A recent news story reported on the creation of a room that can mute 99.99% of all sound. It was designed partly to see how humans exposed to the quiet of outer space might react. Not well, it turns out. It is reported that the longest anyone has been able to endure being alone in the room in the dark has been 45 minutes. The reason? Everyone – not just those “genetically prone to psychosis” – starts to hallucinate.
This should illustrate to anyone who is paying attention that the capacity to hallucinate is something all of us possess, and whether or not we do hallucinate at a given time may depend on the nature of the situation we are in.
There’s really a lot of literature about how isolation contributes to the likelihood of hallucination, particularly in people who are severely stressed as well.
Interestingly enough, the mental health system has for many years used “quiet rooms” which isolated people in a non-stimulating enclosed areas as a way of handling people it perceived as being out of control. Ron Bassman, in his autobiographical book “A Fight to Be: A Psychologist’s Experience from Both Sides of the Locked Door” describes vividly the crazy-making effects of such poorly chosen “treatment.” There is more awareness now that this approach is counter-productive and should be avoided, but it is still used in a great many facilities.
People get isolated, not just by “quiet rooms” but also by the medications, which make people less responsive and less capable of social engagement. People get isolated because of mental health stigma, which causes people to not want to be around someone seen as “mentally ill.” And people experiencing mental health challenges often isolate themselves, for various reasons. People even isolate parts of themselves – we call it dissociation, a process that helps while coping with intense trauma but which often leads to problems later, such as, not surprisingly, seeing and hearing things that “aren’t there”.
What would be really helpful in mental health care would be wider recognition of the role of isolation of various kinds in causing “hallucinations.” This would help us recognize some of the ways people’s problems emerge from what happened to them as well as the ways human contact and friendly relationships can play the key role in healing.
And it would also help to note that healing doesn’t have to mean getting rid of all tendency to “hallucinate” or to have a private world that isn’t shared by others. Some degree of isolation, at times, is actually good for people, and so is the ability to have, or to travel to, worlds that aren’t shared by others. But we also need that healthy human bridge to others that helps keep everything in balance. We really can help people learn to have the best of both worlds, in a way that works for them.
You wrote “People get isolated, ….by the medications, which make people less responsive and less capable of social engagement.”
You have it backwards the illness is making them unwell, not the medications. The medications can only do good things to the patient. The patient is ill and needs medication.
Schizophrenia symptoms. Everything is a symptom of their illness.
It is all in the A’s.
Affective flattening : The person’s range of emotional expression is clearly diminished; poor eye contract; reduced body language.
Alogia : A poverty of speech, such as brief, empty replies.
Ambivalence/Ambitendence: An inability to make decisions .
Anhedonia: The inability to experience pleasure from activities usually found enjoyable.
Apathy: An absence of interest in or concern about emotional, social, spiritual, philosophical and/or physical life.
Associations: Disorganized thinking. Demonstrated by incoherent speech that makes communication impossible.
Asociality: A lack of a strong motivation to engage in social interaction and/or the preference for solitary activities.
Autism: A retreat into an inner world, incomprehensible to the outsider.
Avolition: Inability to initiate and persist in goal-directed activities, in school or work.
Hi Mark,
If you read elsewhere on this site, you will see that I contest the whole notion that there is a distinct “illness” that has the power to make people unwell. Instead, what I believe the evidence shows is that people get caught up in reactions to life situations that are confused and problematic, and that this reaction is then labeled an “illness” by people who don’t understand what is happening and who nevertheless want to appear to have expertise over what is happening by benefit of their medical training.
With that said, I do agree with you that people typically have many of the problems you mention even before they start taking any medications. (Of course, many people who don’t have a “schizophrenia” diagnosis also have many of these problems as well.) But that doesn’t mean that the “antipsychotic” medications can’t add to these problems. In fact, the evidence is that the medications do typically add to many of them.
Antipsychotics act by blocking dopamine in the brain, and dopamine plays a key role in the anticipation of pleasure, so it makes sense that blocking it would make it difficult for people to for example “persist in goal-directed activities, in school or work.” Which is probably one reason why the rates of people returning to school or work was noted to go down once anti-psychotics were introduced – for a citation on that see http://www.madinamerica.com/wp-content/uploads/2011/12/Bockoven.pdf
Life is weird of course, and even though antipsychotics may make people on average disengage from others, some people may engage more once they start taking them. The explanation may be that the person had reasons (“psychotic” or not) for being withdrawn that had caused them to be seriously disengaged, but once on the drug, they were indifferent to these reasons and so re-engaged to some extent. Still a person taking anti-psychotics is likely to be at least somewhat handicapped in being socially engaged compared to how they might be if they could work through their problems in some way other than the drugs.
I was being sarcastic about “the patient is ill”. I thought the long list of magical words starting with the letter “a” would give it away.
Thanks, I guess I was being a little dense. I did have the thought it might be sarcastic, but then I thought instead that someone who believed in “schizophrenia” must have noticed how a whole lot of the “symptoms” can be identified with words that start with the letter “a.”
Which is kind of weird anyway when you think about it…
Ron,
A great topic.
I remember reading about Admiral Byrd, and his journey to Antartica…
The white snow, the white noise, the lack of stimulation caused him to hallucinate.
Also, I remember hearing of swimmers who used to swim the English Channel… The stress on the body did the same thing.
It’s no mystery why people hallucinate in psychiatric hospitals when they are put into seclusion rooms, removed from all human contact, all sound and stimulation. And yet, these rooms are still used. Like so many of the methods in psychiatry, the “treatment” is the problem. Such is the case for seclusion, isolation.
Duane
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