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Interpretation of Schizophrenia

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A forgotten Copernicus

To understand Silvano Arieti's Interpretation of Schizophrenia we must first get straight the facts about psychiatry. Although this review is not the place to do it, those who are familiar with how some psychiatrists and neurologists dismiss bio-psychiatry know what I am talking about. Suffice it to say that there exists a whole journal, Ethical Human Psychology and Psychiatry that debunks biological psychiatry: a profession that has hoodwinked the whole society.

Those who give credibility to everything that, under the banner of science, the status quo sells us (e.g., biological psychiatry), will consider it foolish that I take seriously an author who published a work about schizophrenia in 1955. Long before Colin Ross published Schizophrenia in this century, Arieti had already advanced a trauma model that would later resonate in Ross' psychiatric work.

Virtually forgotten, Arieti's treatise is an authentic mine of theoretical and clinical information to understand psychosis. Most striking about the massive body of literature from Arieti's colleagues that pointed at the family as responsible for the schizophrenias in their patients is that the theory was never refuted. It was conveniently forgotten, swept under the rug of political correctness in the mental health professions. It is very common to read in the textbooks of contemporary psychiatry and psychology that the theory of the schizophrenogenic parents was discarded because it was erroneous with the most absolute absence of bibliographic references to support such claim. I cannot forget an article written in the present century in which an investigator complains that, despite an extensive search, he did not find any coherent and clear explanation of why the schizophrenogenic theory has been abandoned.

As always, everything has to do with the fact that to question the parental deities is terrifying for most people, especially for those who are forbidden from using their own emotions: academics, including the mental health professionals.

Arieti distinguishes between a "paleologic" form of thinking (what Julian Jaynes called "bicameral mind") and the thinking that comes from "Aristotelian logic" that rules Western man. Since the first edition of his book Arieti points out that the paleologic thinking, which modern man only experiences in dreams, was omnipresent in prehistoric cultures. In order to avoid a runaway anxiety that drives the victim into panic, the patient diagnosed as schizophrenic abandons the Aristotelian norms of intuitive logic and lapses into the sort of thinking of our most primitive ancestors.

Like John Modrow, Arieti acknowledges the value of the work of Harry Sullivan about the panic the child experiences as a result of an all-out emotional assault from both parents. The paleologic regression can be adapted years after the abuse occurred, even when the child has become economically independent (cf. Modrow's How to Become a Schizophrenic). The withdrawal from reality, or psychotic breakdown, is the last and most desperate attempt of the unconscious to maintain the ego in a state of internal cohesion. A dramatic regressive metamorphosis arises when, one after another, the defenses that the victim had been using do not work anymore. To a greater or lesser degree all human beings function with a dose of neurosis, but in the psychotic outbreak, when neurotic defenses collapse, the subject falls into even more archaic forms of defense: mechanisms which had been overcome millennia ago, a regression to what Jaynes calls the bicameral mind.

Arieti's book contains chapters about his clinical experiences with patients. In the case of two brothers, Arieti describes how one of them suffered a pre-psychotic panic as a result of the abuse at home and observes that, once in a florid state of psychosis, "The paleologician confuses the physical world with the psychological one. Instead of finding a physical explanation for an event, he looks for a personal motivation or an intention as the cause of an event." Just as the primitive man, in a definitive breakdown of the Aristotelian superstructure, for the disturbed individual the world turns itself animist; each external event having a profound meaning. There are no coincidences for those who inhabit the world of magical thinking. Both the primitive animist and the modern schizophrenic live in distinct dimensions compared to the rational man. The conceptualization of external happenings as impersonal physical forces requires a much more advanced level of cognition than seeing them as personal agents. Arieti wrote:

"If the Greeks are afflicted by epidemics, it is because Phoebus wants to punish Agamemnon. Paranoiacs and paranoids interpret almost everything as manifesting a psychological intention or meaning. In many cases practically everything that occurs is interpreted as willed by the persecutors of the patient."

Arieti also writes about the time before the Homo sapiens acquired the faculty to choose an action through what we call today free will, and he adds:

"Philogenetically, anticipation of the distant future appeared when early man no longer limited his activity to cannibalism and hunting, which were related to immediate present necessities, but became interested in hoarding and, later, in agriculture in order to provide for future needs."

The reference to cannibalism makes me think that, though unlike Jaynes Arieti maintained that schizophrenia is due to the parents' behavior, unlike Lloyd deMause Arieti did not conceive that such cannibal practices, like the ones described in the Preface, could have injured the inner self of the surviving children in prehistoric times. Nevertheless, Arieti disagrees with the theoretical psychiatrists who see no similarities between schizophrenic and non-schizophrenic. He believes that such points of view "are fundamentally wrong", and, speaking of non-Western cultures and even of the times of Cro-Magnon man, he writes:

"Often the culture itself imposes paleologic conceptions and habits on the individual, even though the individual is capable of high forms of thinking. The more abundant is the paleologic thinking in a culture, the more difficult it is for the culture to get rid of it."

Arieti also rises the question of why civilization originated only ten thousand years ago. Like Jaynes, he believes that the incredibly long gestation of civilization had to do with the persistence of paleologic thought, and he adds that presently the paleologic defense mechanisms underlie the human psyche and can return in extreme conditions.

Arieti elaborated his theory twenty years before Jaynes or deMause started to write their books, and he was within an inch of discovering what deMause would discover: precisely that schizophrenogenic forms of childrearing through the Bone Age and the Stone Age had impeded the psychic integration of our ancestors. Getting ahead in time to Ross, Arieti wrote: "A characteristic unique in the human race -- prolonged childhood with consequent extended dependency on adults -- is the basis of the psychodynamics of schizophrenia."

Arieti defines schizophrenia as an extremely regressive reaction before an equally extreme state of anxiety, a dynamic that originates in infancy and that accelerates in adolescence, or later, due to abuses at home. "In every case of schizophrenia studies serious family disturbances were found". He adds that to produce schizophrenia a drama is needed which is sufficiently injuring to the inner self; a drama that, if we ignore it, we become deaf "to a profound message that the patient may try to convey". And writing about one of his patients, and getting again ahead in time to Ross, he tells us that this patient "protected the images of his parents but at the expense of having an unbearable self-image".

Interpretation of Schizophrenia contains the keys to understanding issues that at first sight seem incomprehensible, and even bizarre, for those of us who live in the world of Aristotelian logic: the probable meaning of the symbols of the oneiric world in which the psychotic individual lives; his apparently incoherent salad of words, the linguistic whys of his inner logic and the many regressive stages of the disorder. In Arieti's treatise there is an enormous richness of ideas and theoretical schemas that I cannot summarize here, as well as clinical analyses of his patients, to understand the gradations of madness. Even though, as I said, in the middle 1970s his book won the National Book Award, in a more valiant world his work would have been influential.

But society freaked out before the findings of Arieti because, to understand psychoses, it would have been necessary to point the index finger at the parents. And as an Alice Miller reader would say, the most potent taboo of our species prevents us from knowing the truth about our childhoods.