The madness of living in fear

Dr Peter Chadwick is a psychology lecturer and a schizophrenic. What he says about the illness is challenging in its wisdom and hope. By Glenda Cooper

"The colours of my life were changing from pale blue and grey to lilac pink and purple. The temperature was rising; wine replaced beer; satin sheeted beds replaced sleeping bags...I was besotted by beauty and glamour."

Thus Peter Chadwick describes the beginning of his mental confusion, which marked the beginning of his descent into schizophrenia and a terrible catalogue of mental anguish and attempted suicide.

Now, 22 years on, and long established as a psychology lecturer at the Open University and Birkbeck College London, he tells of his ordeal in a new book, which argues not only against the taboos and fears that still surround schizophrenia but also explains how those who suffer from the illness may have something to offer society that others cannot.

Madness is still one of society's biggest taboos, with schizophrenics receiving overwhelmingly negative press coverage fuelling widespread fear. Earlier this year a survey by Mind, the mental health charity, found that people with a mental illness are less likely to have a job than if they are blind, deaf, have breathing difficulties or a learning disability. This month, a survey of more than 1,000 articles carried out by the Health Education Authority in association with Mind found that almost half press coverage is about crime, harm to others and self-harm.

The reality is that very few people with mental health problems commit acts of violence - and if they do they are far more likely to commit suicide than turn the knife on other people.

In his book Dr Chadwick gives a graphic account of his own illness: the gradual feeling of getting more out of kilter over the years; experimenting with transvestism and adopting different personae such as that of a black man, a woman and an androgyne. His growing paranoia; how he overheard conversations he took to be about him, and ultimately the delusion that he was possessed by Satan.

"The end of these delusions was that I threw myself under the wheels of a double-decker bus on New King's Rd in Fulham, to thrust Satan out of my mind by literally trying to have my brain crushed under the wheels," he says.

Arriving at Charing Cross Hospital he told hospital staff "I sincerely believe that there is an organisation of people out to discredit and humiliate me and to induce me to kill myself. I know that this sounds like the content of a paranoid schizophrenic delusion but nevertheless I believe it to be true."

Certain a shadowy group he imagined "The Organisation" was controlling the staff at the hospital, he made several suicide attempts and was tortured by rappings which he thought were sending messages to him, until (he thinks) by a change of medication the delusions disappeared.

He is still on medication today, but he has not suffered a further episode since 1979 when he attempted to throw himself under the bus. "There is such pessimism about the outcome in schizophrenia but really the outcome in half to two-thirds of cases shows that there is no reason because you have been diagnosed schizophrenic that you are never going to get back into work," he says.

Dr Chadwick feels that such despondency has not been helped by recent focus of much research into schizophrenic conditions - "To borrow a phrase of Keats's the slow progression in this field has been characterised by `alternate uproar and sad peace' " - and calls for a new look at whether schizophrenia endows its sufferers with valuable qualities that we should be nurturing.

"Current research is excessively blinkered in its focus on deficit and disorder," he added. "One can be too portentous about schizophrenic illness. It is true that this group of conditions can kill people - but of course so do mountains kill climbers.

"However if, as a climber [you were] forever thinking of this fact `This peak has claimed three lives this year' or `There's been a death on this mountain every year for the last four years', [your] capacities and confidence are greatly undermined. Forever harping on disasters, dangers, deficits and dysfunctions does not encourage the strength needed to overcome the problems that present themselves."

Indeed he feels that research proves that those suffering from schizophrenic disorders can bring special talents to certain jobs - in particular those which involve creativity, social sensitivity and empathy.

"This is difficult for the public to accept I think," he says. "People can show negative or positive symptoms [of schizophrenia]. The people who tend to be withdrawn tend to be the more serious cases. But those with positive symptoms can be more creative and have more imaginative delusions."

The fine line between madness and genius is an old tale. Thinkers such as James Joyce, Ruskin and Wittgenstein have been accused of possessing a schizophrenia-prone disposition and indeed Joyce's daughter Lucia suffered from the illness although creativity in schizophrenics is still hotly debated. A 1993 study by Felix Post over a 10-year period looking at 300 biographies concluded that "many highly creative men, more so writers and artists than scientists, were highly disturbed". A study in 1993 found participants who were schizotypal [a disorder thought to be linked to schizophrenia] obtained higher scores in figural fluency and figural originality scales on creative thinking tests than the controls did.

"Sufferers of delusion do seem to be preoccupied at least at the time of illness with issues of meaning and purpose," says Dr Chadwick. "And it may be that psychosis can in a sense enhance a person's apprehension of their wider context and of their place in the cosmic scheme of things... As I found myself, psychosis - particularly in the early euphoric phase - can at least be the beginning of spiritual enlightenment. It may open doors to such experiences that the person can make productive use of later when they are well.

"Empathy is the ability to put oneself in another person's shoes," he added. "People with schizophrenic tendencies are more empathetic, particularly those in a paranoid state. This is something which would be useful in things such as acting or writing. If you write you have to imagine the world through their characters, to be able to create such characters. Empathy is also very important in things like teaching or therapy."

Social sensitivity is the third area in which paranoid patients can excel. "An experiment by La Russo in 1970 gave paranoid patients and normal controls the following task," says Dr Chadwick. "People were filmed receiving electrical shocks or faking and from their faces they had to decide whether they had received electric shocks or were faking. In discriminating between the fake and the real the paranoid sufferers were better at distinguishing which was which. It means that paranoid people might be better than normal people at telling when people are lying.

"In the last instance it lies within the individual. The search - even battle - for dignity is in actuality one to be fought by every individual schizotypal, paranoid or schizophrenic person. The real evidence and the answer in all truth is within.

"I want to give people confidence," he adds. "I don't want schizophrenic people to feel all they can do is stay out of hospital, but to take advantage of the capacities they may have, I want the idea of victim consciousness to get out of here because schizophrenic tendencies are not necessarily all negative."

He realises, however, that the solutions to our treatment of those with such disorders is still a long way off and requires all different people working together for it to work: "To beat it [schizophrenic illness] requires a war of attrition, not a magic bullet solution," he says. "This involves professionals, sufferers and community personnel being prepared to negotiate and empathise rather than clash and blame".

`Schizophrenia: The Positive Perspective - In search of dignity for schizophrenic people' is published tomorrow, price pounds 15.99.