CHANGE THE NAME OF SCHIZOPHRENIA

Schizophrenia is a mental illness characterized by thought disorder, perceptual disorders and abnormal social and personal behavior, in general terms. The name of this illness was coined by  the Swiss Psychiatrist Eugene Bleuler one hundred years ago. Before him this mental malady was called Dementia Praecox by the

Emil Kraepelin

German Psychiatrist Emil Kraepelin. Both these terms gave some hints to the inner nature of the ailment. Kraepelin thought that the person afflicted with the illness become demented prematurely and hence the name dementia praecox. Blueler's naming hints to the real cause of the illness. He thought that the mind is split in a person suffering from the disease.
Dr. Mohan Isac a psychiatrist and researcher from Fremantle Hospital, the University of Western Australia participating in a Continuing Medical Education program of the Kerala Branch of the Indian Psychiatric Society, presented his thinking about the changes in concepts and nomenclature of the enigmatic mental illness of schizophrenia. He suggested it is high time to change the name of schizophrenia and proposed "Kraepelin-Bleuler disorder" as a passing remark.
I am also of opinion that it is high time to change the name of schizophrenia. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition - DSM-5  

Eugene Bleuler 

schizophrenia is included in the chapter on Schizophrenia Spectrum and Other Psychotic Disorders. There are two concepts in this terminology. The first concept is that the schizophrenia is a psychotic disorder. The second idea is that schizophrenia is not a single illness, it is the name of a spectrum of illnesses. Both are agreeable concepts. The DSM-5 gives the key features of psychotic disorders. They are delusions, hallucinations, disorganised thinking and speech, disorganised behaviours and negative symptoms such as diminished emotional expressions, inactivity and keeping aloof.
The functional neuro-imaging studies of the brain conducted in schizophrenic patients show poor mentational ability and abnormal activity in Pre-Frontal Cortex of the brain. Evidently the psychotic disorders including schizophrenia are disorders of mentation and psychoses can be renamed as Mentational Disorders.        

MY SELF AND MY MIND

My Self is present only when I am awake. When I was asleep I missed the happenings around me; I was not aware of my surroundings. I was unconscious. When I woke up I regained consciousness.

Consciousness is not merely wakefulness.  When I wake up from sleep I do not look around vacantly, taking in the sights and the sounds around me as if my wake mind belonged to no one. I am the proprietor of my mind. I am aware of each and every happenings and things around me. The myriad of contents displayed in my mind are connected with me through invisible strings  and I feel or experience these connections with me.  In other words my consciousness is endowed with subjectivity. ‘I’ move forward and look back with this innumerable things displayed and connected with me. This forward-moving merriment in me is my Self.

Search for Self

Search for self had been going on from time immemorial. Brihadaranyaka Upanishad is a treatise on Self and the great saint who composed it found that Self is the infinite universe. (Aham Brahmāsmi)

Aristotle 

Buddhist tradition holds that the root cause of suffering is the Ordinary Man’s erroneous view of Self as an unchanging essence. Furthermore, the tradition holds that this error is inevitable in the natural course of life because it is based on inborn patterns, pre-theoretic and unreasoned. 

Aristotle, following Plato, defined the soul as the core essence of a living being, but argued against its having a separate existence. Aristotle also believed that there were four sections of the soul: the calculative and scientific parts on the rational side used for making decisions, and the desiderative and vegetative parts on the irrational side responsible for identifying our needs.

 Avicenna  said that the idea of the self is not logically dependent on any physical thing, and that the soul should not be seen in relative terms, but as a primary substance. This

Avicenna

argument was later refined and simplified by René Descartes in epistemic terms when he stated: "I can abstract from the supposition of all external things, but not from the supposition of my own consciousness."

