What's schizophrenia?

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• Publié le: 06 juillet 2015
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information on schizophrenia Others may find it hard to comprehend what a individual with schizophrenia is talking about. In some cases, the person may spend hours entirely still, without chatting. On other occasions he or she may look fine, until they initiate explaining what they are in fact thinking. The effects of schizophrenia reach far beyond the person afflicted - schizophrenia does not only impact the individual with the dysfunction. Families, friends and society are influenced too. A sizable portion of people with schizophrenia have to depend on some others, because they are not able to hold a career or care for themselves. With appropriate management, sufferers can lead constructive lives, treatment can help minimize many of the signs of schizophrenia. But, many patients with the dysfunction have to cope with the conditions for life. This does not imply that a man or woman with schizophrenia who gets treatment cannot lead a satisfying, constructive and meaningful life in his or her society. Schizophrenia most commonly strikes between the ages of 15 to 25 among men, and about 25 to 35 in females. On many occasions the dysfunction builds up so gradually that the patient does not know he/she has it for quite a time. While, with other people it can assault quickly and develop fast. Schizophrenia, possibly many sicknesses combined - it is a multipart, chronic, harsh, and disabling brain condition and affects around 1% of all grown ups globally. Specialists say schizophrenia is possibly many ailments masquerading as one. Study indicates that schizophrenia is possibly to be the consequence of faulty neuronal development in the brain of the unborn infant, which later in life comes forth as a full-blown sickness. Schizophrenia impacts men and females equally. However, an article in the BMJ says that schizophrenia affects 1.4 males for every 1 woman. The Schizophrenic Disorders Clinic at the Stanford School of Medicine explains schizophrenia as "a thought dysfunction: a brain dysfunction that disturbs with a man or woman's ability to think clearly, manage emotions, make decisions, and relate to other folks." Schizophrenia is a severe brain ailment that interferes with natural brain and intellectual function. it can result in hallucinations, delusions, paranoia, and significant shortage of enthusiasm. Without management, schizophrenia affects the ability to think clearly, regulate emotions, and socialize properly with other people. It is often crippling and can deeply influence all areas of your life (for instance, becoming not able to vocation or go to school). Being told that you or someone you love has schizophrenia can be terrifying or even disastrous. The best way to improve your quality of life with schizophrenia is to learn as much as you can about this condition and then cling to the recommended management. There are quite a few kinds of schizophrenia, and the exact types are recognized based upon

signs and symptoms. The nearly all frequent class is paranoid schizophrenia, which causes frightened thoughts and listening to frightening voices. Schizophrenia does not include multiple personas and is not the same condition as dissociative identity dysfunction (also called multiplepersonalityailment or split personality). What causes schizophrenia? There are many theories about the cause of schizophrenia, but none have yet been confirmed. Schizophrenia may be a genetic disorder, since your odds of getting schizophrenia increase if you have a parent or sibling with the condition, but nearly all people with family members who have schizophrenia will not develop it. It may also be associated to problems experienced during pregnancy (such as undernourishment, or being exposed to a viral infection) that harms the unborn child's developing nervous system. John Nash, an American mathematician who worked at Princeton University, won the Nobel Prize in Economics and lived with paranoid schizophrenia nearly all of his life. He eventually succeeded to live without medication. A film was made of his life "A Beautiful Mind", which Nash says was "loosely accurate". A reasearch published in The Lancet found that schizophrenia with active psychosis is the third nearly all crippling condition after quadriplegia and dementia, and ahead of blindness and paraplegia. The word schizophrenia comes from the Greek word skhizein meaning "to split" and the Greek word Phrenos (phren) meaning "diaphragm, heart, mind". In 1910, the Swiss psychiatrist, Eugen Bleuler (1857-1939) coined the term Schizophrenie in a lecture in Berlin on