Schizophrenia, conversion disorder, stress and immigration

Year ago, when Taylor, my youngest son, was in third grade, he had a friend “Jeremy” (not his real name). Like us, Jeremy and his family had relocated from North America to Europe that year, where the father was employed in high tech. Jeremy was an only child. His mother told me that when they were in the final stages of moving, Jeremy woke up one day and said he had lost all sight in both his eyes. He was blind for about a week or two. You can imagine how terrifying that was for all concerned.

That’s what stress can do to the human mind, or, to turn it around, that’s what the powerful mind can do to the human body. When researchers note that there is a higher proportion of “schizophrenics” seen in the Jamaican immigrant population in England, this doesn’t surprise me. There are enough Jamaican immigrants to form a ready research pool. Moving continents and cultures is a shock. Schizophrenia is a stress reaction but no stranger than going blind is. You have to see it to believe it.

I came across a similar story to Jeremy’s when I was searching for the latest article on the teenage girls in Le Roy, New York who developed bodily tics and twitches. Jeremy had what by all accounts would be  “conversion disorder.” It used to be called hysteria.

What did happen to the girls in Le Roy? There is a fascinating article in the New York Times Magazine  by Susan Dominus. Dominus writes that when the environmental explanation for the phenomenon did not hold up, and the diagnosis was the stress-related conversion disorder, here’s what happened.

To many parents, the diagnosis was woefully inadequate, even insulting.“It’s a very hard pill for me to swallow — what are we, living in the 1600s?” the guardian of one of the girls said. Besides, kids are always stressed, and some of these kids may have been less stressed than most. On CNN, James DuPont, the father of an afflicted girl, said, “A lot of these kids were just, you know, having a happy, normal life.” Miller told me she did not buy the diagnosis, not one bit. “My daughter hasn’t had any trauma,” she said. “She was just happy, going along. She was as happy as can be.”

Like with schizophrenia, it is hard for many people to equate the really strange behavior with the stressors that many of us take for granted in our own lives.

According to Dominus:

A common thread emerged among the five girls I interviewed extensively: none had stable relationships with their biological fathers. And the father of a sixth girl had seen little of his high-school daughter until his concern about the tics galvanized their relationship. Another student was a foster child who switched foster homes shortly before his tics came on; yet another is in the custody of an older sibling. Another two have spotty contact with their fathers. One young woman I interviewed was close to homeless after she and her mother left her father’s trailer. They’re staying with a friend of a friend while her mother, who was laid off two times in the last year, tries to scrape together first and last month’s rent so they can get a place of their own.

Dominus also reveals that Dr. Rosario Trifiletti, who has diagnosed a mysterious and ill-defined “PANDAS-like illness” was unaware of the trauma in his patient’s lives:

When I spoke to him in late February, Trifiletti told me that the girls he was treating were showing dramatic signs of improvement. Katie’s parents said they believed that she was responding well to the antibiotics; Chelsey’s family reported that the drugs are helping her as well. But another patient of Trifiletti’s said she was still fainting.

When the subject of the girls’ personal backgrounds came up — the biopsychosocial factors that might be affecting their health — Trifiletti said he had not had the time to ask them about those kinds of things. The abuse, the troubling family circumstances — much of it came as news to him. “Jeez, I didn’t realize the extent,” Trifiletti said. “These aren’t things people want to talk about. I don’t know, maybe I’m wrong. It’s hard to distinguish between the drug and the placebo effect.”

Schizophrenia is much more common than conversion disorder. Yet, medicine stubbornly resists linking schizophrenia to trauma or stress factors. Medical science favors the biochemical imbalance theory of schizophrenia, almost exclusively. It’s quite insulting, really, to those of us who are wanting answers for schizophrenia, and more importantly, more meaningful help, that conversion disorder is taken more seriously than schizophrenia from the psycho/social point of view.

