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University Microfilms International 300 North Zeeb Road Ann Arbor, Michigan 48106 USA 51. John's Road, Tyler's Green High Wycombe, Bucks, England HP10 8HR 78-10,262 WEAVER, Daniel Joseph, 1944- POLITICAL PHENCMENA OF SaUZOPHRENIA FR<M EMIL KRAEPELIN TO R. D. LAING. University of Hawaii, Ph.D., 1977 Political Science, general University Microfilms International, Ann Arbor, Michigan 48106 ® 1978 DANIEL JOSEPH WEAVER ALL RIGHTS RESERVED POLITICAL PHENOMENA OF SCHIZOPHRENIA FROM EMIL KRAEPELIN TO R. D. LAING A DISSERTATION SUBMITTED TO THE GRADUATE DIVISION OF THE . UNIVERSITY OF HAWAII IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN POLITICAL SCIENCE DECEMBER 1977 Daniel Joseph Weaver Dissertation Committee: Henry Kariel, Chairman Robert Cahill Reuel Denney Manfred Henningsen Deane Neubauer iii ABSTRACT This is an exploration and critical review of the political implications of selected psychiatric, psycho therapeutic, and psychoanalytic theories and therapies of the disease concept and/or the human phenomena of schizo phrenia. It focuses on the nature of medical authority, the wide variety of models of schizophrenia propounded since 1900, and its relation to creative human experience. In practice, the therapy of Silvano Arieti demonstrates the frustrated attempt to balance the assertions of organic etiology and the counterclaim that schizophrenia is a human disorder for which no technological or medical therapies are adequate. Emil Kraepelin invented the concept of schizophrenia in the early twentieth century, and Eugen Bleuler renamed and established the theory and therapy of schizophrenia as an organic illness of unknown etiology and grim prognosis. For these founders (and for Carl Jung as well) schizophrenia was a dangerous organic disorder. Orthodox medical psychia try continues to view schizophrenia in this way. The polit ical implications of the theories and therapies of these scientific pioneers are examined. Harry Stack Sullivan's social psychology is based on his understanding of schizophrenia as a human disorder. A iv critic of normal, well-functioning family and social systems, Sullivan, as therapist, empathizes with the cause of the patient and avoids the institutional role of disciplining psychiatrist. Frieda Fromm-Reichmann's demonstration that schizophrenia is a completely human cultural phenomena, fully treatable by therapists, that can enhance the creative powers of afflicted individuals, makes her a significant figure in psychiatry. Marguerite Sechehaye, Harold Searles, Theodore Lidz, and John Rosen claim they have developed therapies that effectively treat diagnosed schizophrenics. For Sechehaye, a profound and extended commitment resulted in a solid thera peutic achievement. However, her intolerance of regression and her commitment to the medical-scientific version of psychoanalysis are seen as limits in this study. Searles, a successor to Sullivan and Fromm-Reichmann, asserts that regression is always potentially advantageous to the schizo phrenic. Lidz demonstrates the dangers of ideological pos turing in his approach to schizophrenia, and Rosen does the same in his assembly-line therapy in the service of founda tions and governments. Although the genetic/chemical researchers assert that a medical or organic treatment and cure is possible given enough resources, they have not succeeded in curing the dis ease or establishing its etiology, and yet, they dominate the funding and public interest. The work of Franz Kallman and that of the articulate proponents of medical authority, v Abram Hoffer, Humphry Osmond, J. R. Smythies, and Miriam Siegler are critically weighed. The advent of anti schizophrenic drugs is explored from a political viewpoint. Thomas Szasz, a thorough polemicist, intermixes a laissez-faire psychiatry with modern liberal politics. His criticism of public psychiatry is often useful, his vit riolic stand against Laing notwithstanding. R. D. Laing's theory and empirical evidence demonstrates his understanding of schizophrenia as a natural healing process. His role as a social critic and his authority as a medical doctor are examined to explore the future role of the human sciences in the evolution of schizophrenia. Schizophrenia has evolved from an organic disease to a political and cultural phenomenon of importand dimensions leading to the understanding of alienation, creativity, and the social function of med ical knowledge. Two competing models of schizophrenia and of psychiatry are prevalent today: one based on an organic medical etiology, the other on a vision of polit ical possibility. vi TABLE OF CONTENTS .ABSTRACT ••••••••••••••••••••.••• iii CHAPTER I INTRODUCTION . • • • • • . 1 CHAPTER II THE FOUNDERS OF SCHIZOPHRENIA 19 CHAPTER III HARRY STACK SULLIVAJ.'J AND FRIEDA FROI~-REICHMANN . 47 CHAPTER IV MARGUERITE SECHEHAYE AND HAROLD SEARLES. • 83 CHAPTER V JOHN ROSEN AND THEODORE LIDZ .•• 114 CHAPTER VI GENETIC AND CHEMICAL PERSPECTIVES 144 CHAPTER VII THOMAS SZASZ . • . • . • . 188 CHAPTER VIII R. D. LAING: EXPERIENCE, NORMALITY AND SCHIZOPHRENIA . .. .••.... 227 CHAPTER IX R. D. LAING: NATURAL HEALING EXPERIENCES .. .. 261 CHAPTER X R. D. LAING: POLITICS AND MEDICINE 298 NOTES 340 BIBLIOGRAPHY •...•.•.•.•..•..•. 376 CHAPTER I Introduction "Schizophrenia Laid to Misshapen Protein in Brain" A Detroit researcher carried the search for schizophrenia a major step forward yesterday. He blamed it on a tiny corkacr ew-cshaped protein that has run amuck in the emotional center of the brain. The enzyme that regulates that protein is missing from the brain of schizophrenics, but present in normal brains, Dr. Jacques S. Gottlieb told the American Psychiatric meeting here [in DallasJ. In that sense, he said, schizophrenia is like diabetes. In diabetes, an absence of insulin in the blood prevents the conversion of sugars into protein. Gottlieb . said it will take him five years to turn his laboratory findings into treatment methods for the nation's estimated millions of schizophrenics. It appears most probable, therefore, said Gottlieb, "that DMT is being produced in excess in certain parts of brains of schizophrenic patients and this could be responsible for some of the manifestations of the illness." "In effect," he said, "the schizophrenic is his own drug abuse factory." Honolulu Advertiser, June 20, 1973. 2 "Mental Behavior Ills Inherited?" Dr. David Rosenthal, chief of the psychology laboratory of Intermural Research Programs, National Institute of Mental Health, listed major mental ill nesses--or "behavioral disorders" as some scientists prefer to call them--and cited studies implicating genetic inheritable faults in all of them. "There is sufficient evidence for genetic factors in all behavioral disorders for us to take the genetic hypothesis seriously," Rosenthal said. He said there may be more than 60 million schizo phrenics in the u.s. population of 210 million. These are persons who are afflicted to some degree with loss of contact with the real world and subject to many kinds of behavioral disorders. In addition, he said, there are 9 million Americans with "a serious drinking problem" and their number increases by about 200,000 annually. It is estimated that one child in five between ages 10 and 17 will wind up in Juvenile Court. .. "When you add in the neurotics [he said] ... you get into figures regard ing those affected, almost impossible to estimate." Honolulu Advertiser, June 15, 1972 "The Sane and the Insane" by Nigel Hawkes Eight perfectly normal people, by shamming symptoms of a mild kind, successfully gained admission to psych iatric