Defining the nature of schizophrenia continues to be one of the central challenges left to psychiatry and medical science. Here, the biological, psychological and political (social and economic) factors and their strengths and weaknesses are summarised. Refreshingly, author Philip Thomas does not join one or other of the various camps but shows how each perspective is actually necessary if we are to advance to a better understanding of what schizophrenia is. These points are illustrated through recent work by the author and his colleagues with people who hear voices, demonstrating that these experiences are thoroughly understandable in the context of the individual’s life history and social and cultural factors. This is a significant contribution to the ongoing literature on this highly contentious topic.