The book about Schizophrenia and other disorders is based on personal account and experiences. The effects of schizophrenia that impacted the life of Pamela, resulted in hospitalization and breakdowns. This experience has led to the research of the psychiatric disorders detailed in the book, and it provides not only a personal account but a better understanding of the symptoms, treatments and diagnosis of different mental health problems for professionals.
The Author’s Symptoms Analyzed
Pamela started hearing voices during childhood, while her untreated mental illness led to suicide attempts. She through that she was responsible for the death of J F Kennedy, while attending university. She was hiding the symptoms from everyone, including her family until the problems became more prominent. Still, Pamela became a renowned poet while her sister, Carolyn graduated as a psychiatrist. The symptoms of Pamela, according to the symptoms of different schizophrenic mental disorders indicate that she suffered from paranoid type schizophrenia, and she still has symptoms, while the treatments help her control the illness.
Delusions, hearing voices is criterion one for schizophrenia, according to the book. Hearing voices is certainly one of the signs of “misinterpretation of perceptions or experiences”. She was convinced that it was her fault that President Kennedy died and this resulted in voices telling her to commit suicide. She states in her Memoir (Wagner, 2007, web):
“At first, the experience was mildly pleasurable: I “knew” that everyone was thinking and talking about me, but this seemed relatively benevolent and made me feel real. Later on this changed drastically as I came to believe that a local pharmacist was tormenting me by inserting his thoughts into my head, stealing mine, and inducing me to buy things I had no use for.”
There are different characteristic symptoms of schizophrenia found in the memoirs of Pamela: she had hallucinations, delusions, she reports distraction of speech, catatonic behavior when she was walking around the drug store in a mile radius over and over again, and avolition. While the hallucinations and delusions are detailed in the book, the symptoms of speech and demotivation are not clearly defined. In order to confirm the diagnosis of schizophrenia, additional details would be needed regarding the type of childhood hallucinations and the length and persistence of the different negative effects. The fact that the delusions were organized around one theme indicate, however, that Pamela suffered from paranoid type schizophrenia. She mentions that her initial diagnosis was paranoid schizophrenia and she was also said to be schizoaffective, however, she does not believe in that.
Comorbid disorders occurred in the case of Pamela when she became stigmatized and the medication started. She reports a lack of interest and fear from other people, which is a sign of anxiety disorders associated with avoiding company of others. According to Buckley et al. (2008. p. 711.) “panic symptoms may be more common in patients with paranoid schizophrenia, compared with other schizophrenia subtypes or schizoaffective disorder.” However, the autobiography is not clear on when these occurrences appeared and how persistent they were. It cannot be decided whether the comorbid disorders of anxiety and panic attacks were present before the medication started or not.
The author confirms that people living with schizophrenia are strongly stigmatized by the society. She also states that a person suffering from heart problem is never called a “cardiac”, however, people often call schizophrenic patients “schizo” or “psycho”. She calls for a change in treatment, and claims that her doctor never talks to her as a mental illness patient but as another person. She also states that the chemical processes in the brain create hallucinations, therefore, mental illness is not simply “being crazy” but a real disease that is similar to other illnesses that are caused by disorders in the body.
Time and Culture
Carolyn, in an interview and the book talked about the stigmatization of the illness. She compares the illness to leprosy in the 18th Century. People were “sent away” to protect the rest of the people. Society today still feels that they need to be protected from those who suffer from mental disorders, such as schizophrenia. In the interview she talks about how the illness was treated, how patients were “locked up” and treated as “different”. Pamela mentions in an interview (Wagner, 2007) that “From 1980 on, I was in a circle of people at a day hospital and we hung out together at Dunkin Donuts or Bagels East, and none of us cared.” She also says that we, in the 20th Century still exclude people from the society as people fear from the unknown. In the 1960-s, it was even worse.
Pamela did get hospital treatment, medication, but she was excluded from the society. She talks about her loneliness and exclusion, which was made worse by hospitalization. Her doctor tells us: “You keep patients from isolating, because isolation is what has made them sick and, if allowed to continue, isolating will make problems more difficult.” (Spiro and Wagner, pg. 138.)
Ethics is important when it comes to finding the right medication. Pamela talks about pills and treatments that created side effects stronger than the original symptoms of the disorder. She refused to follow the medication plan, got worse, until she got real help from her sister. Her sister tried to understand her as a person and told her to go “bushwacking” instead of following the old path. Doctors often think that there is no reality in having a sensible conversation with a mental health patient. While some medication works, it took Pamela decades to find the right combination that helped her control the illness.
Impact on Family and Friends
Carolyn was feeling unable to help her sister, understand her condition and provide solutions. When a loved one tries to set fire to herself, it is hard to understand the motives. She started to blame her sister, until she fully understood the illness, practicing as a psychiatrist. Nobody in the family understood Pamela at the time, according to Carolyn. Hospitalization was more painful than helpful. At one point she says:
“I thought I was used to her. I thought I’d gotten used to what schizophrenia, medication, and the years of not taking care of herself had done to her. I thought I was accustomed to the incessant movement of her hands, the sometimes violent rocking of her body. I thought I was used to her chain-smoking and the peculiar self-absorbed habits of her solitary life. […] It’s hard to believe this is the twin sister I kept on a pedestal for years, Pammy the brilliant, creative one, the smarter, more special version of me. It is still impossible to reconcile my memories of her with the person schizophrenia has so wrecked.” (pg. 268-269)
Representation of the Disorder in Writing
It is evident from the interviews and the writing style of the book that Pamela still has difficulties with organizing her thoughts. She is able to write down her emotions, but memories often get mixed in with the content she is talking about. She does confirm that the “little people” and “voices” are still with her, and they will never go away. It is possible that her poetry and blog awards are based on her completely unique style and organization.
Spiro, C., Spiro Wagner, P. (2005) Divided minds: Twin sisters and their journey through schizophrenia. St Martin’s Press, 2005
Spiro Wagner, P. (2007) A voice from another closet. Web. Retrieved from: <http://www.schizophrenia.com/newsletter/buckets/newsletter/197/197pwagner.html>
Buckley, P., Miller, B, Lehrer, D., Castle, D. (2009) Psychiatric Comorbidities and Schizophrenia Schizophr Bull (2009) 35 (2): 383-402.doi: 10.1093/schbul/sbn135 First published online: November 14, 2008
Spiro, C., Spiro Wagner, P. (2010) Divided minds: Twin sisters and their journey through schizophrenia. Presentation Video. Web. Retrieved from: <http://www.youtube.com/watch?v=lzDPlktZrGI >
Burni, C. (2007) An Interview with Pamela Spiro Wagner. Web. Retrieved from: <http://www.nami.org>