A schizophrenic man or a man with schizophrenia?

James, a Time to Change bloggerI have noted for several years that the mass media, including the BBC commonly refer to people presumed to be diagnosed with schizophrenia by such terms as 'a schizophrenic man' or ‘a paranoid schizophrenic’.

I am sure no deliberate offence is intended and there have been far worse examples in the media when discussing people with mental health problems but such language does contribute to the stigma that people with severe and enduring mental illnesses have to deal with throughout their lives.

A person is not the sum total of the symptoms that they experience, these can vary greatly from individual to individual and nor are all individuals always symptomatic. 'Schizophrenia' has unfortunately frequently come to be seen as a negative term that refers to certain clusters of symptoms of mental ill health and therefore labelling somebody as ‘schizophrenic’ can mean that an individual immediately has to deal with many misconceptions.

With this in mind, I wrote to the BBC and requested that they take some positive steps to try and reduce the misunderstanding of many in society and, hopefully, increase the public’s understanding that somebody who has been diagnosed with schizophrenia has just as much right as others to be defined by terms other than their illness.

I also wanted to highlight how often 'schizophrenic' is used, unchallenged, on the BBC (again it is not alone in this) as a supposedly humorous or ‘learned’ adjective such as 'schizophrenic taste' or ‘such and such department was positively schizophrenic'. I feel this is insensitive to those individuals and their families that are affected by this illness.

The BBC replied to my complaint 

The BBC replied to my complaint by stating: ‘We feel "schizophrenic" is a correct and appropriate term to describe someone with schizophrenia…. As the Oxford English Dictionary states, the word means simply "a person with schizophrenia". The word itself carries no hidden meaning - thus by way of example, in a similarly medical context we would also use the word "diabetic" to describe a person "suffering from" or "diagnosed with" diabetes.’

I feel that quoting the dictionary does not begin to address the complex issue of how language is used in society. It neither contributes to understanding how stigma can be reinforced and nor does it consider the views of the many individuals with the condition, their families & professionals that object to the term.

In addition dictionaries have many terms that are no longer acceptable in public usage

In addition dictionaries have many terms that are no longer acceptable in public usage and it is those that are affected by such terms that have predominantly brought about changes. Racial terms that were once thought acceptable are no longer deemed so, as are past 'medical' terms that have fallen out of favour: idiot, spastic.

An example was drawn with the word 'diabetic' but it may have been noted that an individual with cancer or HIV is not described by their illness in a comparable way. More appropriate comparisons would be to highlight that People with Learning Disabilities or Alzheimer's Disease are now, more fittingly, referred to as such.

some have argued for the renaming of schizophrenia altogether

I believe that if greater distance is created between terms that are deemed acceptable in the mainstream, and those that are obviously unacceptable, ie 'schizo', that the outright offensive will be much more easily challenged in the future. Indeed some have argued for the renaming of schizophrenia altogether, as has occurred with conditions like cerebral palsy and bipolar disorder, and this could potentially have the knock-on effect that apologists can no longer defend the offensive as being 'simply' medical terms.'

James Beirne is a Senior Nurse Practitioner, Dual Diagnosis, of The 5 Boroughs Partnership NHS Mental Health Trust.

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Comments

Personally I'm against the

Personally I'm against the use of words like schizophrenia,and schizophrenic. I think the idea of a diagnostic label like that is out dated in the mental health service. Identifying symptoms and treating them instead of fitting symptoms to specific diagnosis seems the way foward, I think.

I agree with the BBC on this

I agree with the BBC on this one. Call a spade a spade. I disagree with the BBC on a lot of things, but you are effectively waging a war on the English language. If you have been diagnosed with a condition, and there is a non-slang term to describe a person who has been diagnosed with that condition, then I'm sorry, but that term now applies to you. That's it. End of story. I empathise with you - I have struggled with metal health problems myself, and accepting the situation was not easy (in fact it was one of the hardest things I have done).

How Long is a Diagnosis?

