According to Jerome Elan of the Washington Times, schizophrenics who abuse drugs are more likely to commit violent crimes than other people.

This doesn’t answer the question: Where did the schizophrenia originate from? At one time, there were people who blamed this problem on poor parenting and the term “schizophrenogenic mother” came into being. Then that was not deemed politically correct so it was dropped. Besides, it is more comforting to blame an unknown “disease” process than to reflect hard on one’s own behavior to rule out responsibility for hurting one’s children.

Elan goes on to say, “Elements of psychopathy may be genetic, and overwhelming stress can combine with a psychopathic nature, to cause a reaction that is emotional or just the opposite, coldhearted.”

That sounds like a nice explanation, but what research is it based on?

The Myth of Disease In Mental Illness

Back in 1960, Thomas Szasz wrote a book called The Myth of Mental Illness. I used it as a resource for my 1968 college honors research paper that is reprinted on this site. In researching this article, I was pleasantly surprised to find that Szasz, in 2011, was still alive, well, and kicking. In 2011, he apparently re-printed his book with a new introduction. Here’s what it says:

“The claim that ‘mental illnesses are diagnosable disorders of the brain’ is not based on scientific research; it is a lie, an error.” Szasz’s contention is that if a particular disease in or of the brain is found in a person with abnormal behavior, then the initial diagnosis of “mental” disorder must be corrected to reflect a physical disorder. For example, a person whose bizarre behavior can be tracked to a brain tumor does not really have a mental disorder but a physical one.

He goes on: “If all the ‘conditions’ now called ‘mental illnesses’ proved to be brain diseases, there would be no need for the notion of mental illness and the term would become devoid of meaning.”

That is: The word “mental” does not refer to the brain, but rather to something not physical, the mind. As soon as we have a better, clearer understanding that the disease originates in a physical condition, there is no need for the mental category anymore; the disease can be given a neurological diagnosis.

This is all logical. Szasz concludes that the objection to his logic is political. He says: “However, because the term refers to the judgments of some persons about the (bad) behaviors of other persons [italics in original], the opposite is what actually happens: the history of psychiatry is the history of an ever-expanding list of ‘mental disorders.’”

In other words, psychiatrists make up ever more diagnostic terms so they can justify their existence as a field.

If we were to follow Szasz’s advice and abandon the term “mental illness,” we still don’t have the answer to the question: Where do schizophrenic behaviors come from? Is there a genetic cause?

What About a Genetic Basis for Mental Illness?

The August 5, 2012 Harvard Gazette published an article attempting to address this. Written by Harvard staff writer Peter Reuell, it presents an interview with psychologist Joshua Buckholtz. Buckholtz, who, with co-author Andreas Meyer-Lindenberg, published a paper on this topic.

Buckholtz explained the genetic effect on the brain as follows:

“’Individual genetic differences cause variability in the way that brain circuits function,’ he continued. ‘These differences in brain circuit function lead to the wide range of variation in cognitive, emotional, motivation, and social function that we see in people all around us. The specific genes that are involved, and the way that these genes interact with the environments to which we are exposed, determine how specific brain circuits behave. When those circuits don’t function well, this is expressed as a deficit in whatever domain of cognition is supported by the ‘sick’ circuit.

“The findings are the result of a review of hundreds of papers that examined patterns of brain circuit dysfunction in many different disorders, and how variability in genes responsible for neurotransmitter signaling or neuron growth give rise to this dysfunction. Based on that review, Buckholtz said, researchers were able to identify four brain circuits that are associated with cognitive, emotional, motivational, and social symptoms that span a wide range of disorders.”

This does sound like good progress, doesn’t it? They’ve found specific brain circuits that are associated with dysfunctional symptoms. Great! Except for one thing – that old chicken and egg thing – he doesn’t say which caused which. Being associated doesn’t tell you much.

Did the malfunctioning brain circuitry cause the abnormal behavior or did the process of responding to an abnormal world cause the abnormal brain functioning?

I did a careful search for some hint of an answer dated after research cited in earlier articles in this blog – with no luck. Journal articles don’t get the kind of volume of readership as popular literature so the way that editors of such journals make money is to sell them for prices around $30/article. Under these circumstances, if there was any research, it would surely be there.

The best I could find was a 2009 article in Molecular Psychiatry which has an abstract. It seems that studies of identical twins separated at birth do show a higher than expected rate of mental illness (or in Szasz’s term, undesirable behavior) even when brought up in two entirely different types of families. In other words, there must be something genetic underlying people’s similar behavior.

But that article raises the brilliant point: “Unlike common physical disorders, mental illness usually has an onset early in the reproductive age and is associated with substantial reproductive disadvantage. Therefore, genetic variants associated with vulnerability to mental illness should be under strong negative selection pressure and be eliminated from the genetic pool through natural selection.”

What it is saying is that if it is genetically caused, mental illness should have been de-selected through a natural selection process. Why then is it here?

The Role of the Family In Mental Illness

Every single article in genetics comes away with the following conclusion: Whatever genetic contribution there is to inappropriate behavior and thinking is modulated by the environment. And by the word “environment,” scientists are talking about family and other experience.

Folks, there is no way we will get out of our responsibility to raise our children well. We cannot point fingers at bad genes or chemical imbalances. If there is any influence of these factors, it is only a minor influence. The rest has to do with our own shaping of that raw material.

Let me give you an example: Two children are raised in two different homes. One child is extraordinarily bright. He doesn’t have to do homework and he doesn’t have to show up for class too often. He picks up in a moment what other children take days or weeks to learn. (I had one such girl in my college organic chemistry class. Ugh.) His parents are proud and don’t see the need to make him put effort into what already comes naturally.

The child in the second family is not that much of a genius. She’s bright but has to put the hours in to get those good grades. She has to work. Her parents make sure she does put that time in.

Studies show that the second child will be more successful in life, on average. Of course, if the first child’s parents said, “You were given a gift. If you can’t use it in school, then do some extra-curricular work that will benefit you or your community. Use your brain and don’t be lazy!” – then that child would really have a leg up on all of us.

You see how nature and nurture work together. Nature is the gift and nurture is what we do with it.