Culture, Medicine, and Psychiatry

, Volume 36, Issue 1, pp 154–174 | Cite as

The Texture of the Real: Experimentation and Experience in Schizophrenia



The dominance of the neurosciences in psychiatric research raises questions about the relationship between research practices and the lived experience of mental illness. Here, I use data from a group of researchers focusing on neurocognition in schizophrenia to explore the problem of representation in psychiatric research and the forms that neuroscientific evidence assumes for those who produce it. These researchers grappled with the complexity of schizophrenia not by narrowing disease concepts to biological facts but by referencing measurement techniques to generate new versions of schizophrenia. By linking experimental findings to inchoate concepts of personhood and social experience, I found that they reframed and reinforced cultural values, including that those with schizophrenia are destined to a debased and deficient existence. I argue that cognition has emerged as an essential feature of schizophrenia not only because of its representational utility but also because of the ontological work the concept performs. In closing, I present some implications for the neurobiological and social sciences.


Cognition Reductionism Stigma Schizophrenia Neuroscience 


  1. Almasy, Laura, et al. 2008 A genome screen for quantitative trait loci influencing schizophrenia and neurocognitive phenotypes. American Journal of Psychiatry 165:1185-1192.CrossRefGoogle Scholar
  2. Apud, Jose A., and Daniel R. Weinberger 2007 Treatment of cognitive deficits associated with schizophrenia: potential role of catechol-O-methyltransferase inhibitors. CNS Drugs 21(7):535-557.CrossRefGoogle Scholar
  3. Beaulieu, Anne 2002 Images Are Not the (Only) Truth: Brain Mapping, Visual Knowledge, and Iconoclasm. Science Technology and Human Values 27(1):53-86.CrossRefGoogle Scholar
  4. Bernard, Claude 1957 An Introduction to the Study of Experimental Medicine. New York: Dover.Google Scholar
  5. Biehl, Joao, Byron J. Good, and Arthur Kleinman 2007 Introduction: Rethinking Subjectivity. In Subjectivity: Ethnographic Investigations. J. Biehl, B.J. Good, and A. Kleinman, eds. Pp. 1-23. Berkeley, CA: University of California Press.Google Scholar
  6. Bilder, Robert, et al. 2009 Cognitive ontologies for neuropsychiatric phenomics research. Neuropsychiatry 14(4/5):419-450.CrossRefGoogle Scholar
  7. Bonner-Jackson, Aaron, et al. 2010 Neurocognition in schizophrenia: a 20-year multi-follow-up of the course of processing speed and stored knowledge. Compr Psychiatry 51(5):471-9.CrossRefGoogle Scholar
  8. Brannigan, Augustine 1997 The postmodern experiment: Science and ontology in experimental social psychology. The British Journal of Sociology 48(4):594-610.CrossRefGoogle Scholar
  9. Bromley, Elizabeth 2005 A collaborative approach to targeted treatment development for schizophrenia: a qualitative evaluation of the NIMH-MATRICS project. Schizophr Bull 31(4):954-61.CrossRefGoogle Scholar
  10. Bromley, Elizabeth, et al. 2011 A Video Ethnography Approach to Assessing the Ecological Validity of Neurocognitive and Functional Measures in Severe Mental Illness: Results from a Feasibility Study. Schizophrenia Bulletin. doi:10.1093/schbul/sbr002
  11. Buchanan, Robert W., et al. 2005 A summary of the FDA-NIMH-MATRICS workshop on clinical trial design for neurocognitive drugs for schizophrenia. Schizophrenia Bulletin 31(1):5-19.CrossRefGoogle Scholar
  12. Burdick, Katherine E., et al. 2006 Neurocognition as a Stable Endophenotype in Bipolar Disorder and Schizophrenia. J Nerv Ment Dis 194(4):255-260.CrossRefGoogle Scholar
  13. Carter, Cameron S. 2006 Re-conceptualizing schizophrenia as a disorder of cognitive and emotional processing: A shot in the arm for translational research. Biol Psychiatry 60(11):1169-70.CrossRefGoogle Scholar
  14. Corin, Ellen 1990 Facts and Meaning in Psychiatry. An anthropological approach to the lifeworld of schizophrenics. Culture, Medicine & Psychiatry 14:153-188.Google Scholar
  15. Corin, Ellen 2007 The ‘other’ of culture in psychosis: the ex-centricity of the subject. In Subjectivity: Ethnographic Investigations. J. Biehl, B.J. Good, and A. Kleinman, eds. Berkeley: University of California Press.Google Scholar
