There’s no such thing as treatment resistant schizophrenia and here is an allegorical explanation as to why
By Barry Turner
Senior Lecturer in Environmental and Science Journalism
Lincoln School of Journalism
George Washington the first president of the US was suffering from a throat infection from which he died. It was one that he would have recovered from in less than a couple of days if he had been alive in 20th century America. His physicians subjected him to bloodletting and after hours of pain and suffering the result was inevitable. President Washington was not ‘treatment resistant’ to bloodletting, it was a useless, and in his case a fatal and faulty treatment.
The primitive medicine that was applied to the first president of the United States is considered ridiculous by the standards of our modern scientific and evidence based approach to medicine yet in mental health this kind of ‘faith’ based approach is still alive and well. A belief in an intervention is enough to justify it. No evidence, no pathophysiology, no pharmacokinetics or dynamics, just a ‘belief’ that it is ‘working’. If cardiovascular interventions were done this way we would have a catastrophic death rate.
Patients absurdly labelled (not diagnosed) with schizophrenia are bombarded with powerful psychoactive substances and when they do not conform to the utterly unrealistic expectations of those who purport to be their professional carers are labelled again as ‘treatment resistant’. This has got to be the highest level of all of human rights abuses on the most vulnerable in our society.
Treatment resistant schizophrenia robs patients of the very last vestige of their humanity and turns them into specimens, inmates and objects. This is the deepest cut of all in their depersonalisation and the greatest indictment on those who rob human beings of their most fundamental of human rights, the right to be an autonomous individual.
One of the interesting points about the treatment of George Washington is its startling similarity to the current practice of titrating medication in mental illness. It goes like this. Washington was subjected to multiple bloodlettings and the application of rectal medications. The first, second and third bloodletting did no good so a fourth was administered. The President died soon after.
Today in countless psychiatric hospitals drugs are administered which are observed ‘not to work’. The first response to this is to increase (titrate) the dose and this frequently results in daily dosages well above those recommended in the pharmacopeia. It seems that in very many cases the last question ever asked is “can this patient metabolise this drug?” And even more rarely “does this patient actually have a dopamine or serotonin ‘imbalance’ in the first place?”
If George Washington had been given proper medical treatment instead of a crackpot mix of nostrums and bloodletting he would have lived. If patients with mental health problems were treated instead of ‘processed’ the ‘acute ward’ would wither away and die along with the blood letters of old.
George Washington’s doctors were working decades before modern medicine acquired the knowledge to properly diagnose and treat infections and it would be almost two centuries before a proper treatment for his throat infection was to be developed. They at least had an excuse for giving him a treatment that was useless and caused his already serious illness to get far worse. Modern psychiatrists have no excuse for their behaviour, they have modern science and modern pharmacology to draw on yet they talk of ‘treatment resistance’ when they mean treatment failure. It is not the drugs that are not working, it is not the patient that is at fault it is their inability to place scientific method and patient welfare above dogma and orthodoxy.
Treatment resistant! It is certainly time that ‘treatment’ was resisted!
