There are two different, incomparable levels on which a review of Diagnosis: Schizophrenia, edited by Rachel Miller and Susan E. Mason, can be written: the professional one, analyzing the structure, the meaning and the function of this very important guide to schizophrenia, and what I would call the existential level, following the first-person experiences, the embodied first-person perspectives emerging from the rich narrative texture of a book that is a lot more than a guide. Firstly, however, it must be said that the high-quality of this book is primarily due exactly to the balance between these two levels: mental health science, clinical practice and social services are fruitfully equipped with different personal stories, evaluations, reflections. Third-person analysis and first-person experiences emerge from the book as the two inseparable pillars of the clinical work, as the international research on mental health, particularly the phenomenological one, is pointing out with renewed efforts in this years.
Diagnosis: Schizophrenia is the second edition of the book edited in 2002, one of the first to be thought properly for patients and their families, and probably the first at all born with them. The book, in fact, as Nina Schooler, Director of Research at Hillside Hospital, states in the Foreword, grew out of the patients’ desire: not only to share with others their experiences with the illness and how they’ve coped with problems, as she writes, but also to understand their stories as a whole. That’s why the editors have involved both the thirty-five Participant-Authors, taking part in a National Institute of Mental Health research project at Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, and a large number of different professionals, such as professors of psychiatry, rehabilitation counselors, social workers, but also a professional nurse and a PhD in literature and psychology, to answer with clear and correct information all the doubts and the questions patients can have. The second edition sees no changes to the stories of the thirty-five people who courageously shared their personal experiences, but expands numerous sections to provide recent scientific findings, updates of benefit information, additional material for coping with symptoms, issues of substance abuse treatment and information regarding childhood-onset schizophrenia. A lot of new resources and print materials available via the Internet are added and easily consultable. Almost every page of the book insists on schizophrenia as an illness that can be treated, whose symptoms are caused by chemical imbalance in the brain, even if the exact cause is not yet known. At the moment there is no cure, but there are medications and treatments that can limit the symptoms and help enjoying life again. A stark accent is put also on the fact that no one is responsible for causing it. In this sense, the guide is an excellent instrument of open struggle to the stigma related to the diagnosis “schizophrenia”; it had already some success with the first edition and deserves to go on with the second.
This is, however, more than a guide: this is a collection of stories more fascinating than any novel, not only why they come from real life, but especially why they show through their complexity and contradictions how it is always possible to survive to a desperation that may appear without any hope. It’s a book about an illness, but it is also a book about intelligent strategies to fight against it and the desperation it can cause, which are useful not only in front of every illness, but in front of every complex problem in life. The first and most important one is to trust in others who can help us and let us feel less alone while sharing similar experiences. The second one is to understand what we are experiencing. In this sense an absence in the book has to be remarked: a psychopathological analysis of the main symptoms of schizophrenia is essential to understand delusions, hallucinations and variations in feelings, movements and behavior. This could be a suggestion for the third edition of the book, because such an impulse to know better this peculiar illness so to understand more and more oneself through the experiences of the others and to keep hope staying alive has to be carried on and on through the years.
© 2011 Daria Dibitonto
Daria Dibitonto, Ph.D., Italy