The psychological explanation, of course, hasn’t stopped some of the Le Roy parents from putting their teenage girls on drugs. The Dominus article reports that at least one girl is on eleven different medications! One can only presume it is because the parents don’t believe that stress alone can produce something so strange.

Well, stress can, and does.

Below are some readers’ comments to the Dominus article.

Jill
..Shame on you New York Times for writing such an offensive article. We are not in the dark ages. And to go so far as to blame these girls “instability” on living with single moms is disgusting. These girls don’t have conversion disorder. This is just a made up diagnosis for doctors that have egos so big they can’t say the words “I don’t Know”.

And, the following quote from simon Wessely is offensive to every person who has an illness that is not yet understood by science.

“Wessely, the epidemiologist, cited a medical-journal paper whose title had long resonated with him: “If You Have to Prove You Are Ill, You Can’t Get Better.”

Here is another quote from a recent Washington post article on chronic lyme that I think is more fitting for what is going on in Le Roy.

“Just because scientists don’t understand the cause of a disease doesn’t mean that it doesn’t exist.”


AS Minnesota
..All of the comments here that suggest that somehow their doctors were being “mean,” or were incompetent, or just not empathic enough because they conferred a psychological etiology just seems to further prove the point that for many folks, it IS in their head! Someone who honestly assumes that their doctor is mean for suggesting a psychological contribution has obvious psychological issues. Do you honestly think your doctor is intentionally trying to be mean to you? Why so defensive?? What is so threatening about a psychological diagnosis?? We experience physical symptoms as a result of psychological stress all the time. Nervous about an upcoming performance or a big date (i.e., psychological cause), and so you get an upset stomach (i.e., physical symptom)? Financial stress or work stress (i.e., psychological cause) giving you a splitting headache (i.e., physical symptom)? Honestly, people. Given the complexity of the human brain, it is utterly preposterous that all ailments are due to a physiological cause. Anyone who doctor shops enough will find someone who will eventually render a medical diagnosis (no matter how random or “rare”) that suits their PSYCHOLOGICAL need to have a medical explanation rather than a psychological one. Whenever I hear people maligning the “it’s all in your head” comment, I think to myself, “where else would it be?? OF COURSE it’s all in your head. that’s where the most complex organ in your body sits.”

Matt Evans New Jersey
..There is a fifth dimension, beyond that which is known to man. It is a dimension as vast as space and as timeless as infinity. It is the middle ground between light and shadow, between science and superstition. – Rod Serling

Doc Martin

Last night the family (parts of it) watched two episodes from the first season of the British television series, Doc Martin. The show is about a London surgeon, Dr. Martin Ellingham, who has developed an aversion to blood and must seek other work in his profession. He is invited to be the general practitioner in a small Cornish town populated with the usual lovable British eccentrics. His lack of people skills when dealing with the locals is the humorous premise for the show.

Readers of this blog may enjoy Doc Martin. Here’s why. In one of the episodes, the doctor finally goes to see a man who has been asking that the doctor come to see him. (As a former surgeon, the doctor doesn’t make house calls. He expects people to come to his office at a set time on a set date.) Finally, he goes to see man, who lives on a remote farm. The farm house is fenced and gated and there is barbed wire on top of the wall. The man insists that the doctor stay for lunch, but it is becoming clear that he is quite paranoid. He has a friend “Edward,”  who turns out to be a giant invisible squirrel. Edward has been invited to lunch, too, and a place has been set for him. The man tells the doc that the former doctor in the village gave him a steady supply of a certain medication, and he absolutely must have a prescription from the doctor before the doctor leaves. The doctor, rightly sensing that the man is “squirrely,” figures out that that the old doctor gave him benzodiazepines to calm him down. But Doc Martin won’t do this. Instead, he gives him a lecture on the damage that long term use of benzos will do. 

I’m sorry to say I can’t remember what ruse the doctor uses to get off the farm. Further into the episode the townspeople and the doctor come upon the man hacking down some birdhouses in a psychotic frenzy. “He’s got post traumatic stress disorder from being in Bosnia,” say the townsfolk. “Just give him the tranquillizers, doc — Old doc so-and so always gave them to him.”