April 24th, 1908. Nobody has been able to figure out one single cause. Experts believe several factors are normally involved in contributing to the onset of schizophrenia. The likely factors do not work in isolation, either. Evidence does suggest that genetic and environmental factors generally act together to induce schizophrenia. Evidence revealed that the diagnosis of schizophrenia has an inherited element, but it is also significantly influenced by environmental triggers. In other words, imagine your body is full of buttons, and some of those buttons consequence in schizophrenia if someone comes and presses them enough times and in the right sequences. The buttons would be your genetic susceptibility, while the individual pressing them would be the environmental variables. Your genes. If there is no historical past of schizophrenia in your family your odds of developing it are less than 1%. However, that risk rises to 10% if one of your parents was/is a patient. A gene that is probably the nearly all studied "schizophrenia gene" plays a astonishing role in the brain: It manages the start of new neurons as well as their integration into pre-existing brain circuits, according to a paper posted by Cell. A Swedish study found that schizophrenia and bipolar condition have the same genetic causes. Thirteen locations in the human genetic code may help demonstrate the cause of schizophrenia - a reasearch involving 59,000 people, 5,001 of whom had been clinically determined with schizophrenia, identified 22 genome locations, with 13 new ones that are thought to be involved in the development of schizophrenia. The scientists added

that of particular importance to schizophrenia were two genetically-determined processes - the "micro-RNA 137" pathway and the "calcium channel pathway". Principal investigator, Professor Patrick Sullivan, of the Center for Psychiatric Genomics at the University of North Carolina School of Medicine, said "This study gives us the best picture to date of two different pathways that might be going erroneous in people with schizophrenia. Now we need to focus our research very urgently on these two pathways in our pursuit to comprehend what causes this crippling mental sickness." Chemical imbalance in the brain. Specialists believe that an inequality of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. They also believe that this imbalance is nearly all likely induced by your genes making you prone to the ailment. Some research workers say other the levels of other neurotransmitters, for example serotonin, may also be involved. Changes in key brain functions, such as perception, emotion and behavior lead experts to conclude that the brain is the biological site of schizophrenia. Schizophrenia could be caused by problematic signaling in the brain, according to research posted in the journal Molecular Psychiatry. Family interactions. Although there is no evidence to prove or even indicate that family relationships might cause schizophrenia, some sufferers with the biological disorder believe family tension may trigger relapses. Environment. Although there is yet no definite proof, many suspect that prenatal or perinatal trauma, and viral infections may contribute to the development of the ailment. Perinatal means "occurring about 5 months before and up to one month after birth". Stressful experiences frequently precede the emergence of schizophrenia. Before any acute signs are apparent, people with schizophrenia habitually become bad-tempered, anxious, and unfocussed. This can trigger relationship problems, divorce and unemployment. These factors are frequently blamed for the onset of the illness, when really it was the other way round - the disorder induced the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused certain stresses or occurred as a result of them. Some drugs. Cannabis and LSD are known to cause schizophrenia relapses. According to the State Government of Victoria in Australia, for people with a predisposition to a psychotic ailment for example schizophrenia, usage of cannabis may trigger the first episode in what can be a disabling condition that lasts for the rest of their lives. The National Library of Medicine says that some prescription drugs, for example steroids and stimulants, can cause psychosis. The brain. Our brain consists of billions of nerve cells. Each nerve cell has branches that give out and receive messages from other nerve cells. The ending of these nerve cells release neurotransmitters - kinds of chemicals. These neurotransmitters carry messages from the endings of one nerve cell to the nerve cell body of another. In the brain of a person who has schizophrenia, this messaging system does not work properly.

