Schizophrenia is one of the most serious mental illnesses, which, behind all the variety of manifestations, represents an increasing decrease in volition, which ultimately leads to permanent disability, and sometimes to incapacity. However, in half of the cases, schizophrenia can actually be cured, or at least not interfere with various creative and life successes. Many have been described various forms and types of schizophrenia, which are so different from each other that some say that schizophrenia is not one, but several different diseases.

MANIFESTATIONS OF THE DISEASE

Schizophrenia can begin in childhood and in old age, but more often it manifests itself in adolescence. The disease can occur acutely, suddenly, but the gradual development of the disease is more typical. Incomprehensible fatigue, weakness, feelings of internal tension appear, the boy or girl begins to have difficulty coping with usual responsibilities, becomes isolated, and withdraws into himself. Behavior, social connections and professional skills begin to slowly deteriorate, and after a while others notice that the person has changed. The disease progresses very differently, but all forms are based on the gradual (sometimes over decades) formation of personal and, above all, emotional-volitional decline. The ability to voluntarily perform any actions and the possibility of purposeful behavior decreases. A person can drop out of university while in his last year of study, without apparent reason leave Good work, which I once sought so much, not to come to register my own marriage with my beloved person, etc.

As the disease develops, its symptoms become more complex, becoming more and more unusual, unlike the manifestations of other, familiar diseases. The patient's behavior becomes strange, his statements become absurd and incomprehensible; The patient's perception of the world around him changes. As a rule, psychiatrists diagnose schizophrenia when the patient is already in a fairly serious condition, during the development of psychosis (psychotic state), but unjustified early extensive diagnosis of schizophrenia is no better. The condition of patients with schizophrenia worsens and improves cyclically. These periods are called relapses and remissions. In remission, people with schizophrenia appear relatively normal. However, during the acute or psychotic phase of the disease, they lose the ability to reason logically and do not understand where and when events occur and who is involved in them. Psychiatrists call this a violation of self-identity.

The symptoms often observed in schizophrenia: delusions, hallucinations, disordered thinking and confused speech are the so-called productive symptoms, which usually occur quite clearly, and relatives, and often the patient himself, understand that they cannot do without the help of a psychiatrist. We would only like to remind you that consultation with a psychiatrist in such cases is needed immediately, since it is necessary to determine the likelihood of destructive actions, most often for oneself (the patient’s degree of danger). Thus, hallucinations, which are most often represented by “voices” sounding in the patient’s head or somewhere outside, which comment on a person’s behavior, insult or give commands, can force the patient to perform unusual, inappropriate, and sometimes dangerous actions. The “voice” can order you to jump from a balcony, sell an apartment, kill a child, etc. In such cases, a person does not understand what is happening, cannot resist the order and is not responsible for his actions. It is best to place him in a hospital, where intensive pharmacotherapy will relieve the acute condition and protect him from dangerous actions and will allow the person to subsequently return to his former life.

We often use the word “nonsense” in everyday life, meaning some absurd statements that do not correspond to reality. In psychiatry, this term is used in other cases. Main feature delusion is not that it does not correspond to reality (for example, delusions of jealousy can grow on the completely objective basis of frequent infidelity of a spouse), but that it is an extremely stable system of perception and assessment of the environment, appearing as the certainty of reality itself. Such a system cannot be corrected and determines inappropriate human behavior. Patients feel that someone is watching them, planning to harm them, or can read their thoughts, cause certain sensations, control their feelings and actions, contact them directly from the TV screen, turn them into “zombies” and they feel like “zombies.” ", that is, complete puppets of hostile forces, or, conversely, that they themselves have unusual properties or abilities, transform into real or fairy-tale characters, and influence the fate of the world and the Universe. Such experiences significantly affect the patient’s life and behavior.

