Running Head: ALTERNATIVE MODELS OF TREATMENT AND CONCEPTUALIZATION
Alternative Models of Treatment and Conceptualization of Schizophrenia
Sarah K. Squirrell
Johnson State College, Vermont
ANT 4020 Multi-cultural Studies of Healing
Alternative Models of Treatment and Conceptualization in Schizophrenia
For more than a century one of the most serious of mental disorders,
schizophrenia has both intrigued and eluded psychiatry. The earliest
descriptions of schizophrenia date back to the end of the 19th
century. Generally schizophrenia can be characterized by loss of
contact with reality. Current contemporary research within the
context of medical model is steeped in the heavy study of genetic
influence and brain structure and function. The medical model of
treatment for schizophrenia focuses on stabilization and maintenance;
which are achieved through medication and hospitalization. “At the
most optimistic of times, the traditional treatment paradigm conceded
that 10 percent to 20 percent of those with schizophrenia might
achieve recovery” (McGuire, 2000). These grim statistics coupled with
annual treatment costs of $30 - $65 billion dollars annually indicate
a failed and ineffective model of treatment. Which begs the question,
is our current focus and understanding of schizophrenia in our pursuit
of a “cure” within the context of a medical model working? Or rather,
do we need to shift our model of treatment to incorporate alternative
therapies and medicines that have proven successful or shown promise
as treatment options. There is a large body of work and many dedicated
clinicians who have developed alternative approaches to schizophrenia
that should be further explored and researched. Additionally, we need
to shift and redefine our perspectives on schizophrenia to a holistic
view based on hope and recovery.
Perhaps in order to embrace alternative approaches to healing and
recovery in schizophrenia we first need to reconsider our contextual
framework for understanding it. Some psychiatrists have proposed that
psychiatric patients are not ill, but rather individuals with
unconventional thoughts and behavior that make society uncomfortable.
As a society we are exerting our social control by classifying the
behavior within a medical model. We then must consider societal and
cultural roles in determining what is normal and abnormal. The
symptoms of schizophrenia can be considered as defense mechanisms and
coping strategies. For example, “in the face of stress, some people
just turn inward, or else they may flee. Schizophrenia and psychosis
might be seen as adaptive strategies used by some people to escape
from environmental and psychological stresses” (Gerber, 2001).
Psychiatrist R.D. Laing describes “eleven case studies of people
diagnosed with schizophrenia and argues that the context of their
actions and statements was meaningful and logical in the context of
their family and life situations” (McGuire, 2000). Dr. Lewis Mehl-
Madrona writes of a young schizophrenic Donnie, “who had come home for
Christmas with a shotgun, and had decimated the Christmas tree and all
the presents underneath, thinking that he could kill all the bad
feeling that’s haunted him” (2003). We should view the “madness”
displayed in the behaviors of schizophrenics as an expression of
distress that should be validated and respected in the context of
their life experiences.
Numerous psychologists have proposed that schizophrenia and similar
conditions could be referred to as normal state of human
consciousness. Essentially any “mysterious voices” would be
interpreted as instructions from a higher being or god. Further, some
have speculated that in some cultures schizophrenia or related
conditions may predispose an individual to becoming a shaman. While we
do not want to condone negative symptoms of schizophrenia we should
consider that many important religious and political figures have
experienced many of the behaviors that are currently listed as
symptomatic of schizophrenia. The idea has also been formulated that
schizophrenia may be the evolutionary price we pay for imbalances
between the left and right brain hemispheres as “psychosis is
associated with greater levels of right brain hemisphere activation
and a reduction in the usual left-brain hemisphere dominance” (Gerber,
2001). The aforementioned concepts in terms of our perspectives on
schizophrenia lay the groundwork for pursuit of alternative models of
treatment.
One branch of alternative medicine that deals with schizophrenia is
known as orthomolecular psychiatry. Orthomolecular psychiatry
considers schizophrenia to be a group of disorders that need to be
identified, assessed and then the appropriate therapy implemented. Two
alternative treatments include dietary and supplemental treatments.
