Mental illness and childhood trauma vs. biology
Wednesday January 24, 2007
Dear Dr. Miller,
I read several of your books when I was a teenager about 20 years ago, and they had a big influence on my thinking. More recently, my sister developed schizophrenia. It's a very clear case in terms of all the classic symptoms. Fortunately she has a lot of family support and the first medicine she tried (after a long prodromal phase and living with the illness untreated for a couple years) has controlled the delusions/paranoia/hallucinations/etc. with seemingly no side effects. Still it is a very difficult disease to live with, even with this amazing drug, because of the "negative" symptoms and residual "positive" symptoms she still experiences, because it has drastically changed the course of her life (as well as the family's), and because it is hard to find appropriate daily activities and social environments that encourage reintegration into society.
So, with that backgorund, my question to you is: Do you believe all mental illness is caused by childhood trauma, or do you allow that biological mechanisms are responsible for some illnesses, such as schizophrenia? Or perhaps mental illness symptoms can have multiple causes, just as one could have a heart problem due to lifestyle factors or for other reasons, such as a congential defect, but still experinece similar symptoms? I could see how depression, for example, could have more than one cause. From personal experience, I used to think depression was sort of a personal attitude, but then a few years ago I changed birth control pills for a month and it made me feel depressed in a way I never experienced before or since. This experience made believe some people might natually have these different hormone levels (or other factors) that cause, or make them more prone to, depression. And after experiencing the schizophrenia of my sister, it seems so obvious something got off track in her brain, a misfiring, if you will. It is hard to believe this was caused by childhood trauma. Her childhood may not have been absolutely perfect, but I don't think it was filled with trauma (definitely not violence or abuse). If childhood trauma were the cause of schizophrenia, it seems like there would be a lot more people with schizophrenia than 1-2% of the population. Also there does seem to be a genetic component.
Looking around online, it seems like you are portrayed as a member of the anti-psychaitry movement. It's hard for me to believe that you would take such an extreme stance and disregard other factors involved in the functioning of our brains. I'm curious what your thinking on this matter is. If you have already discussed this topic somewhere, could you point me to that?
I really look forward to your response and thank you for all your great work in educating people about the significance of child abuse in society and the fundamental importance of treating children with respect.
AM: You have a very clear opinion about the causes of schizophrenia and about a non-traumatic childhood of your sister. So everything is okay. Why do you need then my agreement? I don't share your opinion, but it doesn't matter; we don't need to think in the same way.