Patients often experience unusual bodily sensations, burning, vague, shimmering throughout the body, or more specific, but migrating, or indestructibly persistent in one place. Visual hallucinations are rare, much more often with schizophrenia there are influxes of dreams, dream images, a kind of internal cinema. Then the patients freeze for a long time as if spellbound, poorly discerning or disconnected from real reality, giving the impression of absent-minded eccentrics. The depth and intensity of these manifestations can reach complete hardening and be accompanied by motor disturbances, when a person remains tirelessly in any most uncomfortable position given to him.

Patients also have impaired thinking. In their statements, they can move from one topic to another - completely unrelated to the previous one, without noticing the lack of logical and even semantic connection. Sometimes they replace words with sounds or rhymes and come up with their own own words, which are completely incomprehensible to others. Their verbose, complicated or bizarre reasoning turns out to be completely meaningless, or their speech is limited to short, meaningful remarks that are not related to the situation. Sometimes they become silent for a long time. However, there are forms of schizophrenia that occur without any productive symptoms, and they are the most difficult for relatives and loved ones to understand. It seems like nothing happened, but the person stopped going to work, doesn’t want to do anything around the house, is not interested in anything, cannot read, etc. Close people often perceive this as laziness, promiscuity and try to influence their relative. Meanwhile, behind such behavior there is often a decrease in volition caused by illness.

One should not think that people with schizophrenia have completely lost touch with reality. They know that people eat three times a day, sleep at night, drive cars on the streets, etc., and much of the time their behavior may seem quite normal. However, schizophrenia greatly affects the ability to correctly assess the situation and understand its real essence. A person suffering from schizophrenia and experiencing auditory hallucinations, does not know how to react when, in the company of other people, he hears a voice telling him: “You smell bad.” Is it the voice of the person standing next to him, or does this voice sound only in his head? Is this reality or a hallucination?

Misunderstanding of the situation contributes to the emergence of fear and further changes the patient’s behavior. Psychotic symptoms of schizophrenia (delusions, hallucinations, thinking disorders) may disappear, and doctors call this period of illness remission. At the same time, negative symptoms of the disease (withdrawal, inadequate or dulled emotions, apathy, etc.) can be observed both during remission and during periods of exacerbation, when psychotic symptoms reappear. This course of the disease may continue for years and not be obvious to other people. People around them often perceive patients with schizophrenia as some kind of eccentrics who have strange speech and lead a life that is different from the generally accepted one.

There are many different types of schizophrenia. A person who is convinced that he is being persecuted, that they want to deal with him, and hears the voices of non-existent enemies, suffers." paranoid schizophrenia". Ridiculous behavior, pretentious habits and statements without delusional and hallucinatory, but with persistent loss of ability to work, occurs in a simple form of schizophrenia. Quite often, schizophrenia occurs in the form of clearly defined attacks - psychoses, with delusional ideas and hallucinations. However, as the disease develops a person becomes more and more withdrawn into himself, not only loses touch with others, society, but also loses the most important feelings: compassion, mercy, love. Since the disease can vary in intensity, degree, and frequency of exacerbations and remissions, many scientists use the word “schizophrenia " to describe a whole spectrum of illnesses that can range from relatively mild to very severe. Others believe that schizophrenia is a group of related diseases, much in the same way that the word "depression" refers to many different but related variants.

THEORIES OF SCHIZOPHRENIA

Most scientists believe that people inherit a predisposition to this disease. Important factors factors contributing to the onset of the disease are environment: viral infection, intoxication, head injury, severe stress, especially in childhood, etc. A child whose one parent has schizophrenia has a 5 to 25% chance of developing the disease, even if he was later adopted by normal parents. If both parents have schizophrenia, the risk increases to 15-50%. At the same time, children of biologically healthy parents adopted by people with schizophrenia had a one percent chance of getting sick, that is, the same as all other people. If one twin has schizophrenia, there is a 50 to 60% chance that the other twin also has schizophrenia. However, people do not inherit schizophrenia directly, in much the same way that they inherit eye or hair color. It is usually said that schizophrenia is inherited by the move of the chess knight: it is detected along the lateral line.