Schizophrenia causes two groups of signs: negative conditions and positive symptoms. Negative signs and symptoms generally include apathy or lack of motivation, self-neglect (such as not bathing), and reduced or improper emotion (for example becoming angry with strangers). Negative signs usually appear first and may be confused with depression. Positive symptoms, which generally appear later, include signs and symptoms for example hallucinations, delusions, and disorganized or confusing thoughts and speech. conditions of schizophrenia usually emerge in adolescence or early adulthood. symptoms can appear suddenly or may develop gradually, frequently causing the sickness to go unrecognized until it is in an advanced stage when it is more difficult to treat. How is schizophrenia identified? Schizophrenia is clinically determined primarily with a medical history and a mental health assessment. Other tests, for example blood tests or imaging tests, may be done to rule out other conditions that can mimic symptoms of schizophrenia. How is schizophrenia treated? There is no treat for schizophrenia, but many people can successfully manage their symptoms with medicinal drugs and professional counseling. Consistent, long-term treatment is very important to the effective management of schizophrenia. Unhappily, people with schizophrenia frequently do not seek management or they stop treatment due to unpleasant unintended effects of prescription drugs or lack of support. There is, to date, no physical or laboratory test that can absolutely diagnose schizophrenia. The doctor, a psychiatrist, will make a diagnosis based on the person afflicted's clinical signs. However, physical testing can rule out some other disorders and conditions which sometimes have similar symptoms, for example seizure disorders, thyroid dysfunction, brain tumor, drug use, and metabolic disorders. conditions and signs of schizophrenia will vary, depending on the person. The symptoms are classified into four categories: Positive signs and symptoms - also known as psychotic conditions. These are symptoms that appear, which people without schizophrenia do not have. for example, delusion. Negative conditions - these refer to elements that are taken away from the person; loss or absence of normal traits or abilities that people without schizophrenia normally have. let's say, blunted emotion. Cognitive signs and symptoms - these are signs and symptoms within the person's thought processes. They may be positive or negative conditions, just for instance, poor concentration is a negative sign. Emotional conditions - these are conditions within the person's feelings. They are usually negative symptoms, for example blunted emotions. Below is a list of the major symptoms:

Delusions - The patient has false beliefs of persecution, guilt of grandeur. He/she may feel things are being controlled from outside. It is not uncommon for people with schizophrenia to describe plots against them. They may think they have extraordinary powers and gifts. Some sufferers with schizophrenia may hide in order to protect themselves from an imagined persecution. Hallucinations - hearing voices is much more typical than seeing, feeling, tasting, or smelling things which are not there, but look as if very real to the sufferer. Thought dysfunction - the person may jump from one subject to another for no logical reason. The speaker may be hard to follow. The person afflicted's speech might be muddled and incoherent. In some cases the patient may believe that somebody is messing with his/her mind. Other signs and symptoms schizophrenia sufferers may experience include: Lack of motivation (avolition) - the sufferer loses his/her drive. Everyday automatic actions, for example washing and cooking are abandoned. It is significant that those close to the sufferer understand that this loss of drive is due to the sickness, and has nothing to do with slothfulness. Poor expression of emotions - responses to happy or sad occasions may be lacking, or improper. Social withdrawal - when a person afflicted with schizophrenia withdraws socially it is frequently because he/she believes somebody is going to harm them. Other reasons could be a fear of interacting with other humans because of poor social skills. Unaware of biological disorder - as the hallucinations and delusions look as if so real for the sufferers, many of them may not believe they are unwell. They may refuse to take prescriptions which could help them enormously for fear of side-effects, just for instance. Cognitive difficulties - the patient's ability to concentrate, remember things, plan ahead, and to organize himself/herself are affected. Communication becomes more difficult. Impaired eye movements linked to schizophrenia - research workers from the University of British Columbia explained in the Journal of Neuroscience that people with schizophrenia find it harder to follow a moving dot on a computer screen. Tests and diagnosis: A schizophrenia diagnosis is carried out by observing the actions of the sufferer. If the doctor suspects possible schizophrenia, they will need to know about the sufferer's medical and psychiatric history. Certain tests will be ordered to rule out other illnesses and conditions that may trigger schizophrenia-like conditions. Examples of some of the tests may include: Blood tests - to determine CBC (complete blood count) as well as some other blood tests. Imaging studies - to rule out tumors, problems in the structure of the brain, and other conditions/health problems. Psychological evaluation - a specialist will assess the person afflicted's mental state by asking about thoughts, moods, hallucinations, suicidal traits, violent tendencies or potential for physical violence, as well as observing their demeanor and appearance. Schizophrenia - Diagnostic Criteria: patients must meet the criteria laid down in the DSM