As it turn out, the doctor discovers that old doc so-and-so did no such thing. Rather than give the man benzos, the former doctor was giving him placebos. They were were working quite well, until after the old doc died and there was stretch of time when the town had no doctor and no way for the man to access the placebos. So, Doc Martin continues to give him the placebos, and he gets the man’s agreement to begin some psychotherapy.

I’m looking forward to seeing more of Doc Martin. It will be interesting to see how much alternative medical thinking will be written into the scrip

Acting helps soldier cope with post-traumatic stress disorder

I’m holed up here in my vacation pad (LOL) with only my Blackberry to link electronically to the blogging world. There is an interesting story in ocala.com on the value of acting for overcoming PSTD. Schizophrenia is essentially post-traumatic stress disorder, except the trauma that precipitates the psychosis is the former case is usually less obvious in the latter case. There is a time and a place for acting as part of a person’s recovery. As the article states, recovery is individualistic. People have to go with what works for them. My son, Chris, was introduced to acting classes in his two year recovery program, and his psychiatrist observed that Chris really “came alive” in this class. But it was only four or five years later that Chris started to seek out activities that put him on the stage. Recovery is personal. A good approach to it is the holistic one. Try a little bit of everything.

Satori system, post-traumatic stress and schizophrenia

The Financial Times copyright policy forbids distribution of this article by e-mail. You can google it using keywords Satori system, Financial Times and David Kaufman.

This privately developed technology is being used by the US military in veterans centers and in Iraq and Afghanistan. It is becoming widely available in US spas and the developers are partnering with Mental Health America to distribute 250,000 MP3 complimentary downloads to U.S. servicemen (emphasis, my own)

The Satori system uses alpha, theta and delta frequencies to induce relaxation by lowering brainwaves, lowering serotonin levels and bringing the body into a REM-like state. Lucid dreaming anyone?

The client winds down in a specially designed chaise longue type chair where vibrational energy is pumped in via headphones and four strategically placed transducers (which I suspect are located under the length of the chair and in contact with the body.)

I have written elsewhere (here, here, here and here) about Chris’s encouraging experiences with the sound shaman, using a different sound therapy approach but having in common the use of vibrational energy and sound to heal. According to the FT article, the Satori system helps disable your innate “fight or flight” response.

All of this is wonderful, but why isn’t Mental Health America making these downloads freely available to people with schizophrenia, their natural constituency? Come on, what’s the difference between Post Traumatic Stress Disorder and schizophrenia? Dr. Loren Mosher said shell shock (PSTD) resembles schizophrenia but in PSTD it seems obvious where the stressors came from and in schizophrenia it is not so obvious. Okay, PSTD, like autism, is a hot topic, and schizophrenia, as usual, suffers from a dirth of outside the box thinking.

I will follow up with Mental Health America and see if not distributing the free downloads to their natural clients isn’t just an oversight.

Trauma in suburbia

The trauma or shock basis of schizophrenia seems to be accepted by the holistic medical community but does not get a lot of play in the mainstream medical community. In fact, no medical doctor we consulted ever raised the issue with us. What they did say was a little different. I remember being asked by two different doctors what Chris was like at the age of ten. This seemed like a strange question at the time. I was too shell-shocked myself from the diagnosis to ask them why they raised the question. So, instead I answered,”well, uh, let’s see. He was overweight and into playing Magic cards. Other than that, there’s not much to report. He had friends, he seemed normal”.

After learning about the role of shock in schizophrenia, I reviewed Chris’s childhood for signs of shock, but nothing I could think of pointed to a dramatic, isolating event. We lived in suburbia – how dramatic is that? We went to church, my husband and I hadn’t divorced, Chris and his brothers attended Cub Scouts, we had neighborhood boys tearing through the house in great numbers. It seemed white bread boring compared to the kind of shock that schizophrenia produces on the radar screen.