According to modern concepts, schizophrenia is caused by a combination of genetic, autoimmune and viral disease mechanisms. Genes determine how the body reacts to viral infection. Instead of saying "stop" when the infection is stopped, the genes instruct the immune system to continue attacking some part of its own body. In much the same way, theories about the origin of arthritis suggest that the immune system acts on the joints. The successful use of psychotropic drugs that affect the brain's production of dopamine indicates that the brain of a person with schizophrenia is either very sensitive to this substance or produces too much of it. This theory is supported by observations of the treatment of patients suffering from Parkinson's disease, which is caused by a lack of dopamine: treating such patients with drugs that increase the amount of dopamine in the blood can lead to the appearance of psychotic symptoms.

Researchers have found drugs that significantly reduce delusions and hallucinations and help the patient think coherently. However, these so-called antipsychotic drugs should only be taken under the supervision of a psychiatrist. Long-term use of maintenance doses of medications can significantly reduce or even eliminate the likelihood of relapse of the disease. One study found that 60-80% of patients who did not take medications after leaving the hospital had a relapse within the first year, while those who continued taking medications at home relapsed in 20-50% of cases, and taking the drugs even after the first year reduced the number of relapses by up to 10%. Like all drugs, antipsychotic medications can have side effects.

While the body gets used to the drugs during the first week of use, the patient may experience dry mouth, blurred vision, constipation and drowsiness. When standing up abruptly, he may experience dizziness due to decreased blood pressure. These side effects usually go away on their own within a few weeks. Other side effects include restlessness, stiffness, trembling, movement disorders. Patients may experience spasms in the muscles of the face, eyes, neck, and slowness and stiffness in the muscles of the entire body. Although this causes inconvenience, it does not have serious consequences, is completely reversible and can be removed or significantly mitigated by taking correctors (cyclodol). Persistent side effects (although rare) necessitate regular monitoring by a psychiatrist. They are especially common in older people. In such cases, you should immediately consult a doctor, increasing the dose of the corrector or even removing the drug.

There are now new generations of antipsychotics that have less side effects, and it is hoped that with their help, patients with schizophrenia will better cope with the disease. Examples of such drugs are clozapine and rispolept. By significantly alleviating painful symptoms, medications open up the opportunity to use various forms of rehabilitation assistance and help the patient continue to function in society. Social skills training, which can be provided in groups, within the family, or individually, aims to restore the patient's social connections and independent living skills. Research shows this training gives patients the tools to cope with stressors and reduces the likelihood of relapse by half.

Psychiatrists understand that the family is playing important role During the course of the disease and during treatment, they try to maintain contact with relatives. Informing the family, including the patient himself, about the modern understanding of schizophrenia and methods of its treatment, while simultaneously training communication skills and behavior in problem situations, has become a successful practice in many psychiatric clinics and centers. Such training significantly reduces the number of relapses. With the help of family and mental health practitioners working together, patients can learn to control their symptoms, understand signs of a possible worsening of the condition, develop a relapse prevention plan, and succeed in social and vocational rehabilitation programs. For the majority of people with schizophrenia, the future should look optimistic - new more important ones are already visible on the horizon. effective drugs, scientists are learning more about brain function and the causes of schizophrenia, and psychosocial rehabilitation programs are helping to keep patients in society longer and restore their quality of life.

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The double bind is a concept that plays a key role in the theory of schizophrenia developed by Bateson and his collaborators during the Palo Alto Project.

The double connective is based on a paradoxical prescription similar to the Epimenides paradox, that is, based on the contradiction of classification and metaclassification. An example of such an order: “I order you not to follow my orders.”

Epimenides' paradox, also known as the "liar's paradox"

If we assume that Epimenides told the truth, then it turns out that he, like all Cretans, is a liar. Which means he lied. If he lied, then it turns out that he, like all Cretans, is not a liar. Which means he told the truth.

