Schizophrenia is a Chronic Terror Syndrome, Not Genetic: Dr Bertram Karon’s Acceptance Speech for Empathic Therapist Award

psychotherapy-schizophrenia

By Bertram P Karon PhD

[Note from Dr Craig: Dr Bertram Karon influenced me in my development as a psychologist healer more than any other faculty member during my graduate studies at Michigan State University. Our friendship has deepened and grown since a tragic automobile accident which resulted in a serious spinal injury. My great master teacher has courageously faced enormous losses and faced the reality of what he needed to do to regain and maintain as much physical functioning as possible. His beloved wife Mary, who died last year, helped him in remarkable ways to persevere.  If you read this award acceptance speech, you will come to understand the human mind in a way that may be life changing. If you are interested in spending twenty minutes of your time, you may watch Dr Karon deliver this acceptance speech on video. The video has an introduction from Dr Peter Breggin, who has been a pioneer in challenging the destructive influence of biological psychiatry and the pharmaceutical industry].

The first 300 pages of my book, Psychotherapy of Schizophrenia: The Treatment of Choice, describes what we know about schizophrenia and how best to treat its symptoms. The last hundred pages describes a controlled random assignment blind evaluation study comparing 70 sessions of psychoanalytic therapy with medication. The finding was that the optimal treatment was psychotherapy without using medication, if the patient, the therapist, and the setting permit. Next best was psychotherapy with initial medication that was withdrawn as rapidly as the patients could tolerate. Psychotherapy plus medication was better than medication alone, but not as good as withdrawing the medication.

Schizophrenia is a chronic terror syndrome. All of the symptoms of schizophrenia are either manifestations of the terror or defenses against it. Chronic terror blanches out most other emotions, which led Eugen Bleuler to the erroneous conclusion that schizophrenics have no affect.  Many patients are helped by being told in the first or second session that you will not let anyone kill them.

Schizophrenia is not genetic, 85% of patients do not have a first-order relative who has the diagnosis.  Schizophrenia is not primarily a physiological disorder, the disordered physiology is the result of the chronic terror. The physiological changes are the same that everyone experiences when we are terrified. Of course there are also physiological changes which are the effect, usually destructive, of the psychiatric medications.

It is now known that schizophrenics typically have suffered multiple traumas, as well as lesser bad experiences.  Most of the traumatic experiences do not get in to the hospital record, but if you listen to the patients you will eventually learn about them. I have never treated a schizophrenic patient whose life as experienced by the patient would not have driven me, or anyone I could conceive of, crazy. People do not get sick because life has been good to them.

Long-term follow-up studies now show that 30% of schizophrenics will get better in the long run, within 25 years, with no treatment, but continued medication will prevent that 30% from ever having a full recovery. Of course, meaningful psychotherapy, and there are a number of ways to do meaningful psychotherapy, not just the way I work, produces much better results. Most patients get better, at least 80%, but it often takes a lot of work.

In 2008 I published a case study in the online journal, Pragmatic Case Studies in Psychotherapy, which is available without charge, of a man diagnosed as a hopeless schizophrenic by all the psychiatrists who medicated him. They insisted that ECT was his only hope, although it probably wouldn’t help him. His wife had the courage to say no, get him out of the hospital, and bring into my office. He was continuously hallucinating, not eating, and not sleeping. After taking him off all medications, and providing psychoanalytic therapy, the patient improved to the point of being able to work at an intellectually demanding job within six months. He continued in therapy to achieve his own life goals of being a first-rate college professor, a first-rate creative intellectual, a first-rate husband, and a first-rate father. I published the case to correct the myth that such patients are untreatable and never get better.

Hallucinations are basically waking dreams, and can be readily understood with Freud’s theory of dreams, with minor alterations. There are no universal symbols but there are frequently used symbols. Schizophrenic hallucinations may occur in any sensory modality, but auditory hallucinations are most frequent because schizophrenia is an interpersonal disorder, and speech is a communication between people. As with dreams, if the patient associates to the hallucination, the two of you will eventually figure out what the hallucination is about. Patients don’t like being told they hallucinate, but they readily discuss voices and other experiences.

