Imagine a world where strange voices interrupted your thoughts, or you saw people that others did not. Welcome to the nightmare of people with schizophrenia.
To have a diagnosis of schizophrenia must be akin to being told you have cancer, but are we justified to be so scared of this mental disorder, or should we be more optimistic? Most of us would associate schizophrenia with hallucinations and auditory delusions, but the truth is that some people with schizophrenia do not experience these symptoms. In fact, there are many other symptoms that are indicative of schizophrenia, including behavioural disturbances, thought disorder and affected perception.
Research has shown that people with schizophrenia are more likely to experience problems with their perception of the world. They find it extremely difficult to distinguish between reality and the imaginary world. Everything from their surroundings, time, their senses and how they interpret information appears to be mixed up and confusing. How would you cope if your mind starting betraying and you couldn’t trust what it told you anymore?
The anatomy of schizophrenia
The causes of schizophrenia are not fully understood, but we know that we derive information from our environment via our senses. This information undergoes processing where it is then stored into either one of two categories: something that has been experienced before, or something that is new.
We are able to go through life thanks to this processing, which gives us clues about what to expect, thanks to previous experience. So for instance, if you were walking outside and you heard wings flapping above your head, without looking, your brain would have put together many other experiences where you heard this noise and that information would lead you to believing the noise came from a bird.
These previous experiences are called schema. A schema relates to a pattern of behaviour or thought that organizes categories of information and the relationships among them.
The problem that people with schizophrenia have is that they find it difficult to access these schema. So they have no back-up, no previous knowledge, and no helpful stored information that can help them make sense of what is going on around them.
There is also the factor that the schemas of people with schizophrenia are already distorted. Their schema, which are stored memories of earlier experiences, are often impaired experiences.
Because of this people with schizophrenia often have no common sense. This is because of three factors:
- Their beliefs are different from the normal view of the world.
- It is difficult for them to understand what others are feeling or thinking.
- They are likely to have impaired judgements about events or experiences.
Their judgement about the likelihood of events is impaired.
So what does this feel like for people with schizophrenia?
- They may have trouble getting to grip with the chronology of events, with happenings appearing out of order and actions remembered in the wrong context.
- Their reality is confused and they cannot tell whether they are experiencing what is happening in the real world or in an imaginary one.
- They misinterpret events and do not think logically, instead relying on their own perception of things which are typically fragmented and broken.
- They have difficulty socialising with others due to sensory overload.
- They come across as aloof or rude, because they are constantly juggling voices or intrusive thoughts in their head.
- They cannot focus on simple activities, this is regardless of how clever they are.
- They can’t do two things at a time.
- They often feel as if one or more senses are heightened or dulled.
- Their emotions appear flat or blunted, speak in a monotonous manner and appear apathetic.
The bright side of schizophrenia
The symptoms of schizophrenia are not always bleak and troublesome, however. In some cases, people with schizophrenia can actually see the reality when healthy subjects cannot.
In the famous ‘Hollow Mask’ illusion, where a mask that is concave is shown to people with and without schizophrenia, most healthy people see the mask as convex, as you would assume a face normally looks like.
But those with schizophrenia are not fooled by the image. They see the concave image, what is actually being shown. It is thought that the reason people with schizophrenia manage to see past the illusion is to do with top-down and bottom-up processing.
The brain uses both top-down processing and bottom-up processing when it comes to sorting out visual information. Top-down processing holds our memories, it stores images we have seen before, whereas bottom-up processes what we actually see before us, the reality.
Because we are used to seeing people’s faces as a normal convex one, in healthy individuals the bottom-up processing is over-ruled, and our minds do not see the tell-tale shadows that give the image away.
In the test, both healthy subjects and those with schizophrenia were scanned in an MRI scanner where their brain activity was measured. When the healthy subjects undertook the test, it was shown that the front parietal network (associated in top-down processing) and the visual parts of the brain were strengthened. There was no such strengthening with those who had schizophrenia.
It is thought that healthy subjects fill in the gaps with what they are seeing and what is presented to them, whereas schizophrenic patients are not able to do this. This means that despite what we have come to believe about schizophrenia, in some cases, schizophrenics can actually see reality more clearly than healthy people.