I am delighted to have been invited by Anthony Morgan to give the inaugural talk in his seminar series for the Newcastle Philosophical Society entitled “Schizophrenia 100 Years On”. My talk “Schizophrenia: 100 Years of Controversy” will start at 7pm in the Cedar Room, Upstairs at The Dog and Parrot, 52 Clayton Street West, Newcastle, NE1 4EX. Admission is free, all are welcome, and the abstract is below.
Schizophrenia: 100 Years of Controversy
One of schizophrenia’s central paradoxes is that as a diagnostic category it has been both surprisingly stable and intensely contested. The word schizophrenia first appeared in print exactly one hundred years ago as Eugen Bleuler’s new name for dementia praecox, the diagnostic category ‘discovered’ by Emil Kraepelin some fifteen years earlier. Despite extraordinary advances in areas like psychopharmacology, neuroscience and molecular genetics, the basic clinical picture of schizophrenia offered by Kraepelin, Bleuler and their contemporaries has changed little over the course of a century. This apparent stability masks the fact that schizophrenia has been psychiatry’s most consistently and indeed most passionately contested diagnostic category. Is ‘schizophrenia’ a ‘disabling and baffling brain disease’ (Meyer-Lindenerg, 2010, p. 194), a ‘multidimensional psychotic syndrome’ (van Os et al., 2010, p. 203), or a scientific fiction and stigmatising label (Bentall, 2009)? No-one disputes that some people experience anomalous and often distressing changes in their sense of self and world, in their thoughts and feelings, bodies and behaviour. But a growing number of people argue that the ‘schizophrenia label’ is ‘extremely damaging to those to whom it is applied’ and serves ‘to perpetuate the myth that when talking about “schizophrenia” we are discussing something that actually exists’ (Hammersley and Mclaughlin, 2010). This conflict is not about how best to understand, treat, research, or cope with the clinical reality of schizophrenia (although all of these things are strenuously debated); it is, at a deeper level, a conflict about whether or not there is such a thing as schizophrenia.
My aim in this talk is neither to inflame nor to resolve the many conflicts surrounding schizophrenia, but to shed some light on how and why they developed. Mainstream psychiatry tends very much to downplay the paradox described above, viewing conflicts over schizophrenia as diversions or misguided departures from the central narrative of scientific progress. By contrast, this paper argues that the foundational accounts of schizophrenia enabled and even encouraged the controversies that were to follow. Conflict, I will suggest, is not just something that has surrounded schizophrenia in the therapeutic, clinical, scientific, personal and political spheres; it is in fact the very essence of this most enigmatic of psychiatric diagnoses.