I think that it is not helpful to think of a diagnosis as a 'term that now applies to you' The English language has a great many descriptive words and phrases and to criticise the use of one of them in a certain context is not waging war on the language. What happens if the diagnosis changes? The term will stick. I was diagnosed with Schizophrenia some 40 years ago. I managed to live a relatively normal life but with a constant fear of 'madness' and others were a little wary of me. I have always found it difficult to find any meaningful work, perhaps because I couldn't bring myself to lie about my medical history or hide the medication I was taking. The diagnosis has now been changed to bi-polar disorder. So is the 'term' Schizophrenic now retrospectively incorrect? and will those 40 years of fear and confusion now disappear? The diagnosis was most certainly not the end of the story

who are you?

I get really wound up when anyone refers to me as a disabled person, I am a person that happens to have a disabillity!

No surprise there then!

The BBC's response does not fully explain why the term has been used when not pertaining to "a person suffering from schizophrenia" when the dictionary term doesn't apply. This is fault by the media in general and was long discussed at a recent Mental Health First Aid course with the film "Psycho" being another cited example that causes confusion amongst the public at large. At a time when the mass media tries so hard to not offend any group or ethnic minority and raises its collective eyebrow at any celebrity that dares break the invisible PC barrier, why is it deemed acceptable to continue to misrepresent people in this manner?

"skotzo woman"

incomplete poorly researched blogg. lacking detail, & references and isuffisiant information on the condition or labeling process & stigmatization. sorry NOT even D - more of an F OR E

labels

We live in a world with to many labels , I am white, British, fat , blonde, gay, wise, 5'8",funny, sad , sick, well, pet lover, hurt, betrayed, trusted , confident, weak, scared, strong, hateful, giving and loving I am many thing none define me and have a borderline personality disorder what more important the person I am or my illness you don’t know!!!! Mental heath is not a crime or an excuse for one but when it happens why does no one look to doctors and see why they failed to prevent the crime may be it time for the professionals to be accountable happens to social workers why not GP’s mental heath is crap those that suffer are jogged on with pills or limited services no real help because they are understaffed and under budget…. Someone else can rant coz no so many mental ill people in prison because they where not evaluated and cared for correctly they may commit the crime and do the time but right meds right support may never of happened ?????

re-naming schizophrenia

I believe that all mental health diagnostic terms could be re-named simply as emotional trauma

Schizophrenia

I am always pulling people up when they describe others/or even themselves as schizophrenic. I ask them to say "he/she suffers from what psychiatry calls schizophrenia". I am not convinced myself that psychiatry really understands very much at all about the human psyche, but a person who has been given the label "schizophrenic" is certainly suffering.

Disgusting response from the BBC

It irritates me when I hear these descriptions used inappropriately. I feel that they use these descriptions to make a criminal seem more dangerous, or to make someone's point of view seem irrelevant. Often it is used in contexts such as this: "The suspect is thought to be 32 year old, schizophrenic Joe Bloggs." Or similar. But you don't often hear: "The suspect is thought to be 32 year old, Joe Bloggs, who suffers from IBS." So it clearly reinforces the stigma that mental illness = danger. Thanks, BBC.

Labels

James, This is a great blog. Ben

"the word means simply..."

I have to admit that on this issue I’m a bit more radical. I believe that a discussion around “A schizophrenic man or a man with schizophrenia?” is in itself a discussion within the same ideological framework with the caveat of shifting away our attention from a more foundational discussion of schizophrenia as a concept altogether. Obviously, there is no such thing as "the word means simply..." especially in words such as “schizophrenic” - This is just a brilliant example of institutional cynicism from the BBC. Let us suppose that I'm an alien and have absolutely no knowledge of British culture and I decide to read the 21,730 pages of the Oxford English Dictionary in the same way that Neo learns Kung Fu after having information downloaded into his brain (Matrix). Would I be able to understand, communicate and relate to people in Birmingham or Cardiff? Doubtfully, as the dictionary doesn’t really tell us anything about communication or culture. In the same way that the stigmatising layers of the meaning of the word “schizophrenia” are not listed in the dictionary - they often live within and around the labelled person. The concept of “schizophrenia” is a meaningless “scientific” term (and the scientific references for this claim are extensive...) I’m here tempted to say that “the real schizophrenic lives in the mind of the diagnosing Psychiatrist”.