Delusions are distorted beliefs. All of us have a more or less organized understanding of ourselves and of our world. You don’t believe that I’m psychotic, and I don’t believe that you are psychotic, because we have the same general understandings, and if we disagree we can explain the basis for our disagreement. If you think the world is flat, you are normal if the year is 1400, you are at least suspect in 2011. The belief is the same; all that has changed is what other people believe. Schizophrenics have had strange experiences. Their symptoms are strange experiences. Their real lives include strange experiences. They do the best they can to understand themselves and their world. They are as realistic as their anxieties permit.

A non-humiliating non-threatening therapist who encourages them to describe their understandings in as much detail as possible will help them discover the meaning of their delusions. Patients do not like the word delusions, but they will abandon them when they discover inconsistencies and better understandings with the help of their therapist, without ever using the word delusion.

Delusions have four major bases. The most common is transference to the world at large of experiences and feelings from earlier in their life, often in symbolic form.

The second is defenses against pseudo-homosexual anxiety, that is, the fear that something means that they are homosexual, even though that is rarely its true meaning. Freud has talked about this. The patient feels withdrawn from human contacts and has a wish to be close to others. In growing up we felt comfortable with peers of the same sex before we became comfortable with the opposite sex, so when we feel withdrawn from everybody, we have an urge to be close to someone of the same sex. The patient wrongly concludes this is a homosexual urge, setting off the delusional defenses. They need to be told that everybody needs friends of both sexes, and this is not a homosexual urge.

The third basis is that some families teach strange meanings of concepts or strange concepts. The patient believes everyone thinks this way, and only in therapy do they usually learn that that is not true.

The fourth basis is the need to have an organized view of oneself and one’s world, as previously described. The brighter patients are apt to have a better organized view and therefore to get diagnosed as paranoid or paranoid schizophrenic.

When you treat any seriously disturbed patient, you will feel scared, because they are scared. You will be confused, because they are confused. In addition they do not trust you enough to tell you even what they do understand. You may also feel angry, depressed, ashamed, or any other bad feeling the patient has.

But if you can tolerate being confused, and if you can tolerate bad feelings, the patients will learn that they can tolerate being confused, and they can tolerate bad feelings.

And if you continue long enough, things will make sense and you will be helpful. The patients will not be turned off because you do not understand everything, but they will be impressed if you understand anything and are helpful with anything, because most of the mental health professionals they have seen have not been helpful.

With every new seriously disturbed patient, I have felt “Who am I to treat this person? I don’t know enough. I have hangups. The patient needs someone who knows more than me. The patient needs someone with no hangups.” But no one knows enough, and there are no therapists without hangups. But if we can tolerate these feelings, and do our best, patients almost always get better. They don’t need perfect therapists, they just need decent human beings, and it is my pleasure to be talking to a group of you.

Mary

My wife Mary died in February. She made possible everything good I have ever done, and she did a great deal more that I could not do.   It is an extraordinary honor to be recognized by people whom you value and respect. Of all the professional groups with which we were involved, this is the one that she most valued and respected. She did not like professionals who were more interested in impressing their colleagues, or helping themselves professionally or financially than in providing real help to people who need it. All of you are here because you believe in and are furthering treatments that actually help people. She was proud of all of you. So am I.

Thank you for this extraordinary honor,

Bert Karon

Bertram P. Karon, PhD

 

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11 Comments to “Schizophrenia is a Chronic Terror Syndrome, Not Genetic: Dr Bertram Karon’s Acceptance Speech for Empathic Therapist Award”

  1. Fiachra says:

    That’s what it is – a fear based disorder. Once I learnt how to deal with my underlying anxiety there was no more ‘schizophrenia’. Dealing with my anxiety involved standing off the feelings (not preoccupying) – and looking at the focus once my feelings died down – to validate my distortion.
    When I’m calm, my ‘head’ works okay and I can gauge risk.
    When I came off Fluphenazine decoanate depot injections I had to meet all the demons – they had been doing ‘push ups’, while I was away. Its the ‘treatment’ that locks young people into a life of illness not the original problem – because with help ‘schizophrenia’ can be overcome. Its no big deal.

