I still remember my internship days done during my post-graduation. There was visible excitement, exchange of ideas, thoughts regarding various disorders but what bound all of us together was the curiosity to hear and understand patients who were suffering from severe category of disorders. Due to some coincidence, I was given the opportunity to take the case of a person having a history of schizophrenia and who was till present day struggling with the same. I did not know before encountering the person regarding the diagnosis, but like every other psychology student, I was nervous yet excited for it was for the very first time I was taking a case history of a possible patient. The process of taking the case history was very smooth and calm and much to my astonishment, I did not once doubt her diagnosis until she herself shared her history of schizophrenia with us. The excitement among other interns when they knew of what case I had taken was very visible and to an extent embarrassing too. They kept on getting excited about how fortunate I was and congratulated me. The interns wanted to know how the patient looked, what all was spoken and discussed and I got conscious of myself for a moment. Why is there so much enigma over a debilitating disorder? Over a condition which is so life-threatening and thus serious? What does this excitement mean?
Schizophrenia as a word has increasingly become a common phenomena. Doesn’t matter what this particular condition means or its importance as a mental disorder; whenever psychology is discussed, this word termed schizophrenia almost always has an important mention. But do we really know what schizophrenia is? The understanding of the symptoms presented by the mental condition? Lets’ begin then.
Schizophrenia is very simple terms can be considered as a disconnection from reality. It is a psychotic disorder in which the person might be experiencing extreme emotional states, bizarre thought patterns, bodily movements etc. There is a visible disorientation in terms of reality and there is also present imaginings of objects, events not existent in the present living moment. There are various sub-categories of this condition but collectively it is labeled as schizophrenia in the DSM-5.
There are three categories of symptoms namely positive (delusions, disorganized speech and thinking, hallucinations, inappropriate affect etc), negative (poverty of speech, blunted and flat affect, social withdrawal etc) and psychomotor (catatonia). All these symptoms might occur in varied levels of severity, combinations with the common effect of leading to pathological dysfunction and deterioration in a person’s personal, social and occupational life. While there are in existence bizarre additions such that the person might start imagining various kinds of scenarios, objects, people etc; there is also the derailment in thoughts occurring wherein there is a jumble of thought patterns inconsistent to each other. The person with this condition might experience a complete absence of speech or speak in great continuous volumes. There can also be present in some, bizarre movements such that he/she might prefer being motionless or maintain rigid postures or take up postures clearly uncomfortable for any person. There can be abrupt surges of rage inside a person having schizophrenia as a result of which there is increased chances of them harming other people or themselves. This rage which might be perceived as illogical to the layman is justified for the person experiencing it, for this rage has been built-up through the years due to lack of expression, space to process etc.
While it is important to know the symptoms, many fail to understand as to why such a mental condition occur. There may be many factors. Firstly, there is the genetic factor. In various researches, it has been found that schizophrenia is a genetic disorder which can occur in alternative generations. Secondly the family environment specially the parenting styles is a significant factor in bringing about this disorder. The neglect/avoidance parenting style can seriously harm the child psychologically as the child might get the impression of not making an influence no matter what he/she does. Such a situation might occur when both the parents are working, mother might be suffering from some ailment such as a medical condition, post-partum depression and the like, unwanted child etc. If there has occurred a very traumatic event in the family or otherwise and the family attitude towards the event was unfortunately one of indifference, neglect or a restricted form of expressiveness; this can really have a serious effect on the child who has experienced that traumatic event or has been visible affected by the event (vicarious). The object relations school of psychoanalysis becomes a very important space if we are to understand the condition developmentally. Melanie Klein describes the developmental positions of depressive and schizoid which every infant universally goes through. In the event when the infant fears punishment from the caregiver (mother) because the infant behaved inappropriately (biting, screaming etc), it naturally withdraws from the outside world momentarily. It is then the responsibility of the mother to take notice of the infant’s aloofness and ensure necessary care, comfort and love which the infant needs for reassurance of trust and strengthening of the relationship. We must have all noticed new mothers engaging in the behavior of showering their infants with love when the infant appears to be aloof, uninterested in the outside events or unusually calm and still. In case, the mother fails to go back to the infant in such anxious moment which is called the schizoid state, the infant might start living in this state and eventually in later years (adulthood) develop serious psychotic disorders of which schizophrenia is a part. Thus the developmental span of a person’s life who is assumed to having schizophrenia becomes crucial to understand. Abrupt surges of rage is very visible as part of this disorder as a result of which it might be beneficial to be aware of the adjustments with regards to the adolescent phase of development.
In today’s times, parents are as obsessed with techy gadgets as are children. The concept of play has made a transition wherein rarely can we see children engaging in outside play; instead there is increased engagement in online video games. Gone are the days when parents used to patiently sit with their child and engage in feeding or playing activities. In this constant competitive productive world, parents are driven towards the progression of their professional life and in this, the children suffer in terms of lack of emotional engagement, development of cohesive thought structures, flexible mind and body development etc. Such a lack might later lead to a manifestation of serious psychotic disorders in adulthood wherein the what and how of connection with reality is just lost. Perhaps this is the underside of technological advancements and this might not be wrong to say that the pandemic of 2020 has in turn exactly facilitated the manifestation of the same.