by Andrew Roberts
Review by Lorna Lees on Aug 12th 2008
This short book is an explanation, by Andrew Roberts, of a treatment for schizophrenia that he has found successful. He is at pains to point out that it has only been tried once, on him, and may not work for anyone else. The treatment he mentions seems to have been a combination of medication and therapy: Abilify (aripiprazole) is the "wonder drug" Roberts took, and the therapy is a mechanism to "tame" the voices and force them into the realm of imagination.
The style of this book is a fascinating, but not always successful, marriage of technical terms and conversational language. Descriptions are basic -- "The way schizophrenia works is it is like your imagination gone a bit wrong (sic) and is working against you" (p.9). Typos abound, and the relaxed, simple tone of the book and its large, round, well-spaced font creates a strangely cosy, informal effect that might be comforting for someone in the throes of a similar experience. The fellow sufferer is however the main target audience of the book, so this familiarity is not inappropriate. It guides the reader through what s/he might expect to experience during a schizophrenic
This cosy, chatty atmosphere could be, however, unfamiliar and unwelcome territory for the professional. Likewise, for a healthcare professional, the extremely basic explanations of complex concepts and the dismissing of highly contentious issues with barely a mention could prove difficult to get past. "This is caused by stress, drugs and career pressure" (p.16) had this reviewer choking on her tea.
Likewise, there is a spiritual tone to the text that verges on evangelism. The anti-drugs message is laudable, and alleged links between schizophrenia and cannabis use are commonplace in the media. Making similar claims about chocolate and curry may be a step too far. There are other outlandish claims to be found: "cat's toxo[plasmosis] might explain why sometimes people jump into the lions enclosure at zoos" (p.22) is just one example.
This is not to say that the book is not valuable or to be taken seriously. It offers some good advice on coping with a diagnosis of schizophrenia, and to hear a fellow sufferer tell you not to lay blame anywhere and to concentrate on recovery must be more useful than hearing it from a doctor. Other suggestions are also helpful -- avoiding alcohol, seeking medical advice if symptoms of OCD or alcoholism develop, being aware of the potential for alienating family and friends, channeling one's imagination in productive ways are just a few of the suggestions made. Useful information for preventing the person with schizophrenia from losing friends or family is also offered. Small, thoughtful gifts or handmade cards are suggested as a means of showing the recipient that the giver is thinking of them and appreciates them. Communication, even on a basic, discuss-the-weather level, is offered as a suggestion to prevent the loss of friends, as is the maintenance of personal hygiene.
The means of self-treatment Roberts advocates is religiously oriented, although religion can be removed from the equation. Trust, Delight and Commit are the cornerstones of his approach, although none of them are explained or expanded. What is offered is a common-sense approach to making one's way out of schizophrenia: ignoring the voices is advised. From the perspective of the schizophrenic, this sounds like a tough position -- how can a person be expected to ignore what may be noisy, intrusive hallucinations? Roberts notes that it will be relatively easy at first, but will get more difficult as time goes on. The increased difficulty is a sign that the ignorer is being successful. He also notes that the aim of the voices is to cause actions, and that the required actions will become more extreme as the program of not listening to them goes on. He is acutely aware of the level to which the voices may go, and exhorts the reader not to listen to them, whatever they may say.
More concerning, however, is his suggestion that the voice-hearer not discuss the content of his hallucinations with mental health professionals. "If you tell people what they say then it can sometimes be used against you." (p.76). This might be true, at least from the perspective of the person with schizophrenia -- in cases where the voices are suggesting that harm be done to the hearer or to others -- an involuntary committal to protect the voice-hearer might be indicated, depending on the content of the voices -- but deliberately withholding information from the professionals trained to help is at best unwise and at worse highly dangerous. It is also at odds with the message of "seek help when things are bad" that is prevalent elsewhere in the book.
This is an interesting book with some extremely useful suggestions for the person with schizophrenia, but caution is advised in following all of Roberts' suggestions. Maintaining self-awareness and interpersonal relationships is vital in avoiding the drift-down effect associated with mental illness. Withholding information from one's psychiatrist is not a good idea, however, and the results for someone in the midst of an episode could be tragic. Having said that, Roberts discusses his own condition and journey with an unusual degree of insight, and his opinions and experience are an interesting addition to the literature on schizophrenia.
© 2008 Lorna Lees
Lorna Lees is a post-doctoral researcher at the Department of Psychosomatic Medicine of the Technische Universität, Munich. She is a fellow of the DISCOS project and is working on the theoretical and ethical integration of therapy from a philosophical perspective. Her research interests are the philosophy of psychiatry and psychology, particularly when oriented to the self. She is also fascinated by the phenomenon of auditory hallucinations. Email: L.Lees@lrz.tu-muenchen.de