Recovery From Schizophrenia: Psychiatry And Political Economy

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THE PERSON WITH SCHIZOPHRENIA IN WESTERN SOCIETY 193the same active ingredients that proved successful in reversing the institutionalsyndrome—normalizing the environment and engaging the patient in his or herown treatment—are also effective in relieving the effect of the existentialneurosis.ORIGINS OF ALIENATIONThe person with schizophrenia, it appears, is among the most alienated ofindustrial society, and it is in this condition that one may perceive the causes ofthe malignancy of the illness. Looking beyond this, the origins of the mentally illperson’s alienation are to be found in the political and economic structure ofsociety—in the division of labor and development of wage work. For it is theseaspects of production that have rendered the person with schizophrenia—with hisor her limited ability to withstand stress, limited productive capacity and limiteddrive—marginal to the industrial work force, marginal members of (whatanthropologist Jules Henry terms) “the driven society.” 137Caste systems do not perpetuate themselves. Continued enforcement ofdiscriminatory economic and physical sanctions is necessary to maintain theexistence of a pariah group. 138 Similar political and economic pressures arenecessary to restrict the interclass mobility of members of US ethnic minoritygroups. 139 The same is true of the low status of the mentally ill in the West. Thepostwar drive to influence public opinion and increase the community acceptanceof mental patients was equivalent to earnest attempts to adjust the status of a caste.The political motivation at that time, in some areas, was to bring the mentally illinto the work force, in other areas, to transfer the responsibility for their care fromthe state to the community. These efforts decreased as the political motivationreceded. The recent growth in strength and solidarity of advocacy groups for thementally ill, such as the National Alliance of the Mentally Ill, however, has led toa resurgence of interest in combating the stigma of schizophrenia (seeChapter 12). It takes a power differential to erect the barriers of stigma anddiscrimination and it takes the creation of a power bloc to knock them down.SUMMARY• A third of the people with schizophrenia in the US are living in boardinghomes or nursing homes, in hospital, on Skid Row or in jail or prison.• The stigma of mental illness in Western society continues to be great.• A combination of labeling theory and cognitive dissonance theory allows us toexplain how the stigma of mental illness can lead to poor outcome frompsychosis.• People with schizophrenia in Western society have restricted social networksand they and their families become relatively estranged from society.
194 THE POLITICAL ECONOMY OF SCHIZOPHRENIA• The social plight of the person with schizophrenia in the West is encompassedby the single concept of alienation, and has its roots in the division of labor andthe development of wage work.
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Recovery from SchizophreniaRecovery
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First edition published 1985by Rout
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ContentsAcknowledgments viIntroduct
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devotion to excellence in creating
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ixA NOTE ON THEORYThe materialist t
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Part IBackground
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WHAT IS SCHIZOPHRENIA? 3WHAT IS SCH
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WHAT IS SCHIZOPHRENIA? 5syphilis, n
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WHAT IS SCHIZOPHRENIA? 7Table 1.1-c
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WHAT IS SCHIZOPHRENIA? 9complete sy
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WHAT IS SCHIZOPHRENIA? 11patients w
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WHAT IS SCHIZOPHRENIA? 13publicatio
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WHAT IS SCHIZOPHRENIA? 15Figure 1.1
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WHAT IS SCHIZOPHRENIA? 17intrusiven
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WHAT IS SCHIZOPHRENIA? 19Figure 1.3
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WHAT IS SCHIZOPHRENIA? 21Brain stru
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WHAT IS SCHIZOPHRENIA? 23system. Th
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WHAT IS SCHIZOPHRENIA? 25One thing
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WHAT IS SCHIZOPHRENIA? 27of worth,
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Chapter 2Health, illness and the ec
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HEALTH, ILLNESS AND THE ECONOMY 31a
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HEALTH, ILLNESS AND THE ECONOMY 33i
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HEALTH, ILLNESS AND THE ECONOMY 35B
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HEALTH, ILLNESS AND THE ECONOMY 37s
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HEALTH, ILLNESS AND THE ECONOMY 39d
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HEALTH, ILLNESS AND THE ECONOMY 41F
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HEALTH, ILLNESS AND THE ECONOMY 43o
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HEALTH, ILLNESS AND THE ECONOMY 45T
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HEALTH, ILLNESS AND THE ECONOMY 47b
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HEALTH, ILLNESS AND THE ECONOMY 49F
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HEALTH, ILLNESS AND THE ECONOMY 51A
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Part IIThe political economy of sch
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RECOVERY FROM SCHIZOPHRENIA 55impro
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RECOVERY FROM SCHIZOPHRENIA 57categ
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RECOVERY FROM SCHIZOPHRENIA 59Table
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Table 3.1 -continuedRECOVERY FROM S
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RECOVERY FROM SCHIZOPHRENIA 73Figur
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Table 3.3 Recovery rates in the USA
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RECOVERY FROM SCHIZOPHRENIA 77the l
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THE POLITICAL ECONOMY OF SCHIZOPHRE
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MADNESS AND THE INDUSTRIAL REVOLUTI
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25 patients, and on the more distur
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Chapter 6Labor, poverty and schizop
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Page 154 and 155: THE POLITICAL ECONOMY OF SCHIZOPHRE
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ANTIPSYCHOTIC DRUGS: USE, ABUSE AND
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ANTIPSYCHOTIC DRUGS: USE, ABUSE AND
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TREATMENT 247indicated, unemploymen
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TREATMENT 249success, for the lodge
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TREATMENT 251vocational programming
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TREATMENT 253the job is permanent.