Modern options boil down to the following contradiction. If I'm lying, then when I say it, I'm not lying. So, when I say this, I am telling the truth. If I am telling the truth, then the statement “I am lying” is true. And that means I’m still lying. No matter how you answer the question, a contradiction will arise.

Someone says: “I’m lying now. Did I lie in the previous sentence? Or simply: “I’m lying.” There are also options: “I always lie”, “Am I lying when I lie?”

It is worth distinguishing between a double link and a simply mechanical combination of two at the same time impossible demands, for example: “Stay there - come here.” An example of a double connective would be a situation when a person, saying “Yes, I agree!”, demonstrates complete disagreement with his whole appearance, or vice versa. Another example is phrases like “Yes, but...” or “I agree, however...”. In general, any ambivalent (dual) behavior or judgment demonstrates a double bind. Both “yes” and “no” at the same time...

Another example of a pathological double ligament:

A woman offers her husband two ties at once - blue and red. Such a proposal in itself is already strange. “It’s no accident,” the husband thinks, “she’s up to something.” When a man puts on, for example, a blue tie, his wife says to him: “So you don’t like the red tie?” This is a pathological double ligament. The person no longer knows what to do. He is confused, blocked. And in the end he will decide to wear both ties together. And after 6 months he will end up in a psychiatric hospital.

I will quote from A.I. Fet “Double bind. Gregory Bateson's theory of schizophrenia:

“A mother who does not love her child, but is forced to imitate an absent feeling, is a much more common phenomenon than is commonly thought. She cannot bear to be close to the child, but tries to maintain with him the connection required by decency.

A child in need of maternal love instinctively reaches out to his mother, encouraged by her verbal appeal. But with physical closeness, such a mother begins to operate a mechanism of repulsion, which cannot manifest itself in a direct and unambiguous form and is masked in some indirect way: the mother finds fault with the child for any random reason and pushes him away, expressing this on a more abstract level than the primary one. level of “motherly love”.

The child has some kind of shortcoming, he always turns out to be guilty of something; for example, his love for his mother is declared insincere because he did not do this or that.

Thus, the child perceives opposing messages expressing attraction and repulsion, and usually at different logical levels: attraction is expressed in a simpler and more direct form, and repulsion is expressed in a more complex, disguised form, through non-verbal communication or reasoning that questions it. love for mother.

The stereotype of connection between mother and child that develops in this way continues when the child goes to school. The mother’s suggestions in such cases also have a double character: lowest level his mother inspires him that he should not fight with Petya, Vasya, etc., but on a higher, more abstract level - that he should “defend his dignity,” “not allow himself to be offended,” etc.

Of course, in all cases the child turns out to be guilty, since he does not fulfill either the first, direct suggestion, or the second, indirect one. This conflict between two levels of communication, in which the child is “always at fault,” is called the double bind. The double bind mechanism is not at all limited to the relationship between mother and child, but represents a very common pathology of human communication.

Such a conflict does not always lead to catastrophic consequences. A child’s healthy reaction to the mother’s unconscious hypocrisy is resistance: sensing contradictions between the mother’s demands, the child begins to “comment on” them, proving the mother’s injustice and that she is right.

But if the mother reacts with a sharp ban on commenting on her behavior (for example, threatening to leave the child, go crazy or die, etc.) and thereby does not allow him to resist, then the child’s ability to distinguish signals indicating the nature of communication is suppressed, which constitutes the beginning of schizophrenia. Sometimes the intervention of the father can help, but in “schizogenic” families the father is weak and helpless.

If a child has the opportunity to resist the contradictory demands of the mother, this, of course, disturbs the peace of the family, but such a child has a chance to grow up healthy: he will learn to recognize the signals that determine the logical levels of messages. In a more abstract demand, he recognizes the negation of a more concrete one, is indignant and does not always obey, but does not at all confuse the two sides of the “bundle”.

