Up Close With Dr. E

Our worst fear


It all started in kindergarten when Susan, a 5-year-old, gap-toothed girl with penny-brown pigtails, strutted up and, like a tank rolling over debris, invaded my personal space. Now, close enough to feel her breath on my face, she slowly extends her right pointing finger and touches my nose. “COOTIES,” exploded my friend David. “She gave you COOTIES!”

My next encounter with “it” (hold your horses, I’ll soon define “it”) occurred when I was 12. While watching the classic movie, “Ben Hur,” I witnessed the hero, Juda Ben Hur, recoil in shock when he finally was able to locate his mother, who was living in a leper colony. I too recoiled when I saw her face — ulcerated and hideous. She had leprosy, a skin disorder which condemned her to this curse: She will be shunned and feared by all, never again to feel soft hands caress her face or hold her in a loving embrace.

My third encounter with “It” occurred in Jackson, Wyoming, where I and my clinical supervisor, Dr. Spencer, spent several days testing and interviewing patients in the state-run psychiatric hospital. The training I would receive at this hospital would lay the foundation for my beliefs about severe mental illness. The patients I had been assigned to interview had all been diagnosed with schizophrenia, and they, along with my supervisor, would become my teachers.

Oh, thanks for waiting. The “It” refers to what Cooties, leprosy and schizophrenia all have in common. First, they all carry false beliefs, or myths. Cooties are not tiny bugs which jump from girls to boys; leprosy is not a highly contagious disease; schizophrenia is not caused by sinful behaviors. Second, they all are the targets of discrimination. Lepers used to be relegated to isolated colonies; schizophrenics are routinely treated with avoidance, hostility and exclusion. Third, all three produce fear. However, it is schizophrenia which produces the lion’s share of fear.

Why do we fear people who suffer from mental illness? In my opinion, the fear of mental illness is a universal experience expressed by every country and culture — past or present — and is due to the deepest, darkest and most primitive parts of our minds. It is from the depths of these black waters that thoughts such as these whisper in our ears: “What if I lose my mind? What if, while under enormous stress, I go over the edge and become psychotic?” It is this fear, “what if the doctor finds out I am out of my mind?” which blocks patients from obtaining professional help for their suffering. It is this fear which fuels discrimination against patients with mental illness.

Let’s examine three myths about schizophrenia:

• Myth 1 — Schizophrenia is a rare disorder. Schizophrenia is a common, serious psychiatric illness where one loses contact with reality (psychosis), and can experience hallucinations (like hearing voices), or delusions (false beliefs such as — someone is trying to poison my food). The prevalence of schizophrenia is 1 in 300 people worldwide are affected, and it is found in every country. (Source: World Health Organization).

• Myth 2 — Schizophrenia is caused by sinful behavior, and “these patients are different, and perhaps less human. They are erratic, deviant, morally weak, unattractive, lazy, superstitious, ignorant and demonstrate a primitive morality.” (This quote is from “The Hidden Prejudice,” Perlin, Michael, 2000). Recent research on the causes of schizophrenia has proven that it is a genetically inherited disorder which is now viewed “as a misconnection syndrome, reflecting a basic disorder in neural circuits” (“A Primer of Drug Action”, Julien, 2007).

• Myth 3 — Schizophrenics are violent and dangerous people. Patients with schizophrenia are rarely violent. Study after study has proven that these patients are non-violent.

There once was a time when those who had leprosy were removed from their homes, families and communities. The fear of being infected drove the extreme prejudice which forced lepers to live in colonies. Now, substitute the word, “schizophrenia” for “leper”, in the above paragraph, and instead of colonies, use the words, jails, on the streets, as homeless people. Modern medicine created new antibiotics which could treat leprosy, and science removed the stigma when it discovered that 95% of the population had immunity to leprosy. Modern medicine has also created new antipsychotic medications which can treat schizophrenia. But the stigma against mental illness persists.

The content of this article is for educational purposes only, not treatment. The characters in this story are not real. Names and details have been changed to protect confidentiality.


Dr. Richard Elghammer contributes his column each week to the Journal Review.



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