What I do know is this: Chris was a ten month pregnancy and he barely moved in utero. That is unusual. His birth was long and difficult. He didn’t have a lot of energy as a child but he also never got sick. He was abnormally healthy, almost supernaturally so. I did find it a bit strange that a child who never even had a cold developed severe acne as a teenager. Dr. Abram Hoffer observes that his patients tended never to be sick as children and that many people who subsequently develop schizophrenia had severe acne in their teenage years. (Severe acne is characteristic of pellagra, or lack of vitamin B3.)

Chris was not given to emotional outbursts and apart from crying as a baby I remember seeing him cry only once when a door slammed on his finger. He had trouble making choices and he avoided confrontation. He left it to others to choose for him. Me: “Carrots or peas, Chris?” He: “Oh, I don’t care, you decide.” While this was troubling, it wasn’t so troubling that we thought about doing something about it. Chris was a thinker and he was musically talented. He did well in school and he had interests and activities so we overlooked this aspect of his personality, hoping that time would rectify it. I remember thinking, this kid is too perfect. Being perfect was troubling, even then. I felt we were overdue somehow for “the big one.”

Trauma

I have heard people comment from time to time that Chris must have suffered quite a shock over something. “Poor boy,” said a homeopathic consultant, “he must have suffered quite a shock.” This never made any sense to me at the time Chris was first diagnosed. Trauma to me means a car accident, the death of someone close to you, sexual abuse, or witnessing a horrific event.

The shock idea is not new in psychiatric circles. However, it is not currently fashionable in the biochemically determined model of schizophrenia. Dr. Loren Mosher , the first head of the National Institute of Mental Health Center for Studies of Schizophrenia, described psychosis as an understandable coping mechanism, very similar to shell shock, “except that the [shell-shock victim’s] trauma—the overwhelming experience—is very readily identifiable. It’s right there, easy to see. In contrast, the trauma that drives schizophrenics over the edge is not often so readily identifiable, and it is more often cumulative, rather than a single event. But often there’s a lot of things going on, and usually there’s also a trigger event—a romantic rejection, the death of a parent, an excessive involvement with recreational drugs.”

Ryke Geerd Hamer, MD, is famous and infamous in Europe for his Iron Rules of Cancer theory and the astonishing success rate he claims with terminal cancer patients. His approach grew out of a tragic event that occurred in 1978 when Dr. Hamer and his physician wife had clinical practices in Rome. Seventeen-year-old Dirk, the second of their four children, was sleeping on a boat anchored off Corsica when a bullet shot by someone on a nearby yacht lodged in him. He lingered for four months before he died in hospital in his father’s arms in December 1978. Shortly thereafter, Dr. Hamer developed testicular cancer.

Convinced that the shock of what happened to Dirk was reflected in his developing testicular cancer, Dr. Hamer became a cancer researcher. The Iron Rules of Cancer begin with what he calls a DHS, or Dirk Hamer syndrome. Every cancer or cancer-equivalent ailment begins with a severe, highly acute, dramatic, and isolating conflict-occurrence shock that registers simultaneously on three levels: in the psyche, in the brain, and in the organ. The shock registered to the brain can be photographed as concentric circles (or Hamer Herds) using computed tomography (CT). Where the Hamer Herd is located in the brain determines the theme of the conflict. By looking at the location of the Hamer Herd in the brain, it can be determined in which organ the cancer will arise and vice versa. In the case of the schizophrenic brain, according to Dr. Hamer, there are two (and sometimes three) such concentric circles, registering two (or three) shocks.

Schizophrenia was not the main focus of Dr. Hamer’s work, but reading about his theory started me thinking. I began to look at illness differently. Physical symptoms can be manifested by the mind and emotions and registered on the brain. It ties in very nicely with Dr. Masaru Emoto’s work with water molecules.