PTSD and Schizophrenia may be related as varying degrees of a similar malfunction.
I was describing a recent flashback to my therapist, and I finally got brave and actually described it without watering it down. I told her how it seemed so real, and that I could see, hear, feel, smell – everything- my past superimposing and flickering over my present – leaving me unsure for moments which age I actually was. I told her I was afraid to say that before, afraid I would get taken away and locked up. She smiled her sad smile at me, knowing what I meant. I asked her if any of her other clients describe flashbacks as powerful hallucinations – and she said yes.
So that got me thinking – woah – what if my brother’s schizophrenia is similar to my PTSD flashbacks? What if all hallucinations work on the same mechanism, the same spectrum of disorder, but that schizophrenia is much more severe?
What if schizophrenia is a flashback that doesn’t end with a safe return to reality? I shudder at the thought.
Turns out some recent studies have been thinking along the same lines. Check out this article: http://healingattention.org/documents/doc_litreviewpsychosis.pdf
Excerpts from that article:
“Paranoid delusions: faulty attempts to explain traumabased hallucinations? Some people, when faced
with negative, emotionally loaded, or unusual or anomalous experiences quickly jump to the
suspicion of external threat, i.e. they become paranoid. Hearing voices when there is nobody
there is often (but not always) a negative experience, and is often experienced as unusual
or anomalous. Paranoid delusions are sometimes, therefore, understandable attempts to make sense
of hallucinations (in various sense modalities) (106, 146–148, 155–157).
Paranoid delusions can, of course, develop in the absence of hallucinations. Is there a diﬀerence
between the hypervigilance to threat acknowledged in PTSD patients to be the outcome of
trauma and the belief that people are out to get you which is labelled delusional in traumatized
people diagnosed psychotic? (30, 33). Having been severely or repeatedly abused as a child is
likely to render other people a serious potential threat, a threat that can easily be generalized to
anyone or anything that is reminiscent of the perpetrator or the circumstances surrounding the
abuse. The processes by which hypervigilance develops into ﬁxed paranoid delusions would
appear to be a fruitful research avenue. Again, Nadel and Jacob’s (159) work on the impact of
trauma on the brain is salient. Whether we label this PTSD, DID or schizophrenia, the resulting
fear, distortions and impoverishment of lives remain. Heightened sensitivity to stressors: the Traumagenic
Neurodevelopmental (TN) model Many of the theories attempting to explain trauma’s relationships with hallucinations and
delusions, such as high levels of distress in the face of anomalous experiences and hypervigilance
to threat, are consistent with a heightened sensitivity to stress in general. A study of 271 severely ill
in-patients found that the two subscales of the Brief Symptom Inventory most strongly related to
sexual and physical abuse were psychoticism and interpersonal sensitivity (164).
Heightened reactivity to stressors is a cardinal feature of schizophrenia (165) and is considered
the core of the constitutional vulnerability that forms the diathesis in the stress-diathesis model.”
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