 Specific solutions of psychotic mechanisms. Chapter 38 Psychodynamic analysis. Chapter 39 Other aspects of psychotherapy. Chapter 40 Two cases treated with intensive psychotherapy. Chapter 41 Psychotherapy of chronic schizophrenia.

Part Eight: Physical Therapies of Schizophrenia. Chapter 42 Drug therapy. Chapter 43 Other physical therapies.

Part Nine: The Larger Horizons and the Concept of Schizophrenia. Chapter 44 Syndromes related to schizophrenia. Chapter 45 The concept of schizophrenia.

See also

  • R.D. Laing
  • Refrigerator mother
    Refrigerator mother
    The term refrigerator mother was coined around 1950 as a label for mothers of children diagnosed with autism or schizophrenia. These mothers were often blamed for their children's atypical behavior, which included rigid rituals, speech difficulty, and self-isolation.The "refrigerator mother" label...

  • Ross Institute for Psychological Trauma
    Ross Institute for Psychological Trauma
    The Ross Institute for Psychological Trauma is a psychiatric hospital in Dallas, Texas in the United States founded by Colin A. Ross in 1991, treating adults suffering from depression, self-mutilation, suicide ideation, anxiety, dissociative schizophrenia, dissociation and substance abuse...

  • The Gene Illusion
    The Gene Illusion
    The Gene Illusion is a book by clinical psychologist Jay Joseph, published in 2003, which challenges the evidence underlying genetic theories in psychiatry and psychology. Focusing primarily on twin and adoption studies, he attempts to debunk the methodologies used to establish genetic...

  • Schizophrenia compared to dream
    Dream speech
    In 1906 the famous German psychiatrist Emil Kraepelin published a monograph titled Über Sprachstörungen im Traume . In his psychiatry textbook Kraepelin used the shortcut Traumsprache to denote language disturbances occurring in dreams...


External links

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