Things will turn out differently if the child cannot resist. The child learns not to distinguish between logical types of messages, thereby taking the first step towards schizophrenia. He now responds to his mother’s claims with sincere misunderstanding, so that he is considered “abnormal.” And then the same pattern of relationships is transferred to other people...

This does not mean at all that such a child will certainly become mentally ill. He goes to school, spends time outside the family and can gradually learn to distinguish between messages of different logical types if his relationship with the “schizogenic” mother was not too intense. Maybe he won't do it as well as others; He probably won't develop much of a sense of humor and won't laugh as contagiously as his friends.

And now about heredity and gender stereotypes...

One can understand how this whole sequence of events is related to heredity. First of all, a person brought up in a “double bind” himself subconsciously gets used to this system of relationships and applies it to his children.

It is the mother who is inclined to pass on the skills of double ligaments to her children, because the father does not have instinctive love for his children, and culturally conditioned feelings, no less genuine and strong, are not subject to the distortion associated with instinct.

If conditions do not allow children to resist this upbringing, then a “schizophrenic family” arises. If allowed, then such a “tradition” is not formed, and in the next generation this mechanism may disappear. Such “heredity” does not depend on genes, but on upbringing - it is cultural heredity.

“A schizophrenic family” influences exclusively the formation of a person’s “internal duality,” and “escaping reality” in the version of “rose-colored glasses” is already a consequence of the discomfort that a person experiences from his duality... a specific method of “psychological defense.”

As for “not giving a fuck,” in its extreme form it can manifest itself in the form of autism, in this context - the tendency of individuals not to have contact with others in accordance with generally accepted principles and norms.

By the way, “duality”, “raggedness, spasmodic thinking” and “autism” are the three main diagnostic

Any disease takes a person by surprise and everyone needs the help of loved ones. It is much more difficult to overcome an illness alone, especially if it is a mental pathology. Therefore, an important aspect in treatment is consultation with relatives of patients with schizophrenia, in which clear recommendations for correct behavior are given.

It is impossible to recover from schizophrenia without the help and support of relatives

For many centuries, healers have tried to figure out the nature of mental disorders belonging to one group - schizophrenia. It was possible to determine the classification, forms and course of the disease at the beginning of the twentieth century. Thanks to the painstaking work of English and German specialists, it became possible to identify, based on behavior, manner of communication and other signs, how complex the form of the disease is inherent in to this person. With the development of technology and the pharmaceutical industry, drugs were created, surgical methods and physical procedures that cause complete cure or stable remission. But no matter how far science has advanced, there are moral nuances that include the question of how to behave with a patient with schizophrenia. For this purpose, a consultation has been created for relatives of a patient with schizophrenia, during which they can receive valuable and vital answers to pressing questions. For those who still doubt whether mental pathology is really present, they should study what kind of disease it is, where it comes from, what signs indicate the disease and how to communicate with a patient with schizophrenia.

What is schizophrenia

According to the translation, the term is divided into two components - “schizo” - mind, “phren” - splitting. But it would be a mistake to assume that everyone who suffers from mental disorders is truly a splitting personality. There are many forms and trends, and each one contains certain pathologies associated with character, life history, heredity, lifestyle, etc.

There are several forms:

• Catatonic— human motor functions are impaired. Excessive activity or a state of stupor occurs, freezing in an unnatural position, monotonous repetitions of the same movement, words, etc.
• Paranoid— the patient suffers from delusions and hallucinations. Voices and visions can command, entertain, criticize, appear in the form of knocking, crying, laughter, etc.
• Hebephrenic- arises from a young age, develops gradually, causing a disruption in speech, isolation in one’s own world. Over time, patients develop more serious symptoms:
  • untidiness;
  • grimacing;
  • loss of emotions;
  • development of hallucinations, delusions.
  • Simple - loss of ability to work, loss of emotionality, and impaired thinking develop gradually. This form is the rarest in the history of observations. The person becomes apathetic and withdraws into himself.
  • Residual - a consequence of the acute form mental illness. After exposure medicines or other methods, the patient retains a residual process - apathy, inactivity, feeble-mindedness, poor speech, loss of interest.

