Treating Schizophrenia With Therapy

Researchers are testing cognitive behavioral therapy for coping with the delusions and hallucinations that torment people with schizophrenia.

Transcript courtesy of Australian ABC TV

May 30, 2003

KERRY O'BRIEN: More than one in a 100 Australians will be affected by schizophrenia at some time in their lives.

The condition affects the normal functioning of the brain, leading to disturbances in feelings, perception and behaviour.

Antipsychotic medication can help reduce the symptoms, but its success varies.

Now a team at Sydney's Macquarie University is exploring a new approach to coping with the delusions and hallucinations that torment people with schizophrenia.

Assisting with the research, a remarkable couple who have unwittingly become living proof that the theory just might work.

Tracy Bowden reports.

SEAN McARDLE: I hear voices all the time.

But some voices I hear really bother me.

I was up the ladder, and it's a pretty tall step ladder, and I was using a new pair of clippers and a voice said to me, "You're going to fall on these clippers today and they're going to go straight through you."

And then, as I was cutting, I had a delusion I could actually see myself falling with the ladder and falling straight through the clippers, and it frightened me.

If you don't understand schizophrenia, it's a living hell, it's just a living hell.

TRACY BOWDEN: No-one understood Sean McArdle when, as a boy, he started hearing voices.

It wasn't until he was 32 that he was diagnosed with schizophrenia.

He and his wife of 26 years, Kerrie McArdle, have learnt to live with the delusions and hallucinations but it's still a struggle.

SEAN McARDLE: By the end of the day, by me doing what I want to do, you're exhausted.

You're mentally exhausted fighting off the voices.

PROFESSOR MAX COLTHEART, MACQUARIE CENTRE FOR COGNITIVE STUDIES: We're trying to work out an understanding of where delusional beliefs come from.

TRACY BOWDEN: Sean McArdle is part of a Federal Government-funded research project that could have a dramatic impact on the way schizophrenia is treated.

PROFESSOR MAX COLTHEAT: When you hear these voices, are they always saying sort of unpleasant or dangerous things to you or is it ever nice?

SEAN McARDLE: I have voices I confide in.

I know it sounds mad, but I confide in them.

We have the best conversations.

Some of them like, without a word of a lie, they're so clever.

They're 15 years ahead of their time.

They can predict things.

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TRACY BOWDEN: Professor Max Coltheart and his team at Sydney's Macquarie University are investigating the mental basis of delusions in the hope that these thoughts can then be targeted in therapy sessions.

Sean McArdle, who stopped taking medication after a serious allergic reaction, gives researchers a rare insight into his world.

PROFESSOR MAX COLTHEAT: He gives us very good examples of the dangerous or hostile suggestions that these voices put to him.

So he's a really valuable source of ideas about what hallucinations are like and we need to know those to try and understand where they come from.

DR MELISSA GREEN, MACQUARIE CENTRE FOR COGNITIVE SCIENCE: The test is designed to examine where people's eyes are moving when they're making judgments about people's facial expressions.

People with schizophrenia tend to look in the wrong places when they're making social judgments, and that probably accounts for partly at least why they make incorrect social judgments or their interpersonal communication is compromised.

TRACY BOWDEN: Medication is an important and effective part of controlling schizophrenia but its success varies and for some, like Sean, the side effects can be traumatic.

SEAN McARDLE: I had such a dry mouth.

My vision would blur where I could hardly see.

I was like a zombie.

TRACY BOWDEN: Cognitive behavioral therapy ... in simple terms, reasoning with the person ... could provide an alternative.

Kerry and Sean McArdle approach his illness as a team.

When her husband is tormented by voices, Kerrie acts as the voice of reason.

KERRIE McARDLE: What I would say to Sean is, "You know they're not real and you know that what you're actually thinking is not going to happen."

PROFESSOR MAX COLTHEAT: In the case of Sean, he can do this by himself most of the time.

He's learnt these techniques.

Now and then things get a bit tough and Kerrie can just remind him about what the techniques are.

So he's a model of what I hope can happen with future patients ... they learn these techniques so that the symptoms are still there but they're manageable, you can cope with them.

SEAN McARDLE: I couldn't distinguish between the voices till I went there.

I can pinpoint delusions and thought disorders, and I couldn't before the role model.

So the program is having an effect on my mind.

TRACY BOWDEN: This remarkable couple devotes almost all their time to educating the community about mental illness.

Today, they're speaking to a group of psychology students.

SEAN McARDLE: You might come in here and you might think, "Oh, yeah, schizophrenia, oh, that's the freak show, they're the people that's in jail."

No.

I'm the real McCoy.

KERRIE McARDLE: A person with schizophrenia has one personality, they don't have a split personality, they don't have a multiple personality.

TRACY BOWDEN: The McArdles' experience shows that cognitive behavioural therapy can help people with schizophrenia.

The team at Macquarie University hopes to uncover the science of why it seems to work.

PROFESSOR MAX COLTHEAT: It would be wonderful if you could actually make the hallucinations go away by cognitive behavioural therapy.

But, even if you can't do that, if you can make the patient see that they're not real, they're still experiences but they're not real, then the patients are going to be much less distressed by the critical content of the hallucinations.

SEAN McARDLE: I'm not saying that medication is bad, but I'm living proof that you can survive schizophrenia without medication.

TRACY BOWDEN: At 52, Sean McArdle now accepts his illness as just a part of who he is.

SEAN McARDLE: When I was young, I didn't like being Sean McArdle and I used to think, "What have you done to me, God?"

But now I like being Sean McArdle.

So do I like having schizophrenia?

Yes, I do, and everything that comes with it.

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