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  4. I just watched Daniel Mackler’s film ‘Take these broken wings’ and the part where Dr Karon says that he would have got crazy if he had lived through the same experiences as a ‘schizophrenic’ made me cry. This is what helps people heal from ‘schizophrenia’ – understanding. Not judging. And yes, the terror thing is spot on – I was literally petrified when I was psychotic. I am well now, and don’t take medication – all I could wish for now is the label to be removed.

    • Dr. Craig says:

      Thanks for writing. I have passed on your message to Dr Karon and I am certain that he will be touched. I wish you the very best in your life journey! Craig

  5. Caroline says:

    Reading this has given me hope.
    My son is 25 years old and we live in the U.K. He has been diagnosed with paranoid schizophrenia for over 4 years. He was living without meds for the last
    8 months but was becoming more and more unwell culminating in him being instructed to carry out dangerous acts by his ‘voices’.
    He is now back on meds.
    I would like a more holistic approach. Can you recommend any one in the U.K. who may be able to help me ?

  6. croft says:

    dear Bert Karon ,

    or a healer ,healer
    I am writing to you`re organisation as i have a colleague who is seeing things ,
    It began after a bereavement and being upset ,
    She is seing things but not all the time ,

    it is more of a social seeing things than anything and ony happens around people .

    I am writing to ask ,if the psychotherapy and healers would beable to help ease, or cure the symptoms of my colleague ,

    She has suffered for a while ,

    Thank you, for reading this letter and I hope to hear from you`re good advice and diagnosis ,

    • Grace says:

      Hi there- absolutely love this piece and Bert’s work. Big big fan and I wish this approach was more easily adopted/accessible. Would you possibly have any information on therapists who take this approach that are located in Australia? Melbourne (city) or Victoria (state) if possible!

      Many thanks!
      Grace

    • Susan McIntyre says:

      Hello,

      This common but overlooked airborne pathogen is known to cause and gave me wild mood swings, delusions, and hallucinations. Some online documents state this cancer-causing, mental illness-inducing airborne pathogen that can cause so many idiopathic diseases/conditions/symptoms is not zoonotic. That’s wrong! It’s carried by bats and shed in their feces. The bats even evolved to deal with the photophobia and tinnitus the pathogen causes by hunting at night by echolocation.

      My coworkers and I, all immunocompetent, got Disseminated Histoplasmosis from roosting bats, that shed the fungus in their feces. The doctors said we couldn’t possibly have it, since we all had intact immune systems. The doctors were wrong.

      This underdiagnosed airborne infectious disease mimics the flu and can cause hematological malignancies, precancerous conditions, rheumatological diseases, connective tissue diseases, heart disease, autoimmune symptoms, inflammation, adrenal insufficiency, seizures, migraines, hydrocephalus, hallucinations, etc., etc. etc. and is often undiagnosed/misdiagnosed in immunocompetent people.

      More than 100 outbreaks have occurred in the U.S. since 1938, and those are just the ones that were figured out, since people go to different doctors. One outbreak was over 100,000 victims in Indianapolis. 80-90+% of people in some areas have been infected, and it can lay dormant for up to 40 years in the lungs and/or adrenals.

      It’s known to cause hematological malignancies, and some doctors claim their leukemia patients go into remission when given antifungal. My friend in another state who died from lupus lived across the street from a bat colony. An acquaintance with alopecia universalis and whose mother had degenerative brain disorder has bat houses on their property.

      Researchers claim the subacute type is more common than believed and that many children in California have the subacute form. It’s known to at least “mimic” autoimmune diseases and cancer and known to give false-positives in PET scans. But no one diagnosed with an autoimmune disease or cancer is screened for it. In fact, at least one NIH paper states explicitly that all patients diagnosed with sarcoidosis be tested for it, but most, if not all, are not. Other doctors are claiming sarcoidosis IS disseminated histoplasmosis.

      What if this infection, that made us so ill, isn’t rare in immunocompetent people? What if just the diagnosis is rare, since most doctors ignore it?

      Older documents state people who spend a lot of time in a building with roosting bats and in caves are known to get Disseminated Histoplasmosis, but the info appears to have been lost, for the most part. And now bat conservationists encourage people to leave bats in buildings/homes. What a terrible mistake they’ve made.

