Childhood Trauma & Psychosis: The genie is out of the bottle

After one hundred years of denial and ignorance, it was finally accepted 20 years ago that sexual, physical, and emotional abuse of children, along with neglect, was a genuine and common phenomenon with potentially devastating long term consequences for the mental health of the survivors.

Until recently, there has been one exception to this rule. Sufferers of psychotic experiences were excluded. Their distress was caused predominantly by genetics or biology, or so they were told. Recent research has shown this to be a fallacy. Some of the recent studies even suggest that psychosis is the diagnostic category most likely to have experienced severe childhood trauma.

This paper summarizes the historical context and offers a preacutecis of the most important recent research findings. In keeping with the ethos of this journal we offer a case study to illustrate the effectiveness of psychotherapy for trauma survivors with psychosis. We end with an appeal to collaborate with the users movement to take this agenda forward.

Bad Science

The CASL campaign is driven by two central factors:

  • The concept of schizophrenia is unscientific and has outlived any usefulness it may once have claimed.
  • The label schizophrenia is extremely damaging to those to whom it is applied.

 The idea that schizophrenia can be viewed as a specific, genetically determined, biologically driven brain disease has been based on bad science and social control since its inception. English scientists have proven that the concept of schizophrenia is invalid. Indeed, few scientists represent themselves as happy with the illness model, and increasingly it is only seen to serve the interests of the pharmaceutical industry’s voracious appetite for control of human experience. It is also harmful because the diagnostic process makes it impossible to make sense of the problems that lie at the root of people’s distress. The scandal is that in the 21st century intelligent human beings are deemed to be ‘lacking insight’ for questioning a label proven to lack scientific validity.

CASL – The Campaign to Abolish the Schizophrenia Label

There have been many historical examples of medical diagnoses that took on different meanings in everyday life to the originally intended  scientific meaning, and as a result were abandoned by psychiatry, psychology and society. The words cretin, moron and idiot were all once formal medical diagnoses.

We believe that the diagnosis of schizophrenia has followed such a pathway and needs to be abolished as a matter of urgency. To describe someone as schizophrenic tells us nothing about them as an individual, and nothing about possible pathways to recovery. Rather, to diagnose someone as schizophrenic carries implications of split personality, hopelessness and in particular unpredictability and dangerousness. Schizophrenia is not a diagnosis it is a term of abuse.

Survival Techniques

Being proud of my experiences and being able to share them with others, challenges the stigma of having what are considered to be mental health problems, and means becoming a part of a collective voice to improve mental health services for all. This is both empowering and liberating, in itself.

Reclaiming Experience

Many of us who have received psychiatric treatment have found that it’s ‘blame the individual and blame the brain’ emphasis, has limited the way we can think about ourselves and our potentials. We are expected to be the silent recipients of treatment for disorders, and often, medication is the only option.  No-one asks, what do you think would help? – Our own expertise and wisdom about our lives is denied or ignored. Like naughty children we are told what to do, and then given contradictory opinions – that the only way to get better is to take medication, but that actually, we wilI never really get better anyway.

The bad brain emphasis in contemporary mental health ideology is that distress and confusion are best explained as unhealthy conditions, products of brain and cognitive faults. For example, personality disorder diagnosis implies that the chaos we can experience is due to a character fault and schizophrenia is presented as a terrible disease that we are passive victims of. We have progressed from blaming the behaviour of the child who is bullied and withdraws to blaming his brain and mind. Our attempts to find meaningful ways to live in an often distressing and confusing world, are not understood as creative, human responses to be valued and shared. Instead, the individual is pathologised, labelled and medicated.

Collective Voices

The Hearing Voices Movement was founded more than 20 years ago, following the ground-breaking research of Professor Marius Romme and Dr Sandra Escher who have advocated for a radical shift in the way we understand the phenomenon of Hearing Voices.  Rather than taking the traditional approach favored by biological psychiatry, which views voices as a product of brain and cognitive faults, their research has firmly established that voices make sense when looking at the traumatic circumstances in life that provoked them. As the improvement in people who are encouraged to talk about their voices becomes apparent, an increasing number of voice hearers and mental health professionals are beginning to see that the key to making sense of these experiences lies in understanding the content of voices. Voices are meaningful and for some, an experience to be celebrated.