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Copyright © 2020, 2021, by Professor Brett Kahr. Please do not quote without the permission of the author.
I have worked in the mental health profession for over forty years, during which time I have encountered far too many types of extreme psychopathology: forensic patients, such as pedophiles, rapists, and murderers; survivors of sadistic abuse; post-traumatically stressed soldiers who have witnessed the deaths of comrades on the battlefield; self-cutters and those who have attempted suicide; alcohol and drug addicts; victims and perpetrators of severe domestic violence; major depressives; and many others besides, including, most recently, those who have succumbed to life-threatening breathing difficulties or who have become bereaved through the wretched, horrific COVID-19 pandemic.
Although every single one of these aforementioned patients will have experienced deep distress of one form or another, few people will have struggled as intensely and as painfully and as chronically as those who have come to receive a formal diagnosis of schizophrenia.
Those men and women who must combat this vicious variety of psychotic illness will often manifest a veritable tsunami of symptoms, ranging from frightening auditory hallucinations to terrifying persecutory delusions. Tragically, patients with particularly severe forms of schizophrenia will often descend into seemingly irreversible catatonic states, imagining themselves to be already dead and, hence, unwilling or unable either to speak or to move.
I first began to practice psychotherapy as a very young trainee psychologist, working at a rather run-down British psychiatric hospital built in the 1840s and located in a tiny village, some sixty miles outside of London. In spite of the decrepitude and backwardness of this old-fashioned institution, I had the privilege of receiving clinical supervision from a very kindly consultant psychiatrist who had trained, years previously, with some of Anna Freud's disciples. Knowing of my i