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Why Can't Prime Time Understand Schizophrenia?

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When I first heard that the U.S. cable channel, TNT, was producing a series about a neuroscientist with paranoid schizophrenia called Perception, I was ecstatic. Finally, we're going to see someone with schizophrenia who is not a crazed killer but is, like many with schizophrenia, doing well. Then I read the description of the show and was appalled. Last night, after watching it on the Bravo network in Canada and I was even more appalled.

The writers seemingly got halfway through "Psych 101" in college, dropped out and went on to write for television -- such is their understanding of this very serious mental illness.

Eric McCormack plays Dr. Daniel Pierce, a neuroscientist with paranoid schizophrenia, who is recruited by the FBI to help solve complex cases. As the official website says, "he struggles with hallucinations and paranoid delusions brought on by his schizophrenia. Oddly, Daniel considers some of his hallucinations to be a gift. They occasionally allow him to make connections that his conscious mind can't yet process. At other times, the hallucinations become Daniel's greatest curse, leading him to behave in irrational, potentially dangerous ways."

What we see in the first episode is that his hallucinations are actually rather benign imaginary friends who appear to the star with clues to help him solve the mystery. I'm told that nobody who actually suffers from schizophrenia ever has fully formed visual hallucinations of friendly people who counsel them wisely. In reality, hallucinations, mainly voices, tend to be negative, mean, demanding and distracting. They often tell the victim to commit suicide or to harm others. And this is only one of the symptoms of schizophrenia. There are also delusions, cognitive loss and paranoia.

As a contrast to this show, I would suggest that readers listen to an interview with a real neuroscientist with paranoid schizophrenia on National Public Radio in Athens Ohio, Erin Hawkes. Erin lives in Vancouver and is the author of When Quietness Came: A Neuroscientist's Personal Journey With Schizophrenia. She begins her book describing how the nasty voices ordered her to kill herself and were so insistent that she complied. Fortunately, she didn't succeed and was hospitalized for the first of over a dozen times until she finally found the right medication that allowed her to continue on with her life.

Erin's experiences are far more common than the benign visions of Perception's hero. But, what I found most galling about the show is that our hero does not take medication to quell his symptoms by choice and gives a lecture to his students at the end telling them that while medication will take away the symptoms we may be robbing people of what makes them unique -- their hallucinations and delusions. Reminds me of the social work professor at the University of Ottawa who thinks that "untreated schizophrenia can be a gift, and that in other cultures, hearing voices is revered as a bridge to the spirit world."

Erin has a different view. As she wrote in The Tyee:

Without medication, I fall into psychosis. My question, then, is this: are my medications changing my brain for the better or for the worse? What I care about is the quality of my life, my sanity, my self. If that takes a bit of brain renovation, so be it. I seem to function better with a (supposed, if I am a typical medicated schizophrenic) smaller brain and enlarged ventricles. Is such medication wrong? We cannot decide that these neural changes are more important than our lives at the behavioral, emotional and cognitive levels. What matters most to me is being well, without hallucinations, delusions and paranoia.

One expert told me that nobody who suffers from untreated schizophrenia has ever been known to function well in the teaching professions. He added that in 40 years of treating people who suffer from schizophrenia, he knows of no one who has stopped taking medication and was still employed or still attending college six months later.

So, while I applaud seeing someone with schizophrenia on T.V. who is likeable, attractive, not violent, successful vocationally, and very smart, it would be nice to see his illness portrayed realistically. Maybe I'm asking too much from T.V. but very often T.V. shapes people's thinking about issues.

I've seen realistic portrayals done with other illnesses on T.V. Michael J Fox struggles realistically with his guest appearances on the Good Wife because he suffers from Parkinson's disease. A number of years ago, we even saw a surgeon on one of the T.V. shows with Tourette's syndrome. He was able to keep his ticks under control while operating but his full blown illness was depicted rather realistically. Aspergers syndrome is well portrayed on Parenthood along with the impact on the young boy's parents.

Those with schizophrenia are often portrayed realistically on other cop-type shows like Law and Order but it is rare to see someone with schizophrenia on any of these shows struggling successfully and coping. Its about time that we had a realistic portrayal of schizophrenia in prime time showing the reality that many with proper treatment can and do lead reasonably normal lives.