In addition to the listed forms, there are types, courses of various classifications, signs of schizophrenia, which only a specialist can know what to do with.

Important: you should not miss the initial stages of the disease in order to stop the process of irreversible and severe symptoms in time.

Untidyness may be one of the signs of schizophrenia

What to do if a person has schizophrenia

It should be clearly understood that a once completely healthy and sane person has now changed. In his mind the world is perceived differently. But you should not assume at the first sign that he is developing schizophrenia. Even an experienced specialist requires at least two months of constant observation of the patient to distinguish mental disorders from neuroses, stress, and depression. Also, a big mistake is the opinion that a person suffering from mental disorders does not need care; schizophrenia, without supervision or outside control, can take on very complex and dangerous contours.

Important: regular monitoring and help are necessary for a person who has lost “himself”, because the condition can be the cause of aggression and dangerous actions not only towards himself, but also towards others.

Schizophrenia: what to do

First of all, the patient’s loved ones are lost and frightened due to ignorance of the rules of behavior. Yes, with schizopathic disorders, oddities are indeed observed, patients behave impartially, repulsively, refuse to maintain contacts, refuse communication, etc. It is difficult to imagine what will come into the head of someone suffering from mental illness in the next minute. But they are not at all to blame for this. They are the same as everyone else around them, but the behavior of a patient with schizophrenia changes due to disturbances caused by various factors. Basically, patients understand their situation very well and are happy to get rid of problems associated with their personality forever.

Most often, it is the wrong approach to such persons that causes dangerous consequences, in which a person commits suicide, becomes a criminal, rapist, maniac, etc.

A modern and adequate approach to treatment involves not only the responsible work of a specialist, but also the patient’s relatives. This includes consultation of relatives on all issues of patients with schizophrenia.

Help for patients with schizophrenia: brief instructions

Correct behavior around a schizophrenic can prevent a complete loss of control, since any wrong word, deed, even look can provoke unexpected actions. To correct behavior, it is enough to pay attention to the following points and methods of dealing with them at home.

How do people with schizophrenia behave?

The early stage of the disease may be hidden behind mild oddities that are familiar to most people. Refusal to communicate, slight aggression, outbursts of anger or complete withdrawal into oneself are typical during troubles at work, in the family, or in relationships with friends. But schizopathic disorders tend to increase. The patient is more alienated, does not want to communicate with anyone, lives in his own world. Delirium arises; the person suffering from the disease hears them only in his head; he sees visions that force him to perform certain actions. You cannot be offended or angry with a person, because this is not a manifestation of him own character, but a consequence of the disease.

Aggression may be one of the manifestations of schizophrenia

Personality changes

During the acute phases, the disease manifests itself with a number of symptoms, observing which one can understand the person’s condition. The way a person with schizophrenia behaves can determine how serious their condition is.

1. Suffering mental pathologies begins to listen to something, look around, conduct a conversation with a non-existent person, a creature.
2. When talking, the logic of thought and consistency are lost, and delusional ideas are observed.
3. Strange ritual habits arise: a person can wipe his feet for a long time before entering a room, wipe one plate for hours, etc.
4. Sexual disorders. With their cheeky, disinhibited actions, they often shock others.
5. Aggression, rude, harsh statements addressed to someone - common symptom mental illness. If these signs appear for no reason or acute form and often, see a doctor immediately.
6. When monitoring, it is necessary to ensure that sharp, cutting objects, ropes, ropes, wires are hidden from the patient’s eyes.

Help for children with schizophrenia

According to statistics from psychiatrists, schizopathic disorders mainly affect people aged 15 to 35 years. But often the disease, unfortunately, can manifest itself in early childhood and be congenital. There are several hypotheses about the occurrence of the disease, which include:

• heredity;
• stress;
• head injury;
• hormonal imbalances;
• alcoholism, drug addiction, etc.

