Schizophrenia: orthodoxy and heresies. A review of alternative possibilities

Conflicts about the nature, causes and treatment of schizophrenia have never ceased. Recently, however, a particular set of beliefs ('the Orthodoxy') has become influential, and dominates political and managerial agenda for controlling clinical practice and educational initiatives. Theories and therapeutic strategies that differ from the particular biological, behavioural, cognitive and family management approaches favoured by orthodox clinicians have been given far less academic and clinical air-space. This review surveys some alternative ideas and practices ('the Heresies') and critically refers to some of the orthodox tenets such as the genetic and biological bases of schizophrenia, the disease model, 'family blaming' and drug treatment. Heresies briefly explored include schizophrenia as an evolutionary inevitability, creative sublimation of schizotypal tendencies and systems-theory-based family therapies.