An eighteenth century philosopher David Hume thought that Self is a bundle of perceptions. “For my part, when I enter most intimately into what I call myself, I always stumble on some particular perception or other

of heat or cold, light or she, love or hatred, pain or pleasure. I never can catch myself as any time without a perception, and never can perceive anything but the perception.  When my perceptions are removed for any time, as by sound sleep, so long am I insensible to myself,  and may truly be said not to exist. And were all my perceptions removed by death, and could I neither think, nor feel, nor see, nor love, nor hate after the dissolution of my body.” David Hume: A Treaties on Human Nature.

All these were brilliant imaginative speculations by the fertile brains of the past. The first psychological enquiry of Self came from William James, an American psychologist who initiated scientific psychological enquiries. He admired Hume’s dazzling speculation on Self, but criticised. “But Hume, after doing this good piece of introspective work, proceeds to pour out the child in the bath, and fly to as great an extreme as the substantialist philosophers. As they say Self is nothing but Unity, unity abstract and absolute, so Hume says it is nothing but Diversity, diversity abstract and absolute; whereas in truth it is that mixture of unity and diversity which we ourselves have already found so easy to pick apart… he denies this thread of resemblance, this core of sameness running through the ingredients of the Self, to exist even as a phenomenal thing.”

Let us leave the brilliant speculations on Self and consciousness in the past. The conscious mind and its proprietor the Self are constructs of the brain. In a series of pioneering studies conducted in North America and Italy during the middle of the twentieth century established with certainty that the brain stem is the

Brain stem

critical contributor to consciousness. More recent studies conducted in neurological patients whose consciousness was compromised by focal brain damage.

Relationship between consciousness and self

Portuguese-American neuroscientist, Antonio Damasio in his marvelous book Self Comes to Mind says: “When selves do not occur within minds, those minds are not conscious in the proper sense. This is a

Antonio Damasio

predicament faced by humans whose self process is suspended by dreamless sleep, anaesthesia, or brain disease.”

Two notions of Self

The Self is a process and not a thing, and this process is present all times when we are conscious. We can consider the Self from two vantage points. One is the vantage point of an observer appreciating a dynamic object.  This dynamic object is constituted by certain working of minds, certain traits of behaviour, and a certain history of life.

The other vantage point is that of the self as knower. This is a process that gives a focus to our experiences and eventually lets us reflect on those experiences. Combining the two vantage points produces a dual concept to Self. In everyday life each concept corresponds to a level of operation of conscious mind, the Self-as-object being simpler in scope than the Self-as-knower. There is no dichotomy between the two. The simpler Self-as-object evolved earlier in the course of evolution and the later evolved Self-as-knower is piled up on the top of the Self-as-object.

The Self as the witness of the mind

Countless creatures for millions of years have had active minds happening in their brains. But only after those brains developed a self as the protagonist capable of bearing witness did consciousness begin, in the strict sense, and only after those brains developed language did it become widely known that minds did exist. The Self, as the witness, is the protagonist is something extra that reveals the presence of implicit brain events that we call mental. Understanding how the brain produces that something extra, the protagonist we carry around  and call self, or me, or I, is an important goal of the neurobiology of consciousness. 

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Curse of knowledge and other cognitive biases that lead to wrong decision making

A person may be consciously biased towards or against an ideology, a political party, a religion, a creed, a caste, a country, an ethnic group etc. But a cognitive bias is different from such conscious partisanship. Cognitive bias is an unconscious psychological process which guides the individual in decision making without the individual’s conscious awareness. It is the result of perceptual distortion, inaccurate judgment, or illogical interpretation of facts. A conglomeration of these is called irrationality.

Cognitive biases are the result of distortions in the human mind that always lead to the same pattern of poor judgment, often triggered by a particular situation. But how can one person decide the judgment of another person poor? In order to decide the judgment to be poor there should a standard of “good judgment”.  In scientific investigations of cognitive bias, the source of “good judgment” is that of people outside the situation which is presumed to cause the poor judgment or a set of independently verifiable facts.

Positive side of cognitive biases

According to the evolutionary psychology some cognitive biases are adaptive and beneficial because they lead to more effective actions in given contexts or enable faster decisions when faster decisions are of greater value for survival or reproduction.  