  16. Corrigan, Patrick W., and Amy C. Watson 2004 At issue: Stop the stigma: Call mental illness a brain disease. Schizophr Bull 30(3):477-479.CrossRefGoogle Scholar
  17. Craddock, Nick, and Michael J. Owen 2005 The beginning of the end for the Kraepelinian dichotomy. British Journal of Psychiatry 186:364-366.CrossRefGoogle Scholar
  18. Delawalla, Zainab, John G. Csernansky, and Deanna M. Barch 2008 Prefrontal Cortex Function in Nonpsychotic Siblings of Individuals with Schizophrenia. Biol Psychiatry 63(5):490-97.CrossRefGoogle Scholar
  19. Desjarlais, Robert 1994 Struggling along: the possibilities for experience among the homeless mentally ill. American Anthropologist 96(4):886-901.CrossRefGoogle Scholar
  20. Desjarlais, Robert 1997 Shelter Blues: Sanity and Selfhood among the Homeless. Philadelphia: University of Pennsylvania Press.Google Scholar
  21. Devereux, George 1978 Cultural thought models in primitive and modern psychiatric theories. In Ethnopsychoanalysis: Psychoanalysis and Anthropology as Complementary Frames of Reference. G. Devereux, ed. Pp. 265-296. Berkeley: University of California Press.Google Scholar
  22. Dumit, Joseph 2003 Picturing Personhood: Brain Scans and Biomedical Identity. Princeton, NJ: Princeton University Press.Google Scholar
  23. Durkheim, Emile 1951 Suicide: A Study in Sociology. New York, NY: The Free Press.Google Scholar
  24. Duster, Troy 2006 Comparative perspective and competing explanations: Taking on the newly configured reductionist challenge to sociology. American Sociological Review 71:1-15.CrossRefGoogle Scholar
  25. Eisenberger, Naomi I., et al. 2007 Understanding genetic risk for aggression: Clues from the brain’s response to social exclusion. Biological Psychiatry 61(9):1100-1108.CrossRefGoogle Scholar
  26. Engelke, Matthew 2009 The Objects of Evidence. Malden, MA: Blackwell Publishing.Google Scholar
  27. Fabian, Johannes 1995 Ethnographic Misunderstanding and the Perils of Context. American Anthropologist 97(1):41–50.CrossRefGoogle Scholar
  28. Fischer, Michael M.J. 2008 Four genealogies for a recombinant anthropology of science and technology. Cultural Anthropology 22(4):539–615.CrossRefGoogle Scholar
  29. Fleck, Ludwik 1979 Genesis and development of a scientific fact. Chicago and London: University of Chicago Press.Google Scholar
  30. Fortun, Michael 2008 Promising Genomics: Iceland and deCODE Genetics in a world of speculation. Berkeley: University of California Press.Google Scholar
  31. Fullwiley, Duana 2008 The biologistical construction of race: ‘Admixture’ technology and the new genetic medicine Social Studies of Science 38(5):695-735.CrossRefGoogle Scholar
  32. Gaines, Atwood D. 1992 From DSM I to III-R; Voices of self, mastery and the Other: A cultural constructivist reading of U.S. psychiatric classification. Social Science & Medicine 35(1):3-24.CrossRefGoogle Scholar
  33. Gard, David E., et al. 2006 Anticipatory and consummatory components of the experience of pleasure: A scale development study. Journal of Research in Personality 40(6):1086-1102.CrossRefGoogle Scholar
  34. Geertz, Clifford 1973 The Interpretation of Cultures: Selected Essays. New York, NY: Basic Books.Google Scholar
  35. Gigerenzer, Gerd 1991 From tools to theories: A heuristic of discovery in cognitive psychology. Psychological Review 98:254-267.CrossRefGoogle Scholar
  36. Gilbert, G. Nigel, and Michael Mulkay 1984 Opening Pandora’s Box: A Sociological Analysis of Scientists’ Discourse. New York: Cambridge University Press.Google Scholar
  37. Gold, Ian, and Lauren Olin 2009 From Descartes to Desipramine: Psychopharmacology and the Self. Transcultural Psychiatry 46:38-59.CrossRefGoogle Scholar
  38. Good, Byron J. 1997 Studying mental illness in context: Local, global, or universal? Ethos 25(2):230-248.CrossRefGoogle Scholar
  39. Goodwin, Charles 1994 Professional Vision. American Anthropologist 96(3):606-633.CrossRefGoogle Scholar
  40. Green, Michael F. 1996 What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 153(3):321-30.Google Scholar
  41. Green, Michael F., Robert S. Kern, and Robert K. Heaton 2004 Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 72(1):41-51.CrossRefGoogle Scholar
