The best and cheapest alternative therapy for schizophrenia

Information about alternative therapies for schizophrenia is cropping up more and more in research journals and in the media, which is a welcome change. In the past, it was almost impossible to find information about schizophrenia except in the medical context of “debilitating and chronic illness requiring life long medication.” I have extracted some recent studies that are reprinted below. What I have to say may sound strange coming from someone who has promoted diverse alternative therapies ranging from sound and music based therapies, to drama therapies and cathartic psychotherapies.

Here’s my two cents worth. Alternative therapies to treat schizophrenia may not be necessary. Plenty of people I have come in contact with through this blog and from reading recovery stories, have never gone in for orthomolecular therapy, or ridden a horse, or participated in dance or drama therapy. What I would consider the most basic alternative therapy that works for most people is take time out to rest and reflect, and to have the non-judgemental and encouraging support of family or a close friend or friends. I call this basic therapy an alternative one because it is actually contrary to what a lot of people believe. The public mainstream still invests in the idea that schizophrenia is a debilitating, chronic illness that medications can manage. Encouraging growth at home is also contrary to how a lot of people are treating their relative, who they have come to view as having a disease. To quote from the Sheila Mehta/Auburn University study testing whether the belief that a disease view of mental disorder reduces stigma:

In general, the disease view did not improve attitudes, except in terms of blame. It did, however, tend to provoke harsher behavior. In contrast, the psychosocial view induced treatment no different from that toward normal others. The results provide little support for the claim that regarding the mentally disordered as sick or diseased will promote greater acceptance and more favorable treatment.

The therapies I have written about in my blog are icing on the cake. They can help and do help a person to be more at ease in their body and mind (enabling them to stop relying on meds), but all of the work the therapies do counts for nothing if a person sees himself as fundamentally a chronic case or if his family and friends treat him as such. You can practice alternative therapies, but if you return each day to an environment that is critical and unnurturing and which supports your patienthood, all the good they have been doing for you will undone.

So, here are just three of the therapies that are gaining attention. I’ve quoted the National Post (horseback riding) and The Cochrane Review research for dance therapy and drama therapy.

One doesn’t really expect to see horse riding and psychiatric illness mentioned in the same sentence, let alone combined as a form of health care. But a recent Canadian study suggests that riding may actually be beneficial for people with schizophrenia. And that is only the tip of the iceberg, it seems, when it comes to horses and treatment.

Dance therapy (also called dance movement therapy) uses dance and movement to explore a person’s emotions in a non-verbal way. The therapist will help the individual to interpret their movement as a link to personal feelings. This review aims to assess how successful this therapy is as a treatment for schizophrenia, when compared to standard care or other interventions. Six studies were identified but five were excluded because there were no reliable data, because they were for a therapy other than dance or because they were not properly randomised. The included study compared 10 weeks of group dance therapy plus standard care, to group supportive counselling plus standard care for the same length of time. It was a community-based project involving 45 people and both groups were followed up after four months.

Drama therapy is one of the creative therapies suggested to be of value as an adjunctive treatment for people with schizophrenia or schizophrenia-like illnesses. Randomised studies have been successfully conducted in this area but poor study reporting meant that no conclusions could be drawn from them. The benefits or harms of the use of drama therapy in schizophrenia are therefore unclear and further large, high quality studies are required to determine the true value of drama therapy for schizophrenia or schizophrenia-like illnesses.

There are several things that I would consider when deciding to undertake an alternative therapy.

1. The words “therapy” and “therapist”, when attached to the word “alternative,” convey a medicalized view of the so-called illness, even when you do not believe in the medicalized view of the so-called illness. There is a danger with alternative therapies of having your patient status reinforced, especially if the therapy is institutionalized and done in a group. Horseback riding is an example. It’s expensive, and probably done in a group for that reason. Group therapy, whatever the kind, has a sheltered workshop aspect to it, the same kind of feeling that you may get from being enrolled, like Chris was, in a hospital program. Chris’s and other people his age, found being in the program, humiliating.

Individual or one-on-one therapies or activities don’t carry the stigma of group activities when it comes to a mental health diagnosis. One benefit of individual treatment  is that the person/therapist may be a guiding light for your relative. This has certainly been the case with Chris. He has benefited from their holistic beliefs in helping to heal a spiritual crisis.

