Of Two Minds 

Two ways of looking at schizo-phrenia; one way of treating it.

John F. Nash and Andrea P. Yates: one a doctor of mathematics and a Nobel Prize winner; the other a registered nurse and housewife. One considered to have "a beautiful mind"; the other as having a mind tormented enough to kill her own children.

Both have been diagnosed as schizophrenic. But while John Nash lives out his life on a bucolic university campus, Andrea Yates will be in a correctional facility for at least 40 years.

The media portrayals of John Nash and Andrea Yates allow us a unique opportunity to put a face to this debilitating disease and to offer hope with regard to recovery.

Schizophrenia is a brain disorder believed to originate prenatally. Its symptoms -- hallucination and delusion -- do not usually appear until early adulthood. More than 2 million Americans (approximately 1 percent of the population) carry this diagnosis.

It is also an equal-opportunity mental illness. Sufferers are a diverse group, but their commonality lies in the limitations of the medical community that manages their care and the social stigma of having a mental illness that almost always takes friends and family by surprise.

John Nash's story gives hope to others who work to coexist in a productive way with this disease. Indeed, his self-created path to recovery may one day win him a second Nobel Prize. Andrea Yates, on the other hand, is still in full-blown sickness, even though she has the same capacity for recovery as Nash.

Their life stories demonstrate three major stages of this disease -- before symptoms emerge, acute illness, and integration of illness into one's life.

Young John Nash was precocious but with limited social skills. His teachers labeled him "backward," yet at age 14 he developed a fascination with classical mathematics. Andrea Yates was valedictorian of her high school, a champion swimmer, and experienced sailor. Like most teens, she held a part-time job.

John Nash completed his Ph.D. and taught at MIT for eight years before his illness became apparent. He first experienced symptoms when his wife became pregnant. During the height of his illness, Nash had hallucinations that included seeing "crypto-Communists," had delusions of thinking he was of "great religious importance," and heard voices.

In A Beautiful Mind, the movie of Nash's life, we see how Nash was led by his voices to compulsively decode "enemy messages" that appeared in daily newspapers. In his mind, peoples' lives depended on his breaking these codes. Hospitalization, medication, and therapy did not help him. The hallucinations and delusions persisted even as Nash periodically produced credible mathematical work.

Andrea Yates worked as a nurse in a cancer center. She married Rusty Yates when she was 25 and seems to have been symptom-free until the birth of her first child. At that point, she had a vision of someone being stabbed with a knife, probably the beginning of active hallucinations and delusions. Unrelenting voices in her head screamed at her that she was a bad mother and that her children had to die to be "saved."

John Nash's symptoms did not begin to abate until 1990 -- nearly 32 years after their dramatic onset. As depicted in A Beautiful Mind, it was Nash's fearless logical nature that broke the hold the hallucinations had on him. He recognized one inconsistency -- that a child in his hallucinations never aged -- and was able to admit to himself that what he was hearing and seeing was not true. He then detached from these hallucinations by consciously holding the belief that they didn't exist.

Just as John Nash made revolutionary strides in mathematics, his work on himself may well revolutionize future psychotherapeutic treatment of the schizophrenic. Along with appropriate medication, the Nash "self-talk" model places a significant tool for recovery and empowerment in the hands of the ill.

It is hoped that Nash's model will be seriously considered when new treatment protocols are developed so that tragedies such as Andrea Yates' situation will never reoccur.

Judy Shepps Battle lives in New Jersey and is an addictions specialist, consultant, and free-lance writer.

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