Schizophrenia As a Deteriorating Disorder

An example of schizophrenic speech:

Financial service senses worries of 35 whirlpools below sound 1846, 45, 44, A.D. Augusta City treasury, Richmond County treasury, United States Treasury of Mississippi River flood area. Gentlemen will you come to…and idenafy none minastrative body that receives the life generated by fourth patented generative below sound.

Further arrange financial credit for same. Would like two bedrooms at up town Hotel and convenient to roof garden. Until you gentlemen decide further what my occupation is you may as well announce me as comforting 35 whirlpools below sound. May you gentlemen have gray eyes and thick bones as the flat sense minastrated are very valuable in idenafying me.

Surely not all schizophrenic speech is like this, which can be called “word salad,” but it can definitely look this way, especially in chronic schizophrenia or chronic paranoid schizophrenia. You can actually watch peoples’ prose declining as they get more ill and deteriorate over time, and after all, schizophrenia is known to be a deteriorating condition, at least for the first five years anyway.

I had a friend who was ill but not too ill, and he definitely had OCD and schizophrenia, which was a nightmare from a diagnostic perspective. It was really hard to parse out one from the other and especially to decide if he just had OCD or if he had schizophrenia + OCD, which is a new disorder called “schizo-obsessive disorder.”

This man definitely looked a lot like the description of this illness, especially with the prominent Scheiderinian symptoms that he had. He also seemed to have a fairly loose and not tight hold on his delusions and hallucinations, which is quite odd if not impossible with schizophrenia.

Worse still, I discovered that he was hiding psychotic symptoms from me. This is known to happen with some schizophrenics. It’s not that they don’t believe in them but instead that they figure out after a while that if they start saying certain things that are going on with them, they remember that in the past, every time they talked about this stuff, they got bundled up and hauled off to the hospital, so after a while, they start hiding symptoms.

Apparently the TV was talking to him and sending him special messages. This is an extremely common schizophrenic experience. For instance, if the TV says it’s going to rain today, that’s really a secret message being sent directly him in code that really means, say, “It’s time for him to go to the store and buy a pack of cigarettes.” On further questioning, he revealed that the TV was actually literally telling him these things and that they were very real. He chalked them up to this mysterious synchronicity stuff.

He also talked a lot about synchronicity and referred to himself experiencing many incidents of this nature. Problem is that there really are no incidents of this nature, and if you are experiencing this all the time, you are quite possibly psychotic, and you may indeed have schizophrenia.

For instance, he told me that he was at a party once, and he said something to the guy next to him and then whatever he said started getting passed around from one person to the person next to them in exactly the way he had said it. He could follow the conversation transiting the room in this extremely weird manner.

If this actually happened, of course, it would be quite extraordinary! I concluded that it didn’t happen. But his brain was such that he was literally experiencing this conversation going around the room from one person to the next, and he swore it really happened.

Sure, in his mind it happened, but since he experienced it as a direct experience the same we experience our own direct experiences, he believed quite reasonably that it obviously occurred. I wasn’t buying it and chalked it up to a psychotic symptom that is actually quite frighteningly common in schizophrenics.

Also, he had surely experienced a schizophrenic episode at around age 18, which is about the right age for a first episode of this disorder. It had lasted for 1 1/2 years and he had been hospitalized at some time during this episode. He also told me that he had no insight whatsoever when this was happening. He described it as “like a dream.” Thing is that if someone had schizophrenia between ages 18-20, it’s highly unlikely to “just go away” after that.

He was also experiencing the very Schneiderian symptom of hearing his own thoughts out loud in the room with his ears so that your thoughts seem like they are just as real as the real words you hear people speak every day. This is called thought broadcasting.

He told me that he was afraid that people on the bus could hear his thoughts. He tried to brush this off as “just OCD,” and he said that the thoughts in his head were so loud that he feared they were being broadcast out into the bus. As such, he had quit riding the bus.

However, no OCD person is ever going to say that their thoughts are so loud that they fear others can hear them. OCD’ers are quite able to differentiate between thoughts and voices at all times. In addition the OCD’er would probably just continue to rid the bus anyway. I figured he was disguising psychotic symptoms from me.

Also, he was apparently hearing voices. He was experiencing the next door neighbors saying bad things about him, as he could hear it through the walls. Most apartments nowadays have thick enough walls that there’s no way you can hear people talking on the other side. Just forget it.

He said they neighbors were saying that they thought he was a pedophile. Well, perhaps they were saying that, but there was no way that he could hear it through the wall if they were. When he remarked on this, his parents bundled him up and took him to the hospital where he was kept for a little while.

He thought this was grossly unfair as he insisted that the neighbors were absolutely saying this and that this could be heard through the wall. I’m sure that’s what he experienced but that doesn’t mean that that was what was really happening. I figured he was hearing voices.

He kept writing me back for a bit, and then I didn’t hear from him for 2-3 years. When he recontacted me then, he had declined so seriously that there was no real way to carry on a conversation with him. Although at first glance it looked like “racing thoughts,” I’m not sure how that plays out graphically in writing, and I doubt if most typical Bipolar types talk that nutty. It looked a lot like rapid jumping from one subject to the other.

Anyway, he had surely declined very badly over 2-3 years, and this was quite typical of schizophrenia in the early stages and not typical of all of OCD, which usually doesn’t present with a gradual deterioration of symptoms or at least not one that could be so easily recognized in writing. Even extremely ill OCD’ers don’t deteriorate like that, and their written communications typically make complete sense even when they are severely ill. I know this because I have had some extremely ill clients who nevertheless had prose that was very clear and coherent.

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