2.Not every therapy is a good choice in the early stages of a crisis. Vitamin therapy is fine in the early stages, and being around animals like a family pet is far less threatening that riding a horse. Chris couldn’t bring himself to do voice lessons, for example, until he was better equipped to handle the voice teacher’s demanding personality.

3. The therapy or activity should suit the person. Horseback riding seems all the rage as a therapy, but as Rupert Isaacson said in his memoir, The Horse Boy, go with what your relative is interested in. Chris has done lots of therapies, but the common ingredient tended to be music and drama. His art is at the stick figure level, so art therapy wasn’t something he pursued.

4. Which brings me around to saying that whatever you do doesn’t have to have the word “therapy” attached to it. I dragged Chris through all those therapies because it felt good for me to be DOING SOMETHING about THE PROBLEM (LOL). Someone who wants to draw and paint only needs access to the materials. Anyone can listen to music.

5. It is just possible that your relative will show an interest in something when recovering that will reveal what he or she was put on earth to do. The crisis was a way of showing that the old expectations were the wrong ones. Don’t urge your relative to just get with the same old program. That old program didn’t work.

Breaking the Silence on Mental Health

Today is World Mental Health Day. I took my dog and pony show to a lunch time presentation on mental health and stigma, given by the former Prime Minister of Norway, Mr. Kjell Magne Bondevik.

Prime Minister Bondevik briefly considered resigning as Prime Minister in 1998 due to depression. He was urged not to resign, but to seek treatment and make this known to the Norwegian public. Three and a half weeks later, he resumed his duties, having succesfully engaged in walking and talking therapy with his psychiatrist, who took him on long walks up the mountains. Medications were also part of this therapy. He received top drawer treatment being the Prime Minister, and a Norwegian one at that, but he was also suffering from a top drawer diagnosis, depression, a time-limited condition. More importantly, the public thinks it understands, and is therefore sympathetic to depression, because it is so easily relatable to sad events in one’s own life. Schizophrenia is not at all easily understood by the public. There are some people whose schizophrenia, like their depression, may be biochemical in nature and therefore can be “corrected” employing short term orthomolecular or drug therapy, but for a lot of people, the cause of the condition is higher up the food chain, so to speak, and related to the same things that make a depressed person, depressed.

I was madly scribbing some ideas to challenge his contention that people should be open and honest about their mental health problems. I think three and half weeks of major depression makes him a credible spokesperson, but I doubt he’s got the full picture of what a major mental health label will do for someone over the long term.

So, I raised my hand and said that anti-stigma campaigns were all well and good, but the cause of stigma is more complex. Why do people discriminate in the first place? I said that as a mother of a son with a diagnosed major mental illness, I would not be so open about opening up and I cited the Sheila Mehta (Auburn University) study*, which found that stigma is increased if people think you have a mental illness caused by a biochemical imbalance as opposed to a mental illness resulting from understandable events in a person’s life. Today, of course, everybody thinks mental illness is caused by a biochemical imbalance. I can run the numbers. This means that a large number of people are willing to discriminate against you.

I made my point. I sat down. Mr. Bondevik’s answer didn’t address my point about belief in the biochemical basis of the condition increasing stigma. He said it was everyone’s personal decision about how much they wanted to open up about their mental illness. Fine, sure, but the Mehta study has raised some provocative issues about stigma that need further thoughtful discourse.

People who know that Chris was diagnosed with a major mental illness (in this case, the S-word), from what they have said to me, think Chris is somehow fundamentally flawed, will always be a “burden” to some extent in Ian’s and my life, and they feel that as long as he stays on his medications he will be able to “cope.” Gee, Chris is doing well,” they may say, “the medications must be working.” Had I not blabbed away the diagnosis in the first place, and did not let people know Chris has been on medications, the Mehta study suggests that people would not single him out as different, and therefore not apply the same pessimistic outlook.

Mehta, S. , & Farina, A. (1997). Is being sick really better? Effect of the disease view of mental disorder on stigma. Journal of Social and Clinical Psychology, 16(4), 405-419.