Saturday, December 08, 2007

Violence and Schizophrenia – Part One

I’ve only ever really skimmed over the symptoms of Schizophrenia in my blog. To be honest, there are so many websites that list the diagnostic criteria for Schizophrenia already, and probably far more accurately and eloquently than I ever could. When you are a sufferer of Schizophrenia though, or care for someone who is a sufferer, you realise that there are other common symptoms which are not listed as part of the diagnostic criteria, but are suffered none the less. One of these symptoms is intrusive thoughts. What do I mean by that?

I don’t mean the compulsive thoughts that Mr Man often struggles with. Compulsive thoughts are similar to what is experienced by a person suffering from Obsessive Compulsive Disorder – an obsessive compulsion to carry out often ritualistic behaviour accompanied by anxiety. For Mr Man these compulsive thoughts present themselves as obsessive counting in his head, and re-arranging things in order. When we had some children’s building bricks in the living room he had compulsive thoughts to build them into a symmetrical shape, dismantle them, and then rebuild them again. Trying to resist this compulsive thought caused him a lot of anxiety until eventually we decided to put the bricks away out of view.

The intrusive thoughts that Mr Man experiences cause him anxiety for very different reasons. These thoughts are very violent in nature, and he describes them as being inserted into his brain as if by an outside source. It is precisely because these thoughts do not reflect his own feelings that they cause him so much anxiety, rather than it being the strain of resisting such thoughts. These violent thoughts are not temporarily accompanied by a surge of anger which could tempt the sufferer into acting upon them; neither are these callous thoughts with no feeling for the victim; rather, they are unwanted thoughts that cause the sufferer a great deal of anxiety as they have no desire to act on them. They are as unwelcome as the frightening hallucinations a Schizophrenia sufferer experiences.

"Intrusive Thoughts" by Philippa King

When Mr Man was at his worst, he had intrusive thoughts of killing me and cutting me up into pieces. He said he also saw himself doing it on a sort of screen in front of him. Was I scared? Not at all. Should I have been? Should I have been afraid of a man who had never raised his voice to me let alone his hand, and who sobbed and shook with grief at the thought of carrying out such atrocities? I never feared that he would ever act on these thoughts. In reality these intrusive thoughts caused him far more anxiety than they ever caused me; my only concern was how traumatic the experience was for him.

As I said though, this is not a symptom I have ever read about. Maybe this is why when Mr Man explained what he was experiencing to the staff in the hospital they didn’t believe him – they actually thought it was an act and that he simply wanted to kill me. He was told that if he killed me he would be held responsible for his actions and he couldn’t “get away with it” by claiming mental illness. My goodness, they must have had some good actors on the ward if they thought this was an act, because I have never seen a man so distraught in my life. Their suggestion that these thoughts were his own desires only distressed him further.

I know another Schizophrenia sufferer who has also experienced very violent intrusive thoughts. She also finds them very distressing. Although describing them in exactly the same way as Mr Man – as being inserted into her brain by an outside source and feeling that they are not her own thoughts – she feared that she was actually a bad person and felt a lot of guilt over it. She never told anyone at the hospital about these thoughts, and no one ever asked her because, I suppose, it is not part of their diagnostic criteria. It would have been helpful for her to know that what she was experiencing was part of her illness though.

I think it’s important to note that although Mr Man has struggled with, and eventually acted on compulsive thoughts and command hallucinations, he has never acted on these unwanted intrusive thoughts.

Does the presence of compulsive and intrusive thoughts mean that people with Schizophrenia are more likely to be violent? Are they “on the edge”, ready to snap at any moment? This will be discussed in the following article.

Related Posts: Violence and Schizophrenia - Part Two, Violence and Schizophrenia - Comments from Readers


MinneSnowta said...

I am glad I read your post. And I am glad you are not affraid of your husband. I know exactly what he is going through. My last session with my Doctor we spent the majority of the time talking about how I murdered my husband, decappetated him, put his head on my lamp and smeared the blood on the walls. I would never hurt my husband. But the thoughts are like movies you can't shut matter how horrible it is I can't press stop..I'm forced to "watch" the whole thing until it is done. Your husband isn't alone. I thought I was until my doctor told me last week about a patient of his years ago who suffered from the same thing. Thank you for your helps me.

Mr Mans Wife said...

MinneSnowta, thank you so much for your comment. This is something I have wanted to write about for some time, but wasn't sure how to get the point across that these thoughts are so unwelcome. You express yourself very well, and I thank you for commenting because I feel that your explanation may help others to understand more.

I was curious to see if I would have any comments from others who have suffered in this way - Mr Man believed he was alone, and so did the other sufferer that I mention in my post. Obviously this symptom is more common than we realised.

I'm glad I chose to write about this and hope it helps other sufferers to realise they are not alone.

Slurry said...

Yet again a very well written post, which describes what I experiance but have so much difficulty talking about for fear they will lock me away.

Mr Mans Wife said...

Hi Slurry, thank you for responding to this post. I suspect many more people with Schizophrenia have this experience but, like you, keep it to themselves through fear of how others will react.

Mr Ian said...