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TREATMENT 255Social enterprises in
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TREATMENT 257pharmacy technicians a
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TREATMENT 259The situation seems to
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TREATMENT 261Though these results a
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TREATMENT 263• raise the minimum
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TREATMENT 265• Social policy inno
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TREATMENT 267Table 12.1 Living situ
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TREATMENT 269A JAIL DIVERSION PROGR
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TREATMENT 271the office work and th
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TREATMENT 273One might imagine that
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TREATMENT 275studies may be the res
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TREATMENT 277established for some o
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TREATMENT 279Another residential pr
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TREATMENT 281interest loans and gra
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TREATMENT 283individual’s goals s
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TREATMENT 285Cognitive therapy, it
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TREATMENT 287Table 12.2 Facts about
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TREATMENT 289consumers and professi
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TREATMENT 291definitively not part
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FIGHTING STIGMAAlthough the mentall
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TREATMENT 295The National Alliance
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TREATMENT 297other medical disorder
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TREATMENT 299when a psychiatrist an
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NotesINTRODUCTION1 Harris, M., Cult
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NOTES 30333 Heston, L.L., “Psychi
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NOTES 30557 Sham, P.C., O’Callagh
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87 Dohrenwend, B. and Egri, G., “
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NOTES 30929 Srole, L., Langner, R.S
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NOTES 311unemployment cause the dea
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NOTES 313107 Warr, P., “Studies o
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138 Dear, M., Clark, G. and Clark,
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NOTES 3178 Epstein, L.J., Morgan, R
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NOTES 31943 Quirk, A. and Lelliott,
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NOTES 32349 Walton, “Pauper lunat
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105 Bockoven, J.S., Moral Treatment
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NOTES 32729 For positive evaluation
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66 Barker, D., “Moscow mayor has
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NOTES 33133 World Health Organizati
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NOTES 33380 Eliade, M., Shamanism:
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NOTES 335homelessness a mental heal
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NOTES 337Academic Press, 1978; Faul
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NOTES 339Washington, DC: House of R
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NOTES 34194 Read, J. and Baker, S.,
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132 Robinson, J.R and Shaver, P.R.,
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NOTES 345“Schizophrenia is not di
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NOTES 34748 Bagley, C., “The soci
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NOTES 34979 ni Nuallain, M., O’Ha
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NOTES 3514 Kapur, S. and Seeman, P.
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NOTES 35327 Pasamanick, B., Scarpet
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NOTES 355Archives of General Psychi
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NOTES 357“Prognostic factors in r
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NOTES 359Chandler, D., Meisel, J.,
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30, 1978; Moffit, R., “The econom
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NOTES 36312 Stein, L.I. and Test, M
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NOTES 36547 Personal communication,
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NOTES 367European Psychiatry, 15:26
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BibliographySTUDIES OF THE OUTCOME
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BIBLIOGRAPHY 371Horowitz, W.A. and
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BIBLIOGRAPHY 373Salokangas, R.K.R.,
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AUTHOR INDEX 375Dunham, Warren 31Du
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AUTHOR INDEX 377Urquhart, M.C. 129n
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SUBJECT INDEX 379atypical 20;compan
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SUBJECT INDEX 381CESP see Carer Edu
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SUBJECT INDEX 383disability pension
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SUBJECT INDEX 385diagnosis of 148;d
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SUBJECT INDEX 387Isle of Wight 33is
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SUBJECT INDEX 389Middlesex, Hanwell
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SUBJECT INDEX 391PACE see Personal
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SUBJECT INDEX 393economic condition
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SUBJECT INDEX 395self-employment 15
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SUBJECT INDEX 397symbolic thinking
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SUBJECT INDEX 399volition disturban
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Recovery From Schizophrenia: Psychiatry And Political Economy

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