While there is little literature to support it some “orthomolecular
proponents claim that an adverse reaction to gluten is involved in the
etiology of some cases” (PeaceHealth, 2008). Controlled trials have
produced conflicting results one “preliminary trial of gluten-free/
dairy-free diet found that patients with schizophrenia improved on the
diet” however another clinical trial “found similar positive response
in only 8% of patients” (PeaceHealth, 2008). This suggests that
dietary changes should be considered when treating schizophrenia, but
not all people will benefit from a gluten-free/dairy free diet.
Another treatment under orthomolecular psychiatry is the utilization
of vitamin supplements. The mainstay of orthomolecular approach to
schizophrenia is niacin and niacinamide (vitamin B3). Vitamin B6 has
also been used in combination with niacin as well as vitamin C. “In a
preliminary trial, some schizophrenic patients continued a course of
vitamins (4 to 10 grams of niacin, 4 grams of vitamin C, and 50mg or
more of vitamin B6) after being discharged from the hospital. Those
who continued to take the vitamins had a 50% lower readmission
rate” (PeaceHealth, 2008). Other studies have found that
schizophrenics may require more vitamin C than the larger population.
People with schizophrenia have also been found to have a greater
tendency to be deficient in folic acid. “A preliminary trial found
that among schizophrenic patient with folic acid deficiency, those
given folic acid supplements had more improvement, and shorter
hospital stays than those not given supplements” (Peacehealth, 2008).
Glycine has also been found to reduce symptoms, however glycine can be
toxic to the nervous system and more studies are necessary. Some
studies report that there is also evidence “that fatty acids such as
omega-6 and omega-3 fatty acids are deficient, or are not used
properly, in people with schizophrenia” (PeaceHealth, 2008). L-
tryptophan has also been found to decrease agitation and lessen fear
and anxiety in patients. Melatonin is another supplement that has been
to be helpful in treatment of schizophrenia, “the results of one
double-bind trial indicate that melatonin supplementation improves
sleep quality in people with schizophrenia” (PeaceHealth, 2008). While
clearly there is conflicting evidence around the use of supplements in
treating schizophrenia it an area of alternative medicine that should
be explored and studied. “Although vitamin and supplementation is an
area of controversy and disagreement between the holistic and
traditional medical communities, this aspect of nutrition can greatly
assist the body and mind to better deal with stress” (Gerber, 2001).
Another alternative therapy to consider is homeopathic remedies. The
theory of vibrational medicine suggest that homeopathic remedies are
able to affect energy healing levels like the chakras, as well as the
emotional/astral body. For instance, “certain cases of manic
depressive illness and schizophrenia have benefited dramatically from
treatment with homeopathic remedies” (Gerber, 2001). This alternative
approach addresses imbalances within our energy levels as well as
within the brain. The flower essence Macartney Rose has been found to
help patients recover neurological functioning. “Macartney Rose eases
epilepsy, alleviates various forms of schizophrenia, and balances
motor neurological tissues” (Gerber, 2001). Color therapy should also
be explored as an alternative treatment. “Violet ray is thought to
provide nourishment of a subtle energetic nature to those neurons in
the cerebral cortex that contribute toward a greater understanding or
our divine nature” (Gerber, 2001). Because of its positive therapeutic
effects it “may be effective in relieving headaches, neuroses, and
even certain forms of schizophrenia and dementia” (Gerber, 2001).
Lifestyle should also be considered when conceptualizing treatment of
schizophrenics.
Exercise has long been recognized for its benefits in treating
depression and as a component of overall well-being. “In one reported
cased, physical activity improved the functioning of a man diagnosed
with schizophrenia” (Peacehealth, 2008). Teaching strategies for
coping as well as stress reduction techniques including relaxation
techniques have been proven helpful. Patricia Deegan of the National
Empowerment Center in Lawrence, Mass states, “There is no one out
there teaching patients how to cope with stressing voices, or how to
avoid or get out of the delusional vortexes of thought that you slide
into. (McGuire, 2000). Mehl-Madrona writes, “the conventional
psychiatry view pathologizes nonordinary states of reality, whereas
the shamanic view explores them and uses them for healing” (2003).
Other holistic approaches include herbs and magnetic stimulation of
the skull, both of which require further study.