      This pathogen parasitizes the reticuloendothelial system/invades macrophages, can infect and affect the lymphatic system and all tissues/organs, causes inflammation, granulomas, and idiopathic (unknown cause) diseases and conditions, including hematological malignancies, autoimmune symptoms, myelitis, myositis, vasculitis, panniculitis, dysplasia, hyperplasia, etc. It causes hypervascularization, calcifications, sclerosis, fibrosis, necrosis, eosinophilia, leukopenia, anemia, neutrophilia, pancytopenia, thrombocytopenia, hypoglycemia, cysts, abscesses, polyps, stenosis, perforations, GI problems, hepatitis, focal neurologic deficits, etc.

      Many diseases it might cause are comorbid with other diseases it might cause, for example depression/anxiety/MS linked to Crohn’s. (It’s known to “mimic” inflammatory bowel disease.)

      The fungus is an Oxygenale and therefore consumes collagen. It’s known to cause connective tissue diseases (Myxomatous degeneration?), rheumatological conditions, seizures, and mental illness. Fungal hyphae carry an electrical charge and align under a current. It causes RNA/DNA damage. It’s known to cause delusions, wild mood swings (pseudobulbar affect?), and hallucinations. It’s most potent in female lactating bats, because the fungus likes sugar (lactose) and nitrogen (amino acids, protein, neurotransmitters?), releasing lactase and proteinases to obtain them. What about female lactating humans…postpartum psychosis (and don’t some of these poor women also have trouble swallowing)? The bats give birth late spring/summer, and I noticed suicide rates spike in late spring/early summer. It’s known to cause retinal detachment, and retinal detachments are known to peak around June-July/in hot weather. A map of mental distress and some diseases appear to almost perfectly overlay a map of Histoplasmosis. Cancer is known to occur more often near rivers than in mountains or deserts, just like this infection. Johns Hopkins linked autism to an immune response in the womb. Alzheimer’s was linked to hypoglycemia, which can be caused by chronic CNS histoplasmosis.

      The bats eat moths, which are attracted to blue and white city lights that simulate the moon the moths use to navigate, so diseases in cities would be expected to increase. Bats feed up to 500 feet in the air and six miles away in any direction from their roost, but not when it’s raining or when the temperature is less than approximately 56° F. The fungus can grow in bird feces, but birds don’t carry it because their body temperature is too high, killing the fungus.

      I believe the “side effects” of Haldol (leukopenia and MS symptoms) might not always be side effects but just more symptoms of Disseminated Histoplasmosis, since it causes leukopenia and MS symptoms. What about the unknown reason why beta receptor blockers cause tardive dyskinesia? The tinnitus, photophobia, psychosis “caused” by Cipro? Hypersexuality and leukemia “caused” by Abilify? Humira linked to lymphoma, leukemia and melanoma in children? Disseminated Histoplasmosis is known to cause enteropathy, so could some people thought to have nonsteroidal anti-inflammatory drug enteropathy have it and taking NSAIDs for the pain/inflammation it causes, and the NSAIDs aren’t the actual culprit?

      From my experience, I learned that NO doctor, at least in DFW, will suspect subacute and/or progressive disseminated histoplasmosis in immunocompetent people. Some doctors, at least the ones I went to, will actually REFUSE to test for it, even when told someone and their coworkers have all the symptoms and spend a lot of time in a building with bats in the ceiling. Victims will be accused of hypochondriasis. (My doctors told me only farmer’s or AIDS patients get it, it’s only in bird feces, and it always infects the lungs…wrong, wrong, and wrong!) In fact, the first doctor to diagnose me was a pulmonologist, and the only reason he examined me was to try to prove that I didn’t have it, when I really did. No doctor I went to realized bats carry the fungus. And NO doctor I went to in DFW, even infectious disease “experts,” understand the DISSEMINATED form, just the pulmonary form, and the only test that will be done by many doctors before they diagnose people as NOT having it is an X-ray, even though at least 40-70% of victims will have NO sign of it on a lung X-ray. It OFTEN gives false-negatives in lab tests (some people are correctly diagnosed only during an autopsy, if then, after obtaining negative test results) and cultures may not show growth until after 6-12 weeks of incubation (but some labs report results after 2 weeks).

