The Real Cost of Schizophrenia

With a foreword by Bob Hinshelwood, The Psychiatry of Resolving Schizophrenia Psychoanalytically integrates two approaches to treating schizophrenia.  Written by Dr. Gillian Steggles, this book outlines her own PPCC model and describes, meticulously, how it aligns with the work of Dr. Michael Robbins in his psychoanalytic psychotherapeutic work with patients.  In a short extract from this important work, the author addresses the human cost of this serious mental illness.

Quite apart from financial considerations in relation to how the schizophrenic individual copes with the world, the cost to themselves of their illness is terrible to contemplate. They endure a much lesser degree of competency in their level of engaging with the world than if they were well. This affects their self-regard, self-compassion, and self-esteem.  They must accept every last detail and effect of their lesser functioning. 

It can be a miserable realisation for them, and yet to survive they must remain on good terms with the world. If they are treated promptly at the time of their first episode then most of their personality can be rescued and preserved. This bodes well for their future. Their determination to help themselves must be enlisted, and the cost to themselves in terms of lost opportunities, achievements, and skills tolerated with as good grace as they can summon up. 

If they find their outlook too much to manage, especially at the time of onset of their symptoms, they may feel depressed and may actually develop a full-blown secondary depression. At this time particularly they are in great need of psychological resuscitation by the clinical staff tending them. It may appear to them that every hour that passes in intolerable, so how on earth are they going to survive the rest of their life?

Their organising skills are likely to be poor, which otherwise they could employ to help themselves re-engage with what their life situation offers them as it stands at the moment. The acute onset stage of illness precludes every consideration other than the patient reconciling themselves to their present moments and learning to tolerate the experiences they are living through. 

These may be very harsh and frightening. The cost to their peace of mind is swingeing, and this will continue for the foreseeable future. Loved ones are needed like never before, with encouragement towards patience, trusting communication with those around them, and any spiritual benefits available such as music, artwork, and the hospital chapel. Occupational therapy in the hospital can be of tremendous assistance in picking up the patient’s self-belief.


The Psychiatry of Resolving Schizophrenia Psychoanalytically by Dr. Gillian Steggles is available to buy now.

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