Far from the Tree: Parents, Children, and the Search for Identity

by Andrew Solomon

four years on average, in which positive symptoms begin g...

changes in cognition, perception, volition, and motor function; has strange thoughts flash across his mind; struggles to understand whether illogical beliefs...

curiously detached from the real world even in childhood and graduall...

This marks entry into the psychotic phase, with the onset of hallucinations or bizarre delusions, including delusions of control, thought insertion, thought broadcasting, and thought withdrawal. This usually occurs between ages fifteen and thirty and lasts for about two years.

There are three primary possibilities. One is that the teenage rush of hormones changes gene expression in the brain. The second is that myelination, the adolescent process in which the brain wraps neuronal cables in a sheath so that they become maximally functional, goes wrong. The third is that synaptic elimination, or pruning, malfunctions.

An unhealthy brain may prune too much, not enough, or in the wrong places.

progressive phase, which leads to clinical deterioration except when effectively controlled with medication.

chronic and residual phase.

By this time, there has been an irrecoverable loss of grey matter in the brain. Positive symptoms tend to fade somewhat, while negative ones become more pronounced.

Janice Lieber

Her father, Steve, brought her home; when she got there, she threw everything she loved out the window because a voice told her to do so.

schizophrenias.

“Fact one: most schizophrenics do not have a schizophrenic parent,” Deborah Levy, a practicing psychologist and a

“Fact two: the incidence of schizophrenia is not decreasing, and in some places it is actually increasing.

Fact three: schizophrenics have a very low re...

Nobody knows what protects some gene carriers from the condition.

One mechanism of psychosis is an imbalance in neurotransmitters, particularly dopamine.

Genetics most likely mix with environment to cause a shift in biochemistry, which then has a degenerative effect on brain structures.

genetic vulnerability may be activated by a parasite.

the way those are expressed depends on the way the chromosomes are configured and on how external processes sup...

accounting for a large proportion of cases, a multiplicity of so-called private mutations—many, copy-number variations—may each be sufficient to cause the illness.

offspring of older parents, especially older fathers.

Another mechanism is spontaneous genetic mutation, the same process responsible for most oc...

have no way to tell if mice are hallucinating. Some such transgenic mice, however, become reclusive, hyperaggressive, or asocial; some refuse to affiliate with animals of the opposite gender or recoil from strangers.

demotivation of schizophrenic people.

“paradigm shift for schizophrenia.”

Schizophrenia may originate in genes, but turning them off will not mitigate the illness; once it’s in play, it must play itself out.

One man told me that his girlfriend had refused to marry him because his schizophrenic brother represented a risk to his future children.

schizophrenogenic mother was put forward by the Freudian analyst Frieda Fromm-Reichmann in 1948.

Another, Gregory Bateson, said that schizophrenia is likely to occur for “a child whose mother becomes anxious and withdraws if the child responds to her as a loving mother.”

Philip and Bobby Smithers

Paul’s aunt had been institutionalized her entire adult life with “postpartum depression,” an uncle was “sick in the head,” and many “quirky” cousins could barely function.

diagnosed.” Secrecy is a difficult habit to break. “Every year we have a Thanksgiving for Freda’s family, and then we have one for mine,” Paul said. “If we mix the two, I’m defensive, my mom is defensive of my brothers, and it’s upsetting to Freda’s family to see these sick people.

We strip them naked; we’re going through their whole bodies looking for webbed toes.

more schizophrenics are born in the winter, so we timed it to have summer babies.

We really don’t care. As long as they’re healthy.”

Thorazine

“It’s as though you’ve got a house that’s burning down; you come in with the fire trucks and pump the place full of water; you put out the conflagration. It’s still charred, smoke-damaged, flooded, structurally unstable, and pretty much uninhabitable, even if flames are no longer licking the walls.”

Thorazine flattens personalities much as lobotomy did, and while newer medications are somewhat better, the number of people with schizophrenia who go off their medications indicates how detested they are by the patients who must take them.

“Although I am afraid of death, let them shoot me rather than this.” A patient named Janet Gotkin described her contemporaneous treatment

“I became alienated from my self, my thoughts, my life, a prisoner of drugs and psychiatric mystification; my body, heavy as a bear’s, lumbered and lurched as I tried to maneuver the curves of my outside world. These drugs are used not to heal or help, but to torture and control.” Another patient said, “The muscles of your jawbone go berserk, so that you bite the inside of your mouth and your jaw locks and the pain throbs. Your spinal column stiffens so that you can hardly move your head or your neck, and sometimes your back bends like a bow and you cannot stand up. The pain grinds into your fiber. You ache with restlessness, so you feel you have to walk, to pace. Then as soon as you start pacing, the opposite occurs to you; you must sit and rest.” These accounts relate to older antipsychotics and neuroleptics, but the side effects

Malcolm Pease

During his freshman year at Franklin Pierce, in the winter of 1975, he began hearing voices and developing paranoid fantasies.

“He was completely out of control, didn’t know why, and we didn’t, either.”

Their sister, Polly, said, “Once he was feeling normal, he would think, ‘I don’t need to take these anymore.’ Then you crash and burn again. And again. And again.” When he wasn’t taking his drugs, he would become paranoid. “Everybody who came near, he would think, ‘Oh, you’re

just trying to put me in the hospital and force me to take antipsychotics,’”

“All you can do is tell him what reality is, in a loving way,”

“He still liked animals, and playing cards. He missed the friends he’d had before he became sick.”

clozapine,

“Malcolm didn’t complete college because of his illness. But he finally got into Harvard, and he’s teaching the neuroscientists.”