Schizophrenia and the mind

Schizophrenia affects about one out of two hundred people.  It’s a serious mental disorder that typically involves distortions in perception, especially vivid auditory hallucinations, and bizarre and usually paranoid delusion.  Imagine trying to carry on a conversation with while at the same time you’re surrounded by four other people, talking loudly to you, often about thoughts you might have considered to be private.  That’s an exercise support groups often use to suggest to family what it’s like to be a schizophrenic.

The best-known portrayal of a schizophrenic is probably the movie `A Beautiful Mind’.  Russell Crowe plays John Nash, a mathematician who won a Nobel Prize in Economics.  In the movie, Nash’s hallucinations are portrayed as both auditory, visual and tactile.  But that’s really not at all common, and wasn’t truly the case with Nash.  Like most schizophrenics, his hallucinations were purely auditory.

There is some debate whether schizophrenia is just a label for a bundle of commonly co-occurring symptoms, or a single underlying disease.  There are no laboratory tests for schizophrenia.  However, it is frequently associated with excess dopamine — a neuro-transmitter in the brain.  On the basis of this, there are some pretty good medications.

John Nash in real life, and in the movie, preferred not to take medication.  That’s very common.  There are side-effects, and the schizophrenic also often sees the medications as part of a conspiracy.

Schizophrenia is interesting to philosophers for several reasons.  Schizophrenics often think the thoughts they’re directly aware of in their own minds belong to someone else.  Sometimes they just mean that the thoughts come from the outside — perhaps in radio transmission through their fillings, or some other bizarre way — and they can’t control them.  But sometimes they insist that the thoughts actually and literally belong to someone else.

That challenges a very fundamental view in the philosophy of mind, that when you are aware of a thought, you know it’s your own; it makes no sense to be introspectively aware of the thoughts of another.

Schizophrenics also challenge a picture of thoughts that many philosophers find attractive.   Many philosophers feel thoughts are beliefs gained through perception, desires, and thought-processes.  In this view, to attribute thoughts to a person presupposes a certain modicum of rationality.  The thoughts you pick up from perception should be related to what you perceive in some rational ways.  Schizophrenics seem to challenge that picture.

Schizophrenia also poses ethical problems that have to do with this irrationality.  For example: we think it’s OK, in the case of children, or old folks with dementia, to violate their autonomy — the right to make their own decisions — in various ways, including forced medication.  The schizophrenic may be motivated by extremely bizarre beliefs.  But, given those beliefs, their reluctance to take medication, or leave the house, may make perfect sense, and indeed be articulately defended.  Is forced medication a violation of autonomy, or something required to give them meaningful autonomy and a hope for a normal life?

 We’ll talk with John Campbell from the philosophy department at Berkeley, who has thought and written deeply about schizophrenia.