Genetic predisposition. The disease is inherited in 25% if one of the parents is sick, and in 65% if both are sick. Experienced stress, social disadvantage - living in a poor family, in a poor neighborhood, communication with people of low social sufficiency can provoke thinking disorders. Alcoholism of parents, drug addiction, a poorly tolerated pregnancy, trauma during childbirth, trauma in emergency situations, and domestic violence can also become provocateurs of mental disorders.

In this case, important point is the participation of adults, parents to the child. Adequate therapy and advisory supervision are required for delusional disorder so that the child’s condition does not worsen and he is able to adapt to the surrounding society. What points should you pay special attention to:

• the child often withdraws into himself;
• the teenager often talks about suicide;
• unreasonable aggression, outbursts of anger and irritability appear;
• he repeats long time monotonously the same movements;
• communicates with non-existent beings, personalities;
• complains of voices in the head, sounds, knocking;
• expresses emotions inadequately: when he needs to cry, he laughs; in cheerful moments, he cries and gets irritated;
• food falls out of the mouth, cannot quickly chew a small piece.

Important: the child’s psyche is very vulnerable. If a child already has disabilities, it is absolutely forbidden to swear, make trouble, or scream in front of him. Also, you should not have parties where you drink alcohol or gather noisy groups.

Treatment of childhood schizophrenia should be treated with special responsibility

The personality characteristics of patients with schizophrenia during the acute phase manifest themselves in different ways. Hallucinations and sounds in the head can cause delusions - delusions of grandeur, a feeling of superpower, invention.

Important: the patient often leaves home, forgets his address, and wanders. Relatives need to put a note in his pockets with his details and exact address.

How to convince a patient with schizophrenia to get treatment

Most often, with schizopathic disorders, patients do not recognize their illness. On the contrary, due to mental disorders, they are sure that a fortune is being imposed on them, that they are trying to limit their freedom, and that their interests are being infringed upon. The reason for refusing treatment can be either a lack of understanding of one’s own situation or a disastrous experience in psychiatry. When diagnosing schizophrenia, a stigma is placed on the person. They treat him with caution, try to avoid him, and often laugh at him. Therefore, many do not know how to force a patient to be treated. But if the life of a loved one is precious, it is necessary to persuade him to undergo a course of treatment or force him to hospitalization with the help of a psychiatric team.

In specialized institutions, even if the patient does not want to be treated, there are many opportunities in which the condition will be relieved. Applicable drug therapy- taking antipsychotics, nootropics, sedatives and sedatives, as well as innovative methods based on stem cells, insulin coma, surgery, psychotherapy.

Schizophrenia in late life

Senile dementia - dementia, unfortunately, often occurs in older people. There are many factors for the development of pathology. This includes death of brain cells, poor blood circulation, chronic diseases, oxygen starvation etc. It is important to understand that old age awaits each of us, and we too may find ourselves in the place of the patient. The main component of care is attention and care, as well as compliance with the recommendations of doctors in treating a sick person. In cases acute disorders, treatment is required in a specialized institution under the supervision of experienced specialists and medical staff who know the specifics of working with a patient with schizophrenia.

Considering the fact that the mental illness of a loved one becomes a burden for his relatives, you need to remember the basic truths, which will make it easier to endure and cure the pathology. Thus, relatives concentrate their attention precisely on eliminating the disease, and not on its manifestation.

What to do if the patient’s relatives have schizophrenia

1. Refuse self-medication and seek qualified medical help.
2. Control yourself, control pain, anger, resentment, irritability.
3. Accept the fact of the disease.
4. Don't look for reasons and culprits.
5. Continue to love and take care of your sick relative.
6. Continue to live the same life, do not lose your sense of humor.
7. Appreciate the efforts of a relative suffering from an illness.
8. Do not allow illness to strain family relationships.
9. Take care of your own safety. If the situation forces you to place the patient in a clinic, come to terms with it.