Some common cognitive biases

Anchoring

This common cognitive bias is also called focalism. It refers to a common human tendency to rely too heavily, or “anchor” on one piece of information when making decisions. During normal decision making anchoring occurs when individuals overly rely on a specific piece of information to govern their thought-process. Once the anchor is set, there is a bias toward adjusting or interpreting other information to reflect the “anchored” information. Through this cognitive bias, the first information about a subject can affect future decision making and analysis of new information. For example when a person looks to buy a used car he/she may focus attention excessively on the distance travelled by it as indicated by the odometer rather than considering how well the engine or the transmission is maintained.

Focusing effect

Daniel Kahneman 

It is also called focusing illusion. This cognitive bias occurs when people place too much importance to an event, causing an error in accurately predicting the utility of future outcome.  In economics utility means a measure of satisfaction. People focus on notable differences, excluding those that are less conspicuous, when making predictions about happiness or convenience. For example, a rise in income has only a small and transient effect on happiness and well-being, but people consistently overestimate this effect. Nobel laureate Israeli-American psychologist Daniel Kahneman and associates proposed that this is as a result of a focusing illusion, with which people focusing on conventional measured of achievement rather than on everyday routine. Kahneman writes: “Surveys in many countries conducted over decades indicate that, on average, reported global judgments of life satisfaction or happiness have not changed much over the last four decades, in spite of large increase in real income per capita. While reported life satisfaction and household income are positively correlated in a cross-section of people at a given time, increase in income has found to have mainly transitory effect on individuals’ reported life satisfaction.” (Would You Be Happier If You Were Richer? By Daniel Kahneman et. al. CEPS Working Paper No. 125 May 2006)

Confirmation Bias

The confirmation bias refers to the tendency to selectively search for and consider information that confirms one's beliefs.

Examples: A student who is going to write a research paper may primarily search for information that would confirm his or her beliefs.  The student may fail to search for or fully consider information that is inconsistent with his or her beliefs.

A reporter who is writing an article on an important issue may only interview experts that support her or his views on the issue.

An employer who believes that a job applicant is highly intelligent may pay attention to only information that is consistent with the belief that the job applicant is highly intelligent.

Curse of knowledge

Robin Hogarth 

The curse of knowledge is a cognitive bias according to which better-informed individuals may have the disadvantage that they lose some ability to understand properly the lesser-informed individuals. As such added information may convey some disutility. The term “curse of knowledge” was coined by the film and TV music composer Robin Hogarth. In one experiment, one group of participants "tapped" a well-known song on a table while another group listened and tried to identify the song. Some "tappers" described a rich sensory experience in their heads as they tapped out the melody. Tappers on average estimated that 50% of listeners would identify the specific tune; in reality only 2.5% were able to. This means that the better informed individuals failed to understand properly the lesser informed individuals.  It has been argued that the curse of knowledge could contribute to the difficulty of teaching.

Conservatism

It is a cognitive bias. In 1973 British psychologist Glenn Wilson published an influential book providing evidence that a general factor underlying conservative beliefs is “fear of uncertainty.” An analysis of research papers in 2003 established that not only fear of uncertainty but many other psychological factors like intolerance of ambiguity and need for “cognitive closure” contribute to the degree of one’s political conservatism. The term cognitive closure has been defined as “a desire for definite knowledge on some issue and eschewal of confusion and ambiguity.” (European Review of Social Psychology No. 18 pps. 133-173)

Availability bias

Availability bias is a cognitive bias that causes many to overestimate probabilities of events associated with memorable or dramatic occurrences. More than a bias, it is a “cognitive illusion.” Since, memorable events are further magnified by coverage in the media; the bias is compounded on the society level. Two well-known examples would be estimations of the probability of plane accidents and the kidnap of children. Both events are quite rare, but the huge majority of the population outrageously overestimates their probability, and behaves accordingly. In reality, one is more likely to die from an automobile accident than from a plane accident, and a child has a higher risk of dying in an accident than the risk of getting kidnapped. Availability bias is at the root of many other human biases.