Reply to pabds

I agree with pabds' comment about the term 'schizophrenia' possibly needing to be replaced altogether (I referred to this on the blog) and a former tutor of mine was part of a campaign to do this. I also agree with another response about the desirability of placing less emphasis on diagnosis and more on presenting needs but, for better or worse, diagnoses are currently part of the 'system' (ie diagnoses are requested in lots of different areas: health, occupational health, criminal justice...). The title wasn't mine but it does summarise my point - if psychiatry does continue with its use of such a diagnosis, and the media insist on reporting a person's psychiatric diagnosis (although I think this should only be done if it is actually relevant) then I think the least they can do is use it in the least stigmatising way (althouh the media putting an individual's diagnosis into the public domain via a news story is not likely to reduce the stigma that they may experience in the future). Cheers

I question who the 'mad' people are

I teach children with emotional and behavioural difficulties in a special school. Why?, because I can empathise with them through my own childhood trauma. Last year I had a psychotic episode which scared me so much (it was a major over reaction to being bullied by my boss when I stood up to him, where I reverted to my childhood fears). I was disgusted with my treatment. I got access to my mental health records last month...to find I have diagnoses of unstable personality disorder (borderline in USA speak), polymorphic psychotic disorder and recurrent schizophrenia, all of which had been kept hidden from me!! I self diagnosed I was in the bracket of borderline personality many years ago and have self treated outside the NHS. This involved changing the false belief I had that I was somehow a 'bad' person - not easy to change I admit. I am a perfectly normal human being who has been psychotic once and is dealing successfully with anxiety and low self esteem due to emotional trauma in childhood. The psychiatrists can say what they want - their diagnoses is worthless to me..... and could have been damaging to me and my career!

Labels

Back in the 80s I worked in an office with a woman whose husband had epilepsy. She used to get very angry when people described her husband as "epileptic", her argument being that her husband HAS an illness, but is NOT an illness. I have always remembered this and now working in a CMHT, I use this example with colleagues who describe someone as schizophrenic to try and get them to stop using the term - although with at least one colleague it goes in one ear and straight through the other.

labels

I personally think that the comment about one HAS an illness, but is NOT an illness is one of the most concise ways of explaining the negative impact of labelling a human being with an illness diagnosis!! I have always seriously cringed when i have heard an individual called a schizophrenic and even more so when i learnt what the symptons of a person suffering from this illness can go through as someone else stated they may have the illness but they may not be symptomatic at a particular time and unless its relevant to anyone to know they may be symptomatic, is labelling them really needed to scare people? At the very least they should be treated with compassion that one gives to an individual with any condition or illness not highlighting any aspect that may be looked on from ignorance lack of knowledge with fear or/and contempt!

Slap-dash BBC

No one would refer to someone with Cancer as a Canceros, so why a Schizophrenic? The BBC is going too much on received public bad habits and is becoming slack, lazy and slap-dash, if not unfeeling towards people with our plight. Well high-lighted on here: we need a Sea Change on public attitudes, whoever is presenting them. BBC, shame on you.

Semantics

I wish organisations like the ones supporting this page would stop wasting money on silly discussions about names and labels and start doing real work to save the lives of those who suffer from mental illness. I lost my son, who had schizophrenia recently, as he just could not cope any more with the poor treatment and lack of care he suffered so terribly from in the NHS system - no talking therapies or proper support, just medication to subdue him and make his life even less worth living. How easy to set up a blog site like this, so we can all be distracted from the really important issues. Talk is certainly cheap :(

Schizophrenia

No one would define someone suffering from cancer as a 'canceric' and we need to stop referring to people with schizophrenia as 'schizophrenics'. Why should people be defined as their illness?!

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