(Diagnostic and Statistical Manual of Mental Disorders). It is an American Psychiatric Association manual that is used by health care professionals to diagnose mental health problems and conditions. The health care professional needs to exclude other possiblemental healthdisorders, such as bipolar dysfunction or schizoaffective illness. It is also important to establish that the signs and symptoms have not been brought about by, let's say, a prescribed medication, a medical condition, or substance abuse. Also, the patient must: Have at least two of the following typical signs and symptoms of schizophrenia - Delusions, Disorganized or catatonic behavior, Disorganized speech, Hallucinations, Negative signs that are present for much of the time during the last four weeks. Experience considerable impairment in the capability to attend school, carry out their work duties, or carry out every day tasks. Have conditions which persist for six months or more. Sometimes, the person with schizophrenia may find their signs frightening, and conceal them from some others. If there is severe paranoia, they may be suspicious of family or acquaintances who try to help. There are many elements in disease that make it difficult to confirm a schizophrenia diagnosis. Collecting neurons from the nose to diagnose schizophrenia - researchers from Tel Aviv University, Israel, reported in Neurobiology of disorder that collecting neurons from the nose of the patient may be a rapid way to test for schizophrenia. Noam Shomron of TAU's Sackler Faculty of Medicine, and team describe how they devised a potential way of diagnosing schizophrenia by testing microRNA molecules found in the neurons inside the sufferer's nose. A sample can be taken via a simple biopsy. Shomron believes this could become a "more sure-fire" way of diagnosing schizophrenia than ever before. It may also be a way of detecting the disastrous disorder earlier on. Schizophrenia treatment is usually much more effectual if it can start during the early stages. Are autism and schizophrenia related? - when seen at first glance, autism and schizophrenia appear to be totally dissimilar disorders. However, a discovery made by researchers at Tel Aviv University's Sackler Faculty of Medicine and the Sheba Medical Center showed that the two disorders have similar roots, and are linked to other mental conditions, for example bipolar condition. Both schizophrenia and autism share come traits, including a limited ability to lead a normal life function in the real world, as well as cognitive and social dysfunction. The scientists found a genetic link between the two disorders, which causes a higher danger within family members. Dr. Mark Weiser and team found that people with a sibling with schizophrenia had a twelve-fold elevated chance of having autism than those without schizophrenia in the family. Schizophrenia genetically linked to four other mental health problems or disorders - researchers the Cross Disorders Group of the Psychiatric Genomic Consortium reported that schizophrenia, major depressive disorder, bipolar illness, autism spectrum disorders, and ADHD (attention-deficit hyperactivity disorder) share the same ordinary inherited genetic faults. Does schizophrenia begin in the womb? Stem cell study says yes - researchers from the Salk Institute in California have demonstrated that neurons from skin cells of patients with

schizophrenia behave oddly in early stages of development, supporting the theory that schizophrenia begins in the womb. The researchers, who published their results in the journal Molecular Psychiatry, say their findings could provide clues for how to detect and treat the disorder early. Research workers identify genetic mutations that may cause schizophrenia - Schizophrenia affects around 2.4 million grown ups in the US. The exact cause of the condition is unknown, but past study has suggested that genetics may play a part. Now, investigators from the Columbia University Medical Center in New York, NY, have uncovered clues that may build on this idea. The study team posted their findings in the journal Neuron. Schizophrenia and cannabis use may have genetic link - There is growing evidence that cannabis use is a cause of schizophrenia and now a new reasearch led by King's College London, UK, also finds increased cannabis use and schizophrenia may have genes in ordinary. How a genetic variation 'may increase schizophrenia danger' - The exact causes of schizophrenia are unknown, but past study has suggested that some folks with the condition possess certain genetic variations. Now, research workers at Johns Hopkins University School of Medicine in Baltimore, MD, say they have begun to understand how one schizophrenia-related genetic variation influences brain cell development. Research workers identify more than 80 new genes linked to schizophrenia - What causes schizophrenia has long baffled scientists. But in what is deemed