  42. Hall, John R. 1990 Epistemology and sociohistorical inquiry. Annual Review of Sociology 16:329-51.CrossRefGoogle Scholar
  43. Hartmann, Martin 2010 Against first nature: critical theory and neuroscience. In Critical neuroscience S. Choudhury and J. Slaby, eds. Oxford: Wiley-Blackwell.Google Scholar
  44. Healy, David 2004 Shaping the Intimate: Influences on the Experience of Everyday Nerves. Social Studies of Science 34:219-245.CrossRefGoogle Scholar
  45. Hedgecoe, Adam 2001 Schizophrenia and the narrative of enlightened geneticization. Social Studies of Science 31:875-911.CrossRefGoogle Scholar
  46. Herskovits, Elizabeth 1995 Struggling over subjectivity: debates about the “self” and Alzheimer’s Disease. Medical Anthropology Quarterly 9(2):146-164.CrossRefGoogle Scholar
  47. Hess, David J. 1997 Science Studies: An Advanced Introduction. New York, NY: NYU press.Google Scholar
  48. Hogle, Linda F. 2010 Characterizing Human Embryonic Stem Cells: Biological and Social Markers of Identity. Medical Anthropology Quarterly 24(4):433-50.CrossRefGoogle Scholar
  49. Holden, Constance 2010 Proposed Revisions to Psychiatry’s Canon Unveiled. Science 327:770-1.Google Scholar
  50. Insel, Thomas R., and Philip S. Wang 2010 Rethinking Mental Illness. Journal of the American Medical Association 303(19):1970-1971.CrossRefGoogle Scholar
  51. Jablensky, Assen, and Norman Sartorius 2008 What did the WHO studies really find? Schizophrenia Bulletin 34(2):253–255.CrossRefGoogle Scholar
  52. Kee, Kimmy S., et al. 2009 Emotional intelligence in schizophrenia. Schizophrenia Research 107:61-68.CrossRefGoogle Scholar
  53. Keefe, Richard S., et al. 2006 The schizophrenia cognition rating scale: an interview-based assessment and its relationship to cognition, real-world functioning, and functional capacity. Am J Psychiatry 163(3):426-32.CrossRefGoogle Scholar
  54. Keller, Evelyn Fox 2010 The Mirage of a Space Between Nature and Nurture. Durham & London: Duke University Press.Google Scholar
  55. Kerr, Anne, Sarah Cunningham-Burley, and Amanda Amos 1997 The new genetics: Professionals’ discursive boundaries. The Sociological Review 45(2):279-303.CrossRefGoogle Scholar
  56. Kerr, Catherine 2002 Translating ‘mind-in-body’: two models of patient experience underlying a randomized controlled trial of qigong. Culture, Medicine and Psychiatry 26:419-447.CrossRefGoogle Scholar
  57. Kilts, Clinton D., et al. 2003 Dissociable Neural Pathways Are Involved in the Recognition of Emotion in Static and Dynamic Facial Expressions. NeuroImage 18:156 –168.CrossRefGoogle Scholar
  58. Kondo, Dorinne 1986 Dissolution and Reconstitution of Self: Implications for Anthropological Epistemology. Cultural Anthropology 1(1):74-88.CrossRefGoogle Scholar
  59. Lakoff, Andrew 2005 Pharmaceutical Reason: Knowledge and Value in Global Psychiatry. Cambridge University Press, UK.CrossRefGoogle Scholar
  60. Lampland, Martha, and Susan L. Star, eds. 2009 Standards and Their Stories: How Quantifying, Classifying, and Formalizing Practices Shape Everyday Life. Ithaca, NY: Cornell University Press.Google Scholar
  61. Langlitz, Nicolas 2010 The persistence of the subjective in neuropsychopharmacology: Observations of contemporary hallucinogen research. History of the Human Sciences 23:37-57.CrossRefGoogle Scholar
  62. Langwick, Stacey A. 2008 Articulate(d) Bodies: Traditional Medicine in a Tanzanian Hospital. American Ethnologist 35(3):428-439.CrossRefGoogle Scholar
  63. Latour, Bruno 1987 Science in Action: How to Follow Scientists and Engineers Through Society. Cambridge, MA: Harvard University Press.Google Scholar
  64. Latour, Bruno 2008 What is the style of matters of concern: two lectures in empirical philosophy. The Netherlands: Royal Van Gorcum.Google Scholar
  65. Law, John 1999 After ANT: complexity, naming and topology. In Actor Network Theory and After. J. Law and J. Hassard, eds. Oxford, UK: Blackwell Publishers.Google Scholar
  66. Lindemann, Gesa 2009 From Experimental Interaction to the Brain as the Epistemic Object of Neurobiology. Human Studies 32:153–181.CrossRefGoogle Scholar
  67. Lock, Margaret and Judith Farquhar, eds. 2007 Beyond the Body Proper: Reading the Anthropology of Material Life. Durham, NC: Duke University Press.Google Scholar
