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Over-investment in medical models of schizophrenia


Does the treatment of schizophrenics alter onset of schizophrenia?
Oliver Sacks Scientist
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I have wondered whether, if Michael had been differently treated, things would have been very different. This thought has been very much on my mind since I have been visiting various communities where schizophrenic people are supported and richly integrated. One of these, which is of great antiquity, is the little town of Geel in Belgium. In the 13th century a woman was raised to sainthood, there’s a whole story here, and became the saint of the insane, and around 1280, people started to come to Geel hoping to be cured by the saint. Well, whether or not they were cured, they were taken into the homes of people in Geel, and Geel, for more than 700 years, has become a special communal home for the mad. At the end of the Second World War there were 15,000 inhabitants of Geel, and 5000 people with mania, schizophrenia, or whatever, all of whom had a family life, all of whom worked in the fields. You saw in the streets of Geel, deeply regressed or manneristic schizophrenic people, whom one felt should be in a back ward, and yet they... they were playing chess in the cafés or chatting in the streets, or working... one of them had opened a bi... a shop for bicycle repairs, and one saw what a full life a deeply schizophrenic person could have.

I have also seen some of the power of communal support. I visited a... a Gould Farm up in Massachusetts, which originally started as one of these quasi religious sort of moral regeneration places, it’s now become much more secular, but when you... when you go to Gould Farm, and it’s a real working farm which is almost self-sufficient, I think, economically, sometimes it’s hard to distinguish staff from patients. [Erving]Goffman wrote famously about asylums and the, you know, the infinite gulf between staff and inmates. It’s not there in a place like Gould Farm, moreover, there are friendships there, and there is work for everyone to do. The cows have to be milked, you can't say, 'I’m sorry, I’m regressed, Christ told me not to milk the cows’. The others will... will say, 'Go fucking milk the cows'. And the... the work and the friendship and the community hold people together wonderfully, and prepare them for the real world, so-called. So, a place like Gould Farm comes between acute hospitalisation and the real world. And you need also a place like Gould Farm to teach you how to cook, and how to work the washing machine or whatever, how to look at a map. It’s not just the hallucinations and... and delusions, it’s the lack of social skills, of worldly knowledge, which can be so destructive to people with schizophrenia.

Oliver Sacks (1933-2015) was born in England. Having obtained his medical degree at Oxford University, he moved to the USA. There he worked as a consultant neurologist at Beth Abraham Hospital where in 1966, he encountered a group of survivors of the global sleepy sickness of 1916-1927. Sacks treated these patients with the then-experimental drug L-Dopa producing astounding results which he described in his book Awakenings. Further cases of neurological disorders were described by Sacks with exceptional sympathy in another major book entitled The Man Who Mistook His Wife For A Hat which became an instant best seller on its publication in 1985. His other books drew on his rich experiences as a neurologist gleaned over almost five decades of professional practice. Sacks's work was recognized by prestigious institutions which awarded him numerous honours and prizes. These included the Lewis Thomas Prize given by Rockefeller University, which recognizes the scientist as poet. He was an honorary fellow of both the American Academy of Arts and Letters and the American Academy of Arts and Sciences, and held honorary degrees from many universities, including Oxford, the Karolinska Institute, Georgetown, Bard, Gallaudet, Tufts, and the Catholic University of Peru.

Listeners: Kate Edgar

Kate Edgar, previously Managing Editor at the Summit Books division of Simon and Schuster, began working with Oliver Sacks in 1983. She has served as editor and researcher on all of his books, and has been closely involved with various films and adaptations based on his work. As friend, assistant, and collaborator, she has accompanied Dr Sacks on many adventures around the world, clinical and otherwise.

Tags: Geel, Belgium, Gould Farm, Erving Goffman, Michael Sacks

Duration: 3 minutes, 49 seconds

Date story recorded: September 2011

Date story went live: 02 October 2012