the largest ever molecular genetic study of schizophrenia, a team of international research workers has pinpointed 108 genes linked to the condition - 83 of which are newly discovered - that may help identify its causes and pave the way for new interventions. Schizophrenia 'made up of eight specific genetic disorders' - Past scientific tests have indicated that rather than being a single disorder, schizophrenia is a collection of different disorders. Now, a new reasearch by research workers at Washington University in St. Louis, MO, claims the condition consists of eight distinct genetic disorders, all of which present their own specific conditions. Brain network vulnerable to Alzheimer's and schizophrenia identified - New research has emerged that reveals a specific brain network - that is the last to develop and the first to show signs of neurodegeneration - is more vulnerable to unhealthy aging as well as to disorders that emerge in young people, shedding light on conditions for example Alzheimer's illness and schizophrenia. handling options: The UK's National Health Service4 says it is essential that schizophrenia is recognized as early as possible, because the odds of a recuperation are much greater the earlier it is treated. Psychiatrists say the nearly all effectual treatment for schizophrenia patients is usually a combination of medicine, psychological counseling, and self-help resources. Anti-psychosis drugs have transformed schizophrenia treatment. Thanks to them, many sufferers are able to live in the community, rather than stay in hospital. In many parts of the world care is delivered in the community, rather than in hospital. The primary schizophrenia treatment is medication. Sadly, compliance is a major problem. Compliance, in medicine, means following the

medicine regimen. People with schizophrenia often go off their medication for long periods during their lives, at huge personal costs to themselves and frequently to those around them as well. The Cleveland Clinic says that the sufferer must continue taking medication even when conditions are gone, otherwise they will come back. many sufferers go off their medication within the first year of treatment. In order to address this, successful schizophrenia handling needs to consist of a life- long regimen of both drug and psychosocial, support therapies. The medication can help control the person afflicted's hallucinations and delusions, but it cannot help them learn to communicate with other people, get a occupation, and thrive in society. Although a significant number of people with schizophrenia live in poverty, this does not have to be the case. A individual with schizophrenia who complies with the handling regimen long-term will be able to lead a happy and positive life. The first time a man or woman experiences schizophrenia conditions can be very unpleasant. He/she may take a long time to recover, and that recovery can be a lonely experience. It is crucial that a schizophrenia patient receives the full support of his/her family, friends, and society services when start appears for the first time. prescription drugs: The medical management of schizophrenia generally involves drugs for psychosis, depression and anxiety. This is since schizophrenia is a combination of thought disorder, mood ailment and anxiety ailment. The most ordinary antipsychotic drugs are Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel), Ziprasidone (Geodon), and Clozapine (Clozaril): Risperidone (Risperdal) - introduced in America in 1994. This drug is less sedating than other atypical antipsychotics. There is a higher probability, compared to other atypical antipsychotics, of extrapyramidal conditions (affecting the extrapyramidal motor system, a neural network located in the brain that is involved in the coordination of movement). Although weight gain and diabetes are possible risks, they are less possibly to happen, compared with Clozapine or Olanzapine. Olanzapine (Zyprexa) - permitted in the USA in 1996. A typical dose is 10 to 20 mg per day. danger of extrapyramidal symptoms is low, compared to Risperidone. This drug may also improve negative conditions. However, the risks of serious weight gain and the development of diabetes are significant. Quetiapine (Seroquel) - came onto the market in America in 1997. Typical dose is between 400 to 800 mg per day. If the patient is resistant to handling the dose may be elevated. The danger of extrapyramidal signs and symptoms is low, compared to Risperidone. There is a risk of weight gain and diabetes, however the risk is lower than Clozapine or Olanzapine. Ziprasidone (Geodon) - became available in the USA in 2001. Typical doses range from 80 to 160 mg per day. This drug can be given orally or by intramuscular administration. The risk of extrapyramidal conditions is low. The danger of weight gain and diabetes is lower than other atypical antipsychotics. However, it might contribute to cardiac arrhythmia, and must not be taken together with other drugs that also have this side effect. Clozapine (Clozaril) - has been available in the USA since 1990. A typical dose ranges from 300 to 700 mg per day. It is very effective for sufferers who have been resistant to treatment. It is known to lower suicidal behaviors. patients must have their blood regularly monitored as it can affect the white blood cell count. The risk of weight gain and diabetes is significant.

