Posted by Mitchell on November 12, 2001, at 17:10:19
In reply to hearing voices is not schizophreniac?, posted by ttt on November 11, 2001, at 11:44:38
> Has anyone heard voices or sound and proven the it is not schizophrenia?
The idea that "schizophrenics hear voices" arises from a subjective approach to the diagnosis of mental problems, developed during years before science enjoyed a more accurate understanding of neurology. The symptom of "hearing voices" typically associated with schizophrenia involves interpretation of auditory sensation. Schizophrenia, as a pattern of symptoms, is now believed to relate to difficulty in regulating the flood of signals available to the cerebrum at the thalamus.
We are all exposed to a flood of auditory, visual and other sensual information, from both internal and external sources. For most of us, experience has trained cerebral networks to selectively attenuate and interpret these signals in a way that society has agreed to call rational. But we still see and hear far more than we attenuate - we hear neighbors voices through the walls and though we might not know if they are fighting or playing a game, we might reach a conclusion based on previous experiences. We think we can at once see all of the words on a page, but we only attend to the word or phrase we are reading at a given moment. In our field of vision, only a very small conical area in front of our pupil is the product of immediate attention. The rest is a hybrid of vague, imprecise visual input and our recollection - or our confabulation - based on our experience.
There are numerous conditions that can contribute to fallacious interpretation of sensory data in an otherwise sound mind. In Chemistry of Conscious States, Dr. J. Allan Hobson recounts how a strange environment or fatigue can temporarily rend the fabric of reality in even the most sophisticated minds.
As a practical matter, the frequency and depth of these breaches of rational interpretation can be a guide for measuring the degree of a psychopathology. But in the social circumstances of the modern mental health care system, there is ample opportunity for clinical personnel to elicit reports of "hearing voices" from clients who might occasionally suffer illusions or confabulation as a result of fatigue, malnutrition, social disorientation or a common low-grade chronic infection such as gingivitis. As we have seen with "regression" hypnosis procedures that elicited implausible reports of satanic ritual abuse, past life experiences or alien abductions, a clinical analyst can sometimes get a patient to report what the analyst expects to discover.
Any decision about medication for symptoms of schizophrenia should include consideration not only of whether a person "hears voices" but of the frequency, circumstance and reaction to those voices.
poster:Mitchell
thread:83893
URL: http://www.dr-bob.org/babble/20011104/msgs/83988.html