Ever had a doctor tried to scientifically explain schizophrenia?

I’ve had several try to explain to be the point of taking meds and how they work in the brain and tried to explain schizophrenia and schizoaffective disorder. Both of them that have tried explained it simply but still made me feel like a moron because I struggled to pay attention and I only just barely grasped the concept.

How are we actually supposed to be able to understand such explanations when our brains are still running amok? You couldn’t have explained how to log into Facebook to me when my head was “screeching” in '94, '97, '99, '02-'03 and late '03.

BUT… when it stopped screeching (because the Hindu Goddess, Dr. P., told me, “Oh, you’ve got PTSD under all that and we need to get that taken care of first,” I started looking for explanations, regardless of how complex they seemed at first. For me, at least, the explanations opened the gates to the psychotherapeutic solutions.

  1. Psychotherapies for that currently include…
    DBT – http://behavioraltech.org/resources/whatisdbt.cfm
    MBSR – Welcome to the Mindful Living Blog
    MBCT - Mindfulness-based cognitive therapy: theory and practice - PubMed
    ACT – ACT | Association for Contextual Behavioral Science
    .
  2. the even newer somatic psychotherapies like…
    MBBT – An Introduction to Mind-Body Bridging & the I-System – New Harbinger Publications, Inc
    SEPT – Somatic experiencing - Wikipedia
    SMPT – Sensorimotor psychotherapy - Wikipedia
    .
  3. or standard CBTs, like…
    REBT – Rational emotive behavior therapy - Wikipedia
    Schematherapy – Schema therapy - Wikipedia
    Learned Optimism – Learned optimism - Wikipedia
    Standard CBT – Psychotherapy | NAMI: National Alliance on Mental Illness & scroll down
    .
  4. Get two or more of those “down,” and one can use the skills therefrom in this way to combat delusional thinking and emotional reactivity very quickly: 10 StEP – Pair A Docks: The 10 StEPs of Emotion Processing
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This past summer in the ER after I had gone off my meds the on call psychiatrist scientifically broke down schizoaffective D/O to me. He also broke down what would happen to my brain if I continued to stay off my medication. He was very clear and to the point. What he told me actually broke through my psychosis and kind of scared me. From what I remember he talked about how the grey matter in my brain will decrease at a faster rate if I stay off my meds.

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When I am called upon to explain SZ to someone, after telling them I have it, I refuse to do it.

I never know what to tell a person when they ask me to explain it.

Well a full scientific account, specifying not only a handful of causal factors and correlations, but also elucidating the mechanisms that link them up and ultimately make for the specific conscious experience you had with schizophrenia is far, far away for many reasons.

But maybe we don’t need that. My doctor never went much further than talking about dopamine levels, and these can help to explain some general aspects of psychosis, most easily I think, things like delusions of reference by the role of dopamine in salience regulation.

If asked to explain SZ to another person, I suggest you start with what you do know. That is, start with how it affects you as a person either in or out of psychosis. The fear, maybe the difficulties in thinking, and other symptoms. Take hallucinations. You can describe not only the contents, but in some sense also the form of this experience. For instance, my hallucinations came across as extremely authoritative. It was kind of like they had huge amounts of charisma, what they asserted came across as not to be doubted. And so on.

Thought Insertion - this is sometimes said to be very difficult up to not-understandable for the people not familiar with SZ. I try to explain what it is like by analogy. Everyone is familiar with the phenomenon of some of our thoughts occurring to us as inner speech. I typically compare this to an ordinary walk through the park. Both are activities. Theoretical discussions aside, we experience these actions typically as under our command. When walking, we feel in control and the body is typically doing exactly what is intended. So it is - as a rule - for ordinary inner speech. Then I ask the one I’m speaking to, to imagine walking through the park and tripping over some branch. And to imagine how the movements of his body are experienced then. The sense of being in control over the movements is temporarily gone in such cases. But, it seems obvious to the non-SZ, they still feel it is them who are falling in an important sense. The movements of the body in falling, though not initiated by them, are surely happening to them. I typically compare intrusive thoughts/inner-speech to such a way of describing involuntary movement. Inserted thoughts, may in turn be compared by the experience of being pushed.

Personally I strongly suspect that the average person you talk to about SZ, idk, anyone not happening to be a neuroscientist, will ‘get’ me a lot better when I try to describe my experiences in such a way. I am only speculating here, but I assume that the average person is interested in how you are/were doing, not so much how your brain is doing. These two different but related questions, can be said to amount to the same question - yet in different languages. Scientists are working hard to find a way to translate the two. But the average person doesn’t know the neuro-language. I mean, one has to know quite a lot of context about the ordinary workings of a brain, before the notions of such an explanation make sense at all to the listener. To go about introducing this context in order to express how you are feeling, seems to me to amount to someone asking you a question in English, and then teaching him Chinese to be able to answer it in Chinese. While you might as well answer in English.

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