Without wanting to steal your thunder for any upcoming article, I have some thoughts to share on the origins and nature of such thoughts.
Thought, is an area I spend a great deal of thinking on (??) and, in the realm of 'treatment', I get pretty angry at the likes as you describe who take things at face value and immediately cast a judgment upon it in their own context, meaning of course, the staff attitude.
With no expertise or 'doctorologicalship' to rely on, I would regard intrusive thoughts as highly similar to waking dreams, mostly bad ones at that. Using Mr Man's experience as a reference, and considering the thoughts are hardly ideas he might entertain in 'rational' or processed thought, they must come from somewhere. It would be my guess these are 'representations' not realisms of thought or feeling. What they might mean would be down to how or whether you/he would interpret dreams. Nevertheless, for me, this theory provides a rationalisation of such an experience and, since Mr Man's brain is working at double-time already, why couldn't he have dreams while awake?
It's my theory and I'm entitled to it. Tho Freud probably has a gazillion papers on it already.
As for the violence component, I'll await your post :)

Seaneen said...

I've just written a post about this, I get them too.

Mr Mans Wife said...

Thank you for your comment Mr Ian, and welcome to my blog.

Your theory is an interesting one. I have wondered myself if these intrusive thoughts are strongly related to hallucinations, and I suppose hallucinations can be described as waking dreams. Sufferers can’t control hallucinations any more than any other person could control their dreams, and as we all know, sometimes dreams can be horrific and leave us feeling disturbed for days. I’m not sure if I’m convinced by your theory (although as you rightly said, you are entitled to it) but it is a good way of explaining the involuntary aspect of it. Thank you for your input Mr Ian.

Thank you Seaneen for your comment.

Click here to read Seaneen’s post on intrusive thoughts. I also recommend clicking the link contained therein to an earlier post, where Seaneen explains more about this problem under the sub heading “Intrusive Thoughts”.

Anonymous said...

Goodness me.

I've struggled with these thoughts for a long, long time. I thought they made me a horrible person and I have done very silly things to try and erase them from my mind.

I don't know how to express the comfort that this post has given me. I am truely sorry that other people experience the same thing, but it's so nice not to feel alone.

The team of individuals supporting me at the moment would like me to tell them the contents of these thoughts. So far, I have been too scared and too ashamed to say anything more than "they're horrible." I could not even write them down for fear that they would become more real.

Perhaps I'll be able to be a little more open now. Thank you.

Mr Mans Wife said...

Anonymous, thank you so much for your comment - comments such as yours remind me why I write this blog.

I am glad you have found comfort in the expressions of the other readers. Clearly, you are not alone - and not a horrible person.

uphilldowndale said...

Powerful post Mr MW, thanks for shedding some light on this 'taboo' subject

Mr Mans Wife said...

Thank you UpHillDownDale.

You're right, it is a taboo subject. I was a little worried writing about it, in case I gave people the wrong impression that people with Schizophrenia are violent.

I think the comments above from other readers explain this problem far better, and in fewer words!

Anonymous said...

I'm not sure the people at the hospital could have said anything else to him than they did. They have no way of knowing if he's up to something or if it's for real, and they have both their responsibility to protect you and their liability to consider.

Mr Mans Wife said...

Thank you for your comment Anonymous.

I have given your comment considerable thought, and I have to agree that if the staff had no prior knowledge of an individual who was claiming to have intrusive thoughts about murdering people, it would be difficult for them to know if the person was genuine or not (although I have no idea why someone would choose to make something like that up before committing an act of violence). But Mr Man had already been a patient on the ward for quite some time, they had observed (and commented on) our close relationship, and Mr Man had already been assessed and had been found to be suffering from a high level of psychosis.

My apologies for not making these points clear in my post, but for these reasons I feel that their comments showed a lack of compassion and a lack of understanding regarding Mr Mans symptoms, which is why I wonder if they had ever even heard of intrusive thoughts.

Also, they seemed to completely miss the point that Mr Man was trying to express what he was experiencing because he was distressed, rather than "warning" them of what he was going to do.

I could go on and on, and I know I will write about this in more depth some time in the future, but for now I hope this explains why I feel that their comments were inappropriate.

Thank you again for your comment.

ThanksFromAz said...

Thank you Mr. Mans Wife for posting this, and for posting all of the others. But this one in particular was very moving. I recently started dating a man with Schizophrenia and bipolar disorder, and I was reading up on these one day online, when I stumbled upon your blog. And it really did make me feel better, because it helped me feel like I wasn't the only one in the world too feel this way. I know it sounds weird but I did feel alone in the way I felt about him. My mom in particular doesn't see a future for him and I, and always asks me if I'm afraid of him when he has an episode. And my answer is constantly no, because I am not and I don't see how I could. He doesn't even yell, how can I possibly imagine him causing me any harm physical or other. I really do love him, but I was feeling insecure about this, and just reading this quickly erased all of those. I have since shared this thought and many more that I have been keeping for much the same reason, and it hasn't harmed our relationship, in fact it has helped us. So I just wanted to let you know that you have helped me, and I wanted to thank you sincerely.

Mr Mans Wife said...

Az, thank you for your comment and a very warm welcome to my blog.

Your comments don't sound weird at all - you have fallen in love with someone the world regards as unlovable, so no wonder you felt alone. In my case I was seen as someone to be pitied, as I was already married to Mr Man before his symptoms came to light. As your experience proves though, these are individuals with their own personalities suffering from an illness – what’s unlovable about that?

I’m glad you have found this blog reassuring. As you have found, communication with your partner is definitely the key, along with a good understanding of the illness. I wish you and your partner every success for the future. Thank you for commenting.