How common is schizophrenia? The prevalence of schizophrenia worldwide varies slightly, depending on which report you look at, from about 0.7% to 1.2% of the adult population in general. Nearly all of these percentages refer to people suffering from schizophrenia "at some time during their lives". An Australian reasearch found that schizophrenia is more ordinary in developed nations than developing ones. It also found that the sickness is less widespread than previously thought. Estimates of 10 per 1,000 people should be changed to 7 or 8 per 1,000 people, the study concluded. In the USA about 2.2 million grown ups, or about 1.1% of the population age 18 and older in a given year have schizophrenia. Schizophrenia is not a 'very' common disorder. Approximately 1% of people throughout the globe suffer from schizophrenia (or perhaps a little less than 1% in developing countries) at some point in their lives. It is estimated that about 1.2% of Americans, a total of 3.2 million people, have the condition at some point in their lives. throughout the world, about 1.5 million people each year are identified with schizophrenia. In the UK it is estimated that about 600,000 people have schizophrenia. Sometimes people understand psychosis or schizophrenia to be unrelenting, even with the intervention of psychotherapy. It is contended herein that remedy, and humanistic therapy in particular, can be helpful to the psychotic individual, but, perhaps, the therapist may have difficulty understanding how this approach can be applied to the problems of psychosis. Although it is a prevalent opinion in our society that schizophrenics are not responsive to psychotherapy, it is asserted herein that any therapist can relate in a psychotic individual, and, if therapy is unsuccessful, this failure may stem from the therapist's qualities instead of those of the psychotic individual. Carl Rogers created a theory and therapy indicated by the terms "umanistic theory" and "person- centered therapy". This theoretical perspective postulates many essential ideas, and several of these thoughts are pertinent to this discussion. The first of these is the idea of "conditions of worth", and the idea of "the actualizing tendency." Rogers asserts that our society applies to us "conditions of worth". This means that we must behave in certain ways in order to receive rewards, and receipt of these rewards imply that we are worthy if we behave in methods that are acceptable. As an example, in our society, we are rewarded with money when we do work that is represented by employment. In terms of the life of a schizophrenic, these conditions of worth are that from which stigmatization proceeds. The psychotic human beings in our society, without intentionality, do not behave in methods that produce rewards. Perhaps some people believe that schizophrenics are parasites in relation to our society. This estimation of the worth of these human beings serves only to compound their suffering. The mentally ill and psychotic folks, in particular, are destitute in social, personal and financial spheres.

