Can attachment theory help explain the relationship between childhood adversity and psychosis?

Abstract

For several decades our efforts to understand the causes of human distress, despair, and confusion have been impeded by the dominance of a simplistic, reductionist paradigm interested primarily or exclusively in genes and neurotransmitters (Bentall, 2003; Read, Mosher, & Bentall, 2004). This ‘medical model’ has been enthusiastically supported by the pharmaceutical industry, which has much to gain from promulgating an ideology that minimizes psycho-social causes (Mosher, Gosden, & Beder, 2004; Read, 2008). Although the dominance of this model pervades all categories of psychiatric diagnoses, nowhere has it been stronger or more damaging than in the field of psychosis. Since the invention of the supposed illness ‘schizophrenia’ a century ago (Bentall, 2003; Read, 2004a), millions of people worldwide have been condemned to the pessimistic, self-fulfilling, and stigmatizing belief that they are suffering from some kind of irreversible brain disease. This disease, which has wrongly been presented as largely genetically determined, supposedly has little or nothing to do with one’s life history or circumstances. It is important to realize that the public, all over the world, have never accepted the illness model of mental health problems in general, or of ‘schizophrenia’ in particular. In virtually every country where surveys have been conducted, the public believes that madness is primarily a reaction to bad things happening to people rather than bio-genetically based illnesses (Angermeyer & Dietrich, 2006; Read, 2007). Everywhere ‘schizophrenia’ is seen by the public (including patients and family members) to be caused by poverty, isolation, family problems, child abuse and neglect more than by faulty genes or brains. This is despite millions of dollars, often donated by drug companies,