Delusions, Meaning and Transformation by Milt Greek

Author:Milt Greek
Language: eng
Format: epub
Tags: recovery, psychosis, schizophrenia, recovery from schizophrenia, delusions and hallucinations
Publisher: Milt Greek

A Combined Toolkit Approach to Psychosis

The medication debate

At present, there is a very contentious debate on the utility of medication for treating psychosis with what will hopefully soon be an acknowledged common ground. The medication debate, ongoing for decades among some peers and practitioners, has a group of progressive advocates urging that medication be seen as largely counter-productive if not outright toxic to the health of people in psychosis.

The most well-known of this group is Robert Whitaker, who wrote Mad in America and Anatomy of an Epidemic, in which he contends that medication is counter-productive, unnecessary and oftentimes toxic to the person taking it. Even so, on the www.madinamerica.com web journal Whitaker has indicated that a process seeking "optimal use of medicine" is the best approach, thereby allowing that some medication use is beneficial in some circumstances. Another writer, Paris Williams, cites numerous studies of medicine use in his work, Rethinking Madness, indicating that long-term use of medicine to treat psychosis results in substantially worse recovery rates than not using medication. While advocating that individuals experiencing psychosis be given places of respite and care to allow the condition to run its course, Williams indicates that studies are showing the short term use of medicine is more effective than not using medicine.

Long-time peer advocate and innovator Ron Coleman of the United Kingdom's Hearing Voices Network sees psychosis as an adaptive response to trauma and has outlined a process to work with voices as a means to make the experience positive. A married family man who travels the world in his training and advocacy work, Coleman still hears voices but uses them for his benefit. In Recovery: An Alien Concept, Coleman makes the point that studies show that medication and other treatments forced onto people do not work in many cases. In Working with Voices, however, Coleman and his co-author Mike Smith recognize medicine as one response to dealing with voices and madness.

Significantly, many progressives advocate the use of Open Dialogue therapy to help work with the person in psychosis and her or his significant others. While this treatment protocol from Northern Finland uses extensive individual and group counseling to reunite the experiences and thoughts of the person with those around him or her, the treatment team also uses medication for about 20% of the people they work with.

Among conservatives in the debate, E. Fuller Torrey of the Treatment Advocacy Center and author of the well-known guide Surviving Schizophrenia, wrote a highly critical review "Anatomy of An Epidemic – How Robert Whitaker Got it Wrong" in which he strongly defended medication as being crucial to many people's recovery and not a danger to health. Even so, the stalwart advocate for forced treatment and other mainstays of the medical model wrote in the review

It has been known for a century that approximately one-quarter of individuals who develop a schizophrenia-like psychosis will recover without treatment and not get sick again.

(p. 3)

Torrey then cites several studies going back as far as 70 years ago, indicating

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