Carl Roger's disapproved of conditions of worth, and, in fact, he believed that human beings and other organisms strive to fulfill their potential. This striving represents what Roger's termed "the actualizing tendency" and the "force of life." This growth enhancing aspect of life motivates all life forms to develop fully their own potential. Rogers believed that mental biological disorder reflects distortions of the actualizing tendency, based upon flawed conditions of worth. It is clear that psychotic people handle negatively skewed conditions of worth. It is an evident reality that the mentally unwell could more successfully exist in the world if stigmas were not applied to them. The mentally ill engage in self-denigration and self-laceration that culminate in the destruction of selfhood. This psychological violence toward the mentally ill is supported by non-mentally unwell other people. The sort of self-abuse by psychotic individuals would certainly abate if the normative dismissal of the mentally unwell as worthless is not perpetuated. In spite of a prevalent view that psychotic folks are unsuccessful in the context of psychotherapy, Roger's theory and remedy of compassion cannot be assumed to be unhelpful to the mentally ill. The key components of Rogers' approach to psychotherapy include unconditional positive regard, accurate empathy and genuineness. Unconditional positive regard, accurate empathy and genuineness are considered to be qualities of the therapist enacted in relation to the client in terms of humanistic therapy. These qualities are indispensable to the process of humanistic remedy. In terms of these qualities, unconditional positive regard is a view of a man or woman or client that is accepting and warm, no matter what that man or woman in remedy reveals in terms of his or her emotional problems or experiences. This means that an person in the context of humanistic psychotherapy, or in remedy with a humanistic psychologist or therapist, should expect the therapist to be accepting of whatever that person reveals to the therapist. In this context, the therapist will be accepting and understanding regardless of what one tells the therapist. Accurate empathy is represented as understanding a client from that person's own perspective. This means that the humanistic psychologist or therapist will be able to perceive you as you perceive yourself, and that he will feel sympathy for you on the basis of the knowledge of your reality. He will know you in terms of knowing your thoughts and feelings toward yourself, and he will feel empathy and compassion for you based on that fact. As another quality enacted by the humanistic therapist, genuineness is truthfulness in one's presentation toward the client; it is integrity or a self-representation that is real. To be genuine with a client reflects qualities in a therapist that entail more than simply being a therapist. It has to do with being an authentic person with one's client. Carl Rogers believed that, as a therapist, one could be authentic and deliberate simultaneously. This means that the therapist can be a "real" person, even while he is intentionally saying and doing what's required to help you.

The goal of therapy from the humanistic orientation is to allow the client to achieve congruence in term of his real self and his ideal self. This means that what a person is and what he wants to be should become the same as remedy progresses. self-confidence that is achieved in therapy will allow the client to elevate his sense of what he is, and self-confidence will also lessen his need to be better than what he is. Essentially, as the real self is more accepted by the client, and his raised self-confidence will allow him to be less than some kind of "ideal" self that he feels he is compelled to be. It is the qualities of unconditional positive regard, accurate empathy and genuineness in the humanistic therapist that allow the therapist to assist the client in cultivating congruence between the real self and the ideal self from that client's perspective. What the schizophrenic experiences can be confusing. It is clear that most therapists, psychiatrists and clinicians cannot understand the perspectives of the chronically mentally unwell. Perhaps if they could understand what it is to feel oneself to be in a solitary prison of one's skin and a visceral isolation within one's mind, with hallucinations clamoring, then the clinicians who treat mental biological disorder would be able to better empathize with the mentally ill. The problem with clinicians' empathy for the mentally ill is that the views of mentally unwell people are remote and unthinkable to them. Perhaps the solitariness within the thoughts of schizophrenics is the most painful aspect of being schizophrenics, even while auditory hallucinations can form what seems to be a mental populace. Based upon standards that make them feel inadequate, the mentally ill respond to stigma by internalizing it. If the mentally unwell man or woman can achieve the goal of congruence between the real self and the ideal self, their expectations regarding who "they should be" may be reconciled with an acceptance of "who they are". As they lower their high standards regarding who they should be, their acceptance of their real selves may follow naturally. Carl Rogers said, "As I accept myself as I am, only then can I vary." In humanistic remedy, the therapist can help even a schizophrenic accept who they are by reflecting acceptance of the psychotic individual. This may culminate in curativeness, although perhaps not a complete remedy. However, when the schizophrenic becomes more able to accept who they are, they can then alter. Social acceptance is crucial for coping with schizophrenia, and social acceptance leads to self-acceptance by the schizophrenic. The accepting therapist can be a key component in reducing the negative consequences of stigma as it has affected the mental unwell sufferer client. This, then, relates to conditions of worth and the actualizing tendency. "Conditions of worth" affect the mentally unwell more seriously than other people. Simple acceptance and empathy by a clinician may be curative to some extent, even for the chronically mentally unwell. If the schizophrenic individual is released from conditions of worth that are entailed by stigmatization, then perhaps the actualizing tendency would assert itself in them in a positive way, lacking distortion.