By Judy Marshall Ferraro, Ph.D.

[En español]

Schizophrenia is the most disabling and serious of all mental disorders. It is what is usually associated with insanity. All societies describe some variant of schizophrenia-like “madness.” In fact, the rate of occurrence is more or less similar throughout the world.

Most of us have an experiential awareness of one variant of schizophrenia, as a portion of the homeless are schizophrenic. We have all seen individuals dressed not just sloppily but oddly, with bodies rigid and contorted, shouting bizarre statements in an angry, wired fashion. Even a small child can pick up that there is something very basically wrong with their psychological functioning—and that it is tragic. There is so much suffering in schizophrenia.

Schizophrenia means “split mind.” Unfortunately, in popular culture this has been erroneously equated with “split personality,” but this has nothing to do with schizophrenia. With multiple or “split” personality, the idea is that at least two or more distinct personalities inside the person’s head are vying for control. Despite its popularity in the media, true multiple personality disorder is actually quite rare.

In contrast, the “split mind” in schizophrenia means that the mind of one personality is not functioning normally. It is not intact, but “split” or malfunctioning because the actual workings of the mind are so disjointed, disorganized or broken down. Mental processes seem to be fragmented, distorted or chaotic. The result is that thoughts, speech, emotions, and behavior are nonsensical and often chillingly bizarre.

Perhaps, one reason that so little is known about schizophrenia is that it is so disconcerting. We don’t want to deal with it. Schizophrenia affects those fundamental psychological processes that most of us take for granted. Try to imagine yourself unable to think in an organized fashion or to be able to trust your perceptions as real. Think of what it would be like to have terrifying nightmarish images that you are unable to turn off or to hear commanding voices inside your head. What would happen if you “knew” characters on television were controlling your mind or reading all your thoughts? What if you tried to communicate with others, but were unable to use basic, agreed-upon patterns of language?

This is a horrific scenario, but it gets worse. You would likely behave in ways that were entirely misunderstood and ridiculed. You would probably feel isolated and trapped within a mental cage of misperception, miscommunication, and confusion. In fact, you would most likely be perceived as threatening by others.

Being with a schizophrenic individual or truly understanding what happens in schizophrenia can be unnerving and almost always raises existential and philosophical issues because the disorder reminds us of the fragility of normal mental functioning. Schizophrenia also raises moral issues because it is a societal responsibility as well as an individual tragedy. It has been said that the true caliber of a society is revealed in how it treats its disabled members. Many people with schizophrenia clearly fall into this group.

Schizophrenic symptoms vary from person to person, and the more bizarre elements of the disorder are generally not present all the time, even if the condition goes untreated. There are also different types of schizophrenia. For example, in paranoid schizophrenia the bizarre disorganization is not evident on the surface, but underlying are disturbing delusions, which can be acted upon as though real.

Who is affected by schizophrenia? Most studies have found men and women are equally affected, although some research has suggested the disorder is more severe and possibly more common in men. Schizophrenia also appears in all races and social classes. In the United States, schizophrenia affects most cultural groups about equally.

These days most researchers feel that schizophrenia is primarily a biological disorder. The one factor that appreciably seems to bias the odds of getting schizophrenia is genetics. At the same time, it is equally clear that the disorder is not entirely genetically caused. The environment is also thought to play a part by some theorists. In this view, it is felt that the underlying biological disorder causes a predisposition for schizophrenia, which later becomes manifest because of stress.

Some people show marked improvement over time and some even recover from schizophrenia. On the other hand, all too often the disorder is very long-term, if not chronic, and can involve serious problems in basic functioning that require extensive management and ongoing care. The treatment of schizophrenia changed drastically in the 1950s with the introduction of anti-psychotic drugs. These medications reduce the bizarre symptoms—such as hallucinations, delusions, and some of the disorganized thinking. Still, anti-psychotic medications, which work on brain chemistry, are not a cure and do not work for everyone. Even with medication, there can be periodic relapses or residual problems, and there are significant dangers and side effects, which can make life very uncomfortable physically for the schizophrenic person.

The reality of schizophrenia is disturbing and confronts us with the vulnerability, interdependence, and inherent responsibility of all human beings. Schizophrenia is one of the most puzzling and unsettling aspects of the human condition. Schizophrenia forces us, both individually and as a society, beyond rhetoric and abstract attitudes. It is a call for action and true compassion. Whether we heed the call, perhaps like nothing else, demonstrates what our basic values really are. Even the fact that we are so ignorant of what schizophrenia actually involves in our politically correct “Information Age” speaks to a denial and stigma of staggering proportions.


Creative Commons License
Psychmaster/Judy Ferraro Articles by Judy Ferraro, Ph.D. is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Permissions beyond the scope of this license may be available at https://www.psychmaster.com/psychmaster-terms-of-use.html.
Judy Marshall Ferraro
About Judy Ferraro
California | United States

Dr. Judy Ferraro received her doctorate in clinical psychology from the University of North Carolina at Chapel Hill. In thirty years of clinical practice in New York and Los Angeles, she has worked with many different groups, from children to the frail elderly, with particular interests including self-esteem, depression, sensitivity, and creativity.