Schizophrenics especially need support from relatives

The mental illness of a loved one should not become an obstacle to the quality of life of his relatives. Schizopathic disorders are a fait accompli that must be accepted. Yes, you will have to reconsider your previous way of life and plans. The main thing is not to give up, find time for yourself and don’t forget that there is a person next to you who needs your participation.

There are two theories about the family as a cause: one of them considers how main factor deviations in role relationships, the other - disturbances in communication in the family (see: Liem 1980). The special role of the family in terms of its influence on the course of schizophrenia will be discussed further (see p. 228).

Deviations in role relationships

The concept of "schizophrenic mother" was proposed in 1948 by analyst Fromm-Reichmann. When comparing mothers of schizophrenics, mothers of neurotic subjects, and mothers healthy people(control group) Alanen (1958, 1970) found that mothers of schizophrenics had significantly more psychological problems. He suggested that these anomalies could be important reason development of schizophrenia in a child.

Lidz and his colleagues (Lidz and Lidz 1949; Lidz et al. 1965), using intensive psychoanalytic methods, studied the families of seventeen patients with schizophrenia, of whom fourteen belonged to social classes I or P. There was no control group. Two types of pathological family patterns have been reported: (i) “distorted marital relationships,” in which one parent gives in to the eccentricities of the other (usually the mother), who dominates the family; (II) “family schism (splitting),” in which parents hold opposing views, so that the child finds himself in a situation of divided loyalties. It has been suggested that such abnormalities are a cause rather than a result of schizophrenia. Studies conducted by other clinicians have not confirmed these findings (see: Sharan 1965; Ferreira, Winter 1965). But even if they were confirmed, we should not forget that deviations in parents may reflect genetic causes or be secondary to the patient’s disorder. These and some other hypotheses regarding the causal role of family relationships had the negative consequence of stimulating unjustified feelings of guilt in parents.

Disturbed communication in the family

The study of impaired intrafamily communication arose from the idea Dual obligations(double bind) (Bateson et al. 1956). Dual obligations are said to arise when an instruction given openly is contradicted by another, more hidden one. For example, a mother openly tells her child to come to her, while at the same time expressing her rejection of him through her behavior and tone. The next element, according to this theory, is the inability for the child to avoid a situation in which he receives conflicting instructions. According to Bateson, dual obligations leave the child no choice but to respond in an ambiguous and meaningless manner. And if this process continues further, then, as Bateson believes, it may develop. This theory is ingenious, but it is not supported by the facts (for a more detailed description, see Leff 1978).

Wynne and his colleagues suggested that patterns of impaired communication among parents of schizophrenics may vary (Wynne et al. 1958). These researchers first gave these parents projective tests and identified “amorphous connections” (“vague, uncertain, and weakened”) and “fragmented connections” (“easily interrupted, poorly integrated, and incomplete”). In further studies using a blind method of interpreting these tests, more such disrupted connections were found in parents of schizophrenics than in parents of persons suffering from neurosis (Singer and Wynne 1965). In an independent, similar study, Hirsch and Leff (1975) found a similar but less pronounced difference between parents of schizophrenic patients and parents of control subjects. These scientists believed that this difference could simply be explained by the tendency of parents of people with schizophrenia to give more detailed answers during projective testing. However, even after Singer and Wynne's (1965) data were reanalyzed using the number of utterances, some significant differences remained between the parents of schizophrenics and control subjects.

Subsequent attempts to test Wynne's hypothesis used more elaborate methods, such as observing family interactions during a task (see Liem 1980; Wynne 1981). For now, this hypothesis should be treated as unproven. Even if Wynne's findings are confirmed, it remains possible that the corresponding abnormalities are most likely not the cause of the development of schizophrenia in one of the family members, but represent a reaction to his illness. Neither Wynne's theory nor any other theory of impaired communication can convincingly explain why it is extremely rare for more than one child in a family to develop schizophrenia.