From RONALD SIDDLE and DOUGLAS TURKINGTON
A major flaw in the neurological and brain-imaging research which your
article describes, and perhaps the reason for the absence of a single and
coherent ‘scientific’ explanation for ‘schizophrenia’ to date, is the question
of whether it is legitimate to search for an aetiological explanation common
to all cases diagnosed as schizophrenic. Richard Bentall, professor of clinical
psychology at Liverpool University, for example, has argued that the diagnostic
criteria for ‘schizophrenia’ are highly over-inclusive and that any two
‘schizophrenics’ might be suffering from a completely different cluster
of symptoms. He rightly suggests that research should concentrate on classifying
research subjects according to the presence of discrete symptom types such
as ‘hallucinations’ or ‘delusions’ in order to gain an understanding of
the mechanisms maintaining each separate phenomenon, thus avoiding categorical
errors and confusion.
Other research avenues contributing to our understanding of schizophrenic
symptoms include cognitive experimental psychology. Work on reasoning processes
in subjects suffering from delusions, for example, is beginning to tease
out the similarities and differences between ‘normal’ and ‘delusional’ reasoning.
Schizophrenia research and treatment could benefit much from an integrated
approach, leading to the development of a broader spectrum of anti-schizophrenic
drug treatments, and to the continued development of a cognitive therapy
approach. This form of therapy empowers patients through helping them gain
an understanding of their bizarre and frightening experiences, addressing
their emotional distress and employing psychological techniques to enable
them to control, for example, the frequency and intensity of hallucinatory
experiences, or to reduce the degree of conviction in a delusional belief
and to improve appropriate drug compliance.
Ronald Siddle and Douglas Turkington Newcastle Cognitive Therapy Centre
Carolyn John Durham University
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