Care to Share?

Articles By Judy Marshall Ferraro


For most American adults, the period from Thanksgiving though New Year’s is a difficult time. We seem to be plunged into a virtual reality somewhere between a carnival and a nightmare. The streets and the malls are filled with lights, holiday melodies, and glittery ornaments. [Read more...] [En español]

ALZHEIMER'S DISEASE: Reality And Mystery

As people live longer, the specter of Alzheimer’s looms grimly on the horizon. A disease involving progressive brain deterioration, Alzheimer’s results in increasing deficits in mental functioning and behavior. By the middle and later stages, the individual is entirely dependent on others for protection and physical care on a round-the-clock basis. [Read more...] [En español]


The concepts of “stress” and “trauma” are broadly understood by almost everyone in modern society. In fact, we often use the words “stressed” and “traumatic” to describe our reactions to everyday events. Generally, with “stress” and “trauma,” what we are talking about are difficult, sometimes devastating situations that occur in the course of living. [Read more...] [En español]

DEPRESSION: A Negative “Altered” State?

Depression is one of the most painful of human experiences. People who are depressed may actually hurt. When we are depressed, every aspect of our experience is affected. The world tends to look dark, foreboding, or distant. The future seems bleak. Human contact becomes aversive. [Read more...] [En español]

MENTAL ILLNESS: Stigma And Reality

As a society, we are not well informed regarding mental health and illness. This is particularly surprising because we are relatively knowledgeable regarding physical health and illness. Certainly, there is a stigma attached to mental disorder or even unhappiness, despite the politically correct and ostensibly tolerant attitudes of our times. [Read more...] [En español]


By the time I was seven or eight years old, I had classified myself as a sensitive person. This was neither a good nor a bad thing. In my burgeoning self-awareness in the world I was discovering, I just knew I was one of those people who seemed very soft and gentle around the edges. [Read more...] [En español]


The holidays are a time of obvious contradictions and marked extremes. It is a season that invokes the highest spiritual ideals, yet spawns the crassest materialism. From Thanksgiving on, there is a palpable, busy ebullience and expectation “in the air,” which engulfs all of us. [Read more...] [En español]


As a psychologist with over twenty years of clinical experience, I believe that spirituality can transform personal psychology. After evaluating hundreds of people through the legal system, I began to notice that—no matter what the religion or country of origin—people who had faith or spirituality in their lives seemed to react similarly to trauma and challenges, but differently from those who were not spiritually involved. [Read more...] [En español]

SPIRITUALITY: Jumpstarting A Cycle Of Psychological Transformation?

There is a general consensus that spirituality is good for you. This may be the only point of agreement about spirituality these days. Traditionally associated with religion or the occult, spiritual belief and practice in the 21st century are variously and often personally defined. [Read more...] [En español]

SPIRITUALITY: Living Philosophy

In recent years, there has been a rebirth of interest in spirituality. Many people describe regular spiritual practice, which may or may not include affiliation with a traditional church or religious organization. Books and materials on spirituality have become big business. [Read more...] [En español]


Even in the simplest language, the word “sensitive” has positive and negative connotations. On the positive side, being “sensitive” implies a nice and caring person, someone who is considerate, understanding, and mindful of others. On the negative side, being “sensitive” can also mean a tendency to take things too personally, a touchiness, or tendency to overreact emotionally. [Read more...] [En español]


There once was an old farmer who lived in a remote region of the mainland, where the terrain is rough and the villagers manage to eek out a meager existence only through hard work and the grace of God. One day someone left the gate open on the farmer’s pasture, and his only horse ran away. [Read more...] [En español]


Schizophrenia is the most disabling and serious of all mental disorders. It is what is usually associated with insanity. All societies describe some variant of schizophrenia-like “madness.” In fact, the rate of occurrence is more or less similar throughout the world. [Read more...] [En español]

ART: An Emotional Bridge?

When I was in my early teens, I tried to spend every Saturday I could at the local art museum, sneaking into the city without my parents’ permission. Smaller than the Metropolitan in New York, but still noteworthy (not that I would have known), the museum was extraordinary and wondrous to me. [Read more...]

MAKING ART: A Spiritual Opening?

I never could draw well. But as a child, that never stopped me. My passion to make art was undaunted. I particularly loved color, especially all the different shades of reds and blues. For hours I would line up the crayons from my 64 superbox with great care, as though each was a cherished doll and had its own place and personality. [Read more...]


As someone who is more intuitive than logical by nature, I’ve never had a real need for proof. That being said, for many years into my adult life, I didn’t have a real need for God, either. I was more than happy to credit my intuitions to my sensitive nature and a kind of agnostic assumption that there were energies “out there” and between human beings that no one could clearly define. [Read more...]