Are They All Axe Murderers?

In the classic horror movie “Psycho” Norman Bates, a mild-mannered young man, has been obsessed with and emotionally tied to his tyrannical, morbidly possessive mother. When she dies, her loss is apparently so intolerable that Norman’s mind “splits” and incorporates her persona alongside his own. The “mother” talks to Norman through hallucinations and, enacting an overheated version of the Oedipal complex, “she” becomes fiendishly jealous of Norman’s interest in other people, especially young woman.That jealousy apparently evokes in both Norman and his “mother” the threat of separation that can only be prevented by murdering those tempting young women. At the end of the film Norman is left psychotically overtaken by this “mother” who presumably now will “have” him forever. With the enormous popularity of this film Norman Bates became the archetypical killer/schizophrenic.And that is how I first learned about schizophrenia: from movies.Madness and murder, especially fiendish and anonymous murder, plays well in movies. And that informs the popular concept of schizophrenia, typically misrepresented as a mental split. a Jekyll and Hyde division of the mind..

"Those that do kill tend to do so in reaction to intimate, misperceived threats by those closest to them..."

.Schizophrenia is a disorder of brain structure and function that typically begins to manifest in late adolescence. Usually it presents with gross delusions and hallucinations, which can seem real and believable to the person affected. Anti-psychotic medications—the drugs that ushered in the age of modern "evidence-based" psychiatry—can reduce and even eliminate these terrible symptoms. But a less obvious aspect of schizophrenia often remains. These are the deficit symptoms: apathy, absent, blunted or incongruous emotional responses reduced speech production; decreased interests; diminished motivation; and social withdrawal. These symptoms vary so much that the diagnosis is divided into two forms: deficit and non-deficit schizophrenia.Violence and murder are rare among people with schizophrenia. Those that do kill tend to do so in reaction to intimate, misperceived threats by those closest to them: a parent, a sibling, or a partner. Offers of consolation or comfort to a person mentally locked in paranoid, terrifying delusions and hallucinations may appear as an intent to harm them. The caring individual may be perceived as demon-possessed or malignantly transformed or disarmingly substituted. Deluded and terrified the schizophrenic attacks in self-defense.A man in his early twenties, already suffering delusional and hallucinatory episodes, had begun using marijuana in an effort to calm himself only to became increasingly more psychotic. His symptoms worsened. Finally, one evening when he was high and experiencing intense and horrific symptoms, he felt a cold wind signaling the approach of the devil.His mother then entered his room, reaching toward him to comfort and calm him, but she seemed to have been invaded by the devil. Her approach appeared to be the devil's effort to entrap and harm him. He struggled to wrest the devil from his mother, wrestled her to the ground, stumped on her chest, and caused her to asphyxiate. In a crazed effort to undo her death, he pranced wildly around her body and then fled the house. He soon ended in a psychiatric hospital and was kept there for decades. Medication caused his symptoms to vanish. But the horror and guilt of his actions came fully into his consciousness and remained there.The great tragedy of schizophrenia is two-fold: its frequency (1.1% of the world's population—32 million Americans!) coupled with its enduring statistical stability; and the loss of social and personal function, the apparent destruction of the personality that had once seemed normal and promising.The public response to mental illness began in the early nineteenth century as an enactment of the ideals of the new nation: that all people are created equal with equal endowments and equal potential. Mental illness and criminality were regarded as socially-caused deviations due to poverty, crowding, and pollution—fallout from rapid population growth and the new industrialization.Asylums were carefully planned models of a healthy refuge, relief from worries about housing and food and with access to solitude and fresh air. Penitentiaries were created on the same principle to promote remorse and self-restored propriety. These institutions so astounded Europeans that they were studied and emulated.By the end of the nineteenth century, asylums and penitentiaries had degenerated and acquired their enduring horrific meanings. The great experiment had failed to anticipate the power of social (racial, ethnic, economic) pressures as well as indissoluble genetic variation. By this time schizophrenia was identified as a mental disease and its victims shunned and medically tormented and locked away.Schizophrenia is an innocently acquired condition. It needs sustenance, tolerance and decent, responsible care.Is this not an equal right that every American deserves?