When we expand our current medical model of treatment for
schizophrenia we must not only consider the micro level of care, but
the macro level as well. People do recover from schizophrenia, but
frequently without much help from the mental health system. Courenay
Harding of the Center for Pyschiatric Rehabilitation at Boston
University writes, “many recover because of sheer persistence at
fighting to get better, combined with family or community support
(2002).” The old treatment model is insufficient, one that views
patients as hopeless, merely to be maintained and stabilized with
medication and hospitalization. “The concept of recovery, with its
many definitions, is emerging as a new paradigm for schizophrenia
treatment” (McGuire, 2000). What we are presented with is an
alternative framework of care with a focus in the potential growth in
the individual. This growth and its potential is developed by
integrating alternative models of treatment. Recovery is no longer
viewed as cessation of symptoms, but rather a journey of developing
new meaning and purpose. The first step in a successful alternative
model is recognizing the uniqueness of the individual and
acknowledging each patient has different needs.
The recovery movement has been promoted by the work of Harding whose
research centered on a cohort of patients from the Vermont State
Hospital in the late 1950’s. The 10-year rehab program focused on
community and vocational support as well as social skills training and
mentorship. The program connected patients with natural community
supports and mentors who followed the patients for many years, many on
a volunteer basis. Harding writes, “The Vermont model was self-
sufficiency, rehabilitation and community integration” (2002). Here we
can begin to weave the threads of healing between various practices.
Mehl-Madrona writes of Donnie, a schizophrenic who recovered under the
care of a medicine man and healer, Melvin, “community was an important
part of Donnie’s recovery. Through Melvin Donnie acquired an entirely
new family. He was adopted into a tribe” (2003). Mehl-Madrona further
writes, “Donnie’s healing was not just psychological or spiritual
phenomenon; it was also biological. Every cell in the body
participates in this healing, changing the biochemical
environment” (2003). Harding muses on this point as well, “maybe what
we are looking at is the neuroplasticity of the brain that is very
slowly correctly the problem on its own, in interaction with the
environment” (2002). Harding has researched many other longitudinal
studies conducted in eastern countries reporting 50 percent or higher
recovery rates, all of which have been ignored by American
researchers.
In alternative models of treating schizophrenia treatment based upon
the hope of recovery and viewing treatment as a journey of healing are
essential elements. The multitude of alternative approaches and
treatments should be explored for each person and include a holistic
assessment including; diet, nutrition, lifestyle, family and community
support. The nature of schizophrenia is that which takes away what is
most sacred to being human – our sense of being, place, purpose and
safety. It is a darkness that can shroud the most beautiful of minds
and leave families and loved ones in a lurch of confusion, sadness and
anger. Watching this illness strip my brother of all that was life to
him is indeed a deep sadness I can hardly bear. But what also holds
true is that he is not lost or any other individual who has been dealt
the heavy hand of this illness. Within the delusions, the meaningless
words, strange behaviors and deterioration of skills, is an individual
who can be drawn from the depths of their watery state. What has
failed them is not their will to live, but their ability to live. We
must offer them as Mehl-Madrona writes, “the promise of belonging and
acceptance, which every schizophrenic craves and fears more than
anything in the world” (2003). We must pursue the study and practice
of alternative models of treatment that incorporates the physical,
emotional and spiritual elements of the person. Therefore, in a
successful alternative model of treatment all interventions and
treatment work must occur within the single powerful context of a
recovery vision.
References
Harding, C.M. (2002). Beautiful minds can be recovered. New
York Times, March 10, 2002. Retrieved August 18, 2000 from
http://alternativementalhealth.com/articles/beautifulmind.html.
Mehl-Madrona, L. (2003). Coyote Healing: Miracles in Native Medicine.
Rochester, VT: Bear & Company.
PeaceHealth. (2007). Schizophrenia: Alternative medicine.
Healthnotes. Retrieved August 18, 2008 from
http://www.peacehealth.org/kbase/cam/hn-1259003.htm.
McGuire, P.A. (2000). New hope for people with schizophrenia. Monitor
on Psychology, Vol. 31, No. 2. Retrieved August 18, 200 from
www.apa.org/monitor/feb00/schizophrenia.html.
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