  68. Lovell, Anne 1997 ‘The City is My Mother’: Narratives of Schizophrenia and Homelessness. American Anthropologist 2:355-68.CrossRefGoogle Scholar
  69. Lynch, Michael E. 1982 Technical work and critical inquiry: Investigations in a scientific laboratory. Social Studies of Science 12(4):499-533.CrossRefGoogle Scholar
  70. Marder, Stephen R., Wayne Fenton, and Kenneth Youens 2004 Schizophrenia, IX: Cognition in schizophrenia–the MATRICS initiative. Am J Psychiatry 161(1):25.CrossRefGoogle Scholar
  71. Mol, Annemarie 2002 The body multiple: ontology in medical practice. Durham, NC: Duke University Press.Google Scholar
  72. Ochs, Elinor, and Sally Jacoby 1997 Down to the wire: the cultural clock of physicists and the discourse of consensus. Language in Society 26(4):479-505.CrossRefGoogle Scholar
  73. Pickering, Andy 1993 The mangle of practice: agency and emergence in the sociology of science. American Journal of Sociology 99(3):559-589.CrossRefGoogle Scholar
  74. Pickering, Andy 1994 After representation: Science studies in the performative idiom. PSA: Proceedings of the Biennial Meeting of the Philosophy of Science Association 2:413-419.Google Scholar
  75. Pickersgill, Martyn 2009 Between soma and society: Neuroscience and the ontology of psychopathy. BioSocieties (4):45–60.Google Scholar
  76. Pinch, Trevor J., and Wiebe E. Bijker 1984 The social construction of facts and artefacts: Or how the sociology of science and the sociology of technology might benefit each other. Social Studies of Science 14:399-441.CrossRefGoogle Scholar
  77. Prouteau, Anne, et al. 2005 Cognitive predictors of psychosocial functioning outcome in schizophrenia: a follow-up study of subjects participating in a rehabilitation program. Schizophr Res 77(2-3):343-53.CrossRefGoogle Scholar
  78. Rabelo, Mariam, and Iara Souza 2003 Temporality and experience: on the meaning of nervoso in the trajectory of urban working-class women in northeast Brazil. Ethnography 4(3):333-361.CrossRefGoogle Scholar
  79. Rheinberger, Hans-Jörg 1997 Toward a History of Epistemic Things: Synthesizing Proteins in the Test Tube. Palo Alto, CA: Stanford University Press.Google Scholar
  80. Rheinberger, Hans-Jörg2005 A Reply to David Bloor: ‘Toward a Sociology of Epistemic Things’. Perspectives on Science 13(3):406-410.CrossRefGoogle Scholar
  81. Robins, Steven 2006 From ‘Rights’ to ‘Ritual’: AIDS Activism in South Africa. American Anthropologist 108(2):312–323.CrossRefGoogle Scholar
  82. Sapolsky, Robert M. 2001 Depression, antidepressants, and the shrinking hippocampus. Proceedings of the National Academy of Sciences 989(22):12320-12322.CrossRefGoogle Scholar
  83. Shapin, Steven 1994 A Social History of Truth: Civility and Science in Seventeenth-Century England. Chicago and London: The University of Chicago Press.Google Scholar
  84. Silva, Mary C., Jeanne M. Sorrell, and Christine D. Sorrell 1995 From Carper’s patterns of knowing to ways of being: An ontological philosophical shift in nursing. Advances in Nursing Science 18(1):1-13.Google Scholar
  85. Slaby, Jan 2010 Steps towards a Critical Neuroscience. Phenom Cogn Sci 9:397–416.CrossRefGoogle Scholar
  86. Smyth, Mary M. 2001 Certainty and uncertainty sciences: Marking the boundaries of psychology in introductory textbooks. Social Studies of Science 31(3):389-416.CrossRefGoogle Scholar
  87. Sparks, Amy, et al. 2010 Social cognition, empathy and functional outcome in schizophrenia. Schizophrenia Research 122(1-3):172-8.CrossRefGoogle Scholar
  88. Stafford, Charles 2009 Linguistic and cultural variables in the psychology of numeracy. In The Objects of Evidence. M. Engelke, ed. Malden, MA: Blackwell Publishing.Google Scholar
  89. Stenberg, Jan H., et al. 2010 Effects of add-on mirtazapine on neurocognition in schizophrenia: a double-blind, randomized, placebo-controlled study. Int J Neuropsychopharmacol 13(4):433-41.CrossRefGoogle Scholar
  90. Teghtsoonian, Katherine 2009 Depression and mental health in neoliberal times: A critical analysis of policy and discourse. Social Science & Medicine 69:28–35.CrossRefGoogle Scholar
  91. Timmermans, Stefan, and Steven Epstein 2010 A World of Standards but not a Standard World: Toