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REVIEW OF "BREAKDOWNS.." BY THE CHRISTIAN MEDICAL FELLOWSHIP - A REPLY

"Breakdowns are good for you" was reviewed in "Triple Helix" - the journal of the Christian Medical Fellowship, Summer 2000. The crux of their criticisms is in the last few paragraphs which are as follows.

"In the case of schizophrenia, the authors write that symptoms appear in early adulthood because of the `high level of achievement expected of young people'. This is where the book is very difficult to get along with, because of the lack of genuine evidence. Moreover the evidence which is cited comes from William Glasser's book "Reality Therapy". Glasser quotes his teacher Dr GL Harrington, who in 1962 had taken over the care of 206 schizophrenic in-patients and managed to discharge many of them by increasing their freedom to take more responsibility for their activities, so gaining self-worth. The philosophy was one where `mental illness was not accepted'. To reject all biological theories of schizophrenia on the basis of this one non-randomised un-controlled trial is unscientific.
....But, while the authors' wide use of scripture seems impressive, it is not matched by reasoned understanding of mental health issues."
Dominic Beer is a Consultant Psychiatrist in London"

.......................................

I replied but the letter was not published. I was surprised to find the review appearing on their website -
www.cmf.org.uk/pubs/helix/sum00/bookrevs.htm
I think readers might be interested in reading my reply.
.................................

Dear Sir,

"BREAKDOWNS ARE GOOD FOR YOU"

As the co-author of the above book, may I comment upon two points made by Dr. Beer in his review that appeared in the July issue? As a professional psychiatrist it is understandable that he should disagree with much that we claim in the book. However, he makes two points that we would suggest verge on being misleading.

Firstly, when commenting upon the results that Harrington achieved in treating a ward of 206 patients with schizophrenic behaviour, he says that he "managed to discharge many of them by increasing their freedom to take more responsibility for their activities." This would imply that, say, 10-30% of the inmates were treated successfully. In fact, the figure was 25 (12%) for the first year, 72 (35%) the second year and was expected to reach 200 (97%) as patients were sent in from other hospitals (page 30). This is considerably more than "many".

Secondly, he dismisses Harrington's results and criticises the authors, saying "To reject all biological theories of schizophrenia on the basis of this one non-randomised un-controlled trial is unscientific."

He asks for a "randomised test", but in fact, a very accurate comparison was made. Over many years previously, the discharge rate using orthodox treatment was 1%. Harrington's results we give above. This was a different treatment upon the same patients, giving far superior results. Surely this should be convincing enough. In addition, this was not one isolated case as Dr. Beer claims, for similar results were achieved at the Western State Psychiatric Hospital and the Ventura School for seriously delinquent girls. The vastly improved results that were also achieved in these institutions we had clearly set out in the book (pages 28-32).

We would ask just how much evidence does Dr. Beer need to be persuaded that schizophrenia can be cured? Results such as we give surely contradict one Christian psychiatrist's claim that for schizophrenia "we have no cure" (page 178).

We would hope that readers will ascertain for themselves whether Dr. Beer's review as a professional psychiatrist was, all things considered, a fair one.

Yours sincerely,

Malcolm Bowden


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