      One disease of unknown cause that could be caused by Disseminated Histoplasmosis: I suspect, based on my and my coworker’s symptoms (during our “rare” infectious disease outbreak) and my research, that interstitial cystitis and its comorbid conditions can be caused by disseminated histoplasmosis, which causes inflammation throughout the body, causes “autoimmune” symptoms, and is not as rare as believed. I read that “interstitial cystitis (IC) is a chronic inflammatory condition of the submucosal and muscular layers of the bladder, and the cause is currently unknown. Some people with IC have been diagnosed with other conditions such as irritable bowel syndrome (IBS), fibromyalgia, chronic fatigue syndrome, allergies, and Sjogren’s syndrome, which raises the possibility that interstitial cystitis may be caused by mechanisms that cause these other conditions. In addition, men with IC are frequently diagnosed as having chronic nonbacterial prostatitis, and there is an extensive overlap of symptoms and treatment between the two conditions, leading researchers to posit that the conditions may share the same etiology and pathology.” Sounds like Disseminated Histoplasmosis, doesn’t it?

      My coworkers and I were always most ill around May, presumably since the Mexican Free-tail bats gave birth in Texas during May (and the fungus was most potent), and late fall/Thanksgiving to December, for some unknown reason (maybe migrating bats from the north?). We had GI problems, liver problems, weird rashes (erythema nodosum, erythema multiforme, erythema marginatum/annulare, etc.), plantar fasciitis, etc., and I had swollen lymph nodes, hives, lesions, abdominal aura, and started getting migraines and plantar fasciitis in the building, and I haven’t had them since I left. It gave me temporary fecal incontinence, seizures, dark blood from my intestines, tinnitus, nystagmus, blurry vision/floaters/flashes of light, benign paroxysmal positional vertigo, isolated diastolic hypertension, what felt like burning skin, various aches and pains (some felt like pin pricks and pinches), tingling, tremors, “explosions” like fireworks in my head while sleeping, and temporary blindness. Suddenly I was allergic to Comice pears (latex fruit allergy or oral allergy syndrome?). I had insomnia (presumably from the fungus acidifying the blood, releasing adrenaline) and parasomnias. It felt like strong bursts of electrical shocks or steady electrical currents in my body, which now feel like low electrical currents at times, mostly at night. I was always worse at night (because bats are feeding? Or maybe because fungus follows a circadian rhythm?).

      I suddenly had symptoms of several inflammatory/autoimmune diseases, including Fibromyalgia, Sarcoidosis, ALS, MS, Sjogren’s syndrome, etc. that have disappeared since leaving the area and taking nothing but Itraconazole antifungal. No one, including doctors (we all went to different ones), could figure out what was wrong with us, and I was being killed by my doctor, who mistakenly refused to believe I had it and gave me progressively higher and higher doses of Prednisone (2 years after I already had Disseminated Histoplasmosis) after a positive ANA titer, until I miraculously remembered that a visiting man once told my elementary school class that bats CARRY histoplasmosis. There’s a lot more. I wrote a book about my experience with Disseminated Histoplasmosis called “Batsh#t Crazy,” (now you know where that term, “bats in the attic/belfry,” and “going batty” came from) because bats shed the fungus in their feces and it causes delusions and hallucinations, I suspect by the sclerotia fungal mycelia can form emitting hallucinogens (like psilocybin and dimethyltryptamine) along with inflammation in the CNS. (Schizophrenics have 2X of a chemical associated with yeast, part of the fungal life cycle.)

      Thank you for your time,

      Susan McIntyre

      P.S. Doesn’t this infection share all the same symptoms with Gulf War Syndrome?

  7. What a powerful message. Thankyou for sharing this, it’s heartbreaking how simple the answers can really be. This gels well with my experiences of psychosis, although for me other things were in play also, such as creative needs. Terror was certainly a big part of my experiences, and calming that resolved a great deal. Thanks again.

  8. Branka says:

    Hi my name is Branca l have a daughter with mental illness for last 15 years l have been in custody of my granson since he was born he is 8 years now He just started to have aye ticks and movement s thats uncomfortable and a little painful l need help to speak to a professional therapist in a natural way to help both of them as my daughter has been on all posibble meds it just didn help her lf anyone has any recommendations would much appreciate thanks

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