Violent, harsh, threatening for US patients; benign, playful for patients in India.
By Sujeet Rajan
WASHINGTON, DC: Last month, CNN anchor Anderson Cooper tried a ‘schizophrenic simulator’ and walked around the streets of Manhattan: a device with earphones continuously emitted hallucinatory conversations, fragmented sentences, meaningless words, shrill noise into his ears.
The viewers could also hear faintly what Cooper could hear much more explicitly and loudly – much like what a patient suffering from the ailment undergoes. At the end of the hours-long exercise, a disoriented Cooper tried to do some simple tasks, including basic memory tests: he failed miserably.
While that experiment by Cooper projected the deep suffering, confusion a patient of schizophrenia goes through, sometimes life-long, a new study by Stanford anthropologist Tanya Luhrmann, who is the first author of an article in the British Journal of Psychiatry, brings out something interesting, and important in healing the disease: the voices that schizophrenic patients hear in the US is violent, harsh and threatening compared to the benign, playful voices similar patients in India and Ghana hear.
For the research, Luhrmann and her colleagues interviewed 60 adults diagnosed with schizophrenia – 20 each in San Mateo, California; Accra, Ghana; and Chennai, India, said a news report by Stanford University. There were 31 women and 29 men with an average age of 34. They were asked how many voices they heard, how often, what they thought caused the auditory hallucinations, and what their voices were like.
“We then asked the participants whether they knew who was speaking, whether they had conversations with the voices, and what the voices said. We asked people what they found most distressing about the voices, whether they had any positive experiences of voices and whether the voice spoke about sex or God,” Luhrmann said in an interview.
The findings revealed that hearing voices was broadly similar across all three cultures, said Luhrmann. Many of those interviewed reported both good and bad voices, and conversations with those voices, as well as whispering and hissing that they could not quite place physically. Some spoke of hearing from God while others said they felt like their voices were an “assault” upon them.
The striking difference was that while many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful – and evidence of a sick condition.
The Americans experienced voices as bombardment and as symptoms of a brain disease caused by genes or trauma, said the Stanford release.
One participant described the voices as “like torturing people, to take their eye out with a fork, or cut someone’s head and drink their blood, really nasty stuff.” Other Americans (five of them) even spoke of their voices as a call to battle or war – “‘the warfare of everyone just yelling.'”
Moreover, the Americans mostly did not report that they knew who spoke to them and they seemed to have less personal relationships with their voices, according to Luhrmann.
Among the Indians in Chennai, more than half (11) heard voices of kin or family members commanding them to do tasks.
“They talk as if elder people advising younger people,” one subject said.
That contrasts to the Americans, only two of whom heard family members. Also, the Indians heard fewer threatening voices than the Americans – several heard the voices as playful, as manifesting spirits or magic, and even as entertaining. Finally, not as many of them described the voices in terms of a medical or psychiatric problem, as all of the Americans did.
In Accra, Ghana, where the culture accepts that disembodied spirits can talk, few subjects described voices in brain disease terms. When people talked about their voices, 10 of them called the experience predominantly positive; 16 of them reported hearing God audibly. “‘Mostly, the voices are good,'” one participant remarked.
Luhrmann explains that Americans tend to see themselves as individuals motivated by a sense of self identity, whereas outside the West, people imagine the mind and self interwoven with others and defined through relationships.
“The difference seems to be that the Chennai and Accra participants were more comfortable interpreting their voices as relationships and not as the sign of a violated mind,” the researchers wrote.
The findings may be clinically significant, according to the researchers. Prior research showed that specific therapies may alter what patients hear their voices say. One new approach claims it is possible to improve individuals’ relationships with their voices by teaching them to name their voices and to build relationships with them, and that doing so diminishes their caustic qualities. “More benign voices may contribute to more benign course and outcome,” they wrote.
The co-authors for the article included R. Padmavati and Hema Tharoor from the Schizophrenia Research Foundation in Chennai, and Akwasi Osei from the Accra General Psychiatric Hospital in Accra.
Another recent study on schizophrenia, published in Nature, compared the DNA of around 150,000 individuals spanning clinics all over the world, reported the Springfield News-Sun.
In that report in Nature, a consortium of hundreds of researchers has released what’s been dubbed the largest study ever into the genetic causes of mental illness. They found 108 places on the genome that tend to be different in people with the disease than in people without.
Of those 108, 83 are totally new findings, meaning the possibilities for research into the genetic causes of and treatments for the disease have now more than tripled.
Schizophrenia affects around one per cent of the population, according to the National Institute of Mental Health (NIMH), who estimate that the US will spend more than $230 million on schizophrenia research this year.
Some of the common symptoms are hallucinations involving any of the five senses, delusions, particularly feelings of persecution, depression-like symptoms like apathy and lack of pleasure, and what the NIMH calls “disorganized thinking.”
The study by Luhrmann and her co-researchers may be key in murder cases like the ongoing Michael Petrie trial in Ohio. Petrie killed his mother and lived with her corpse for six months at the house they were staying in Barberton.
His defense team says he had paranoid schizophrenia, delusional beliefs that his 67-year-old mother had an ‘inner control’ over him and he could only escape by killing her, according to The Plain Dealer.
The police found Maureen Petrie’s body on April 3, 2013, lying in the exact spot they believe her son killed her, with a martial-arts sai and a kitchen knife beside her. A jury is deliberating this week if Petrie calculated the killing of his mother or if his diagnosed paranoid schizophrenia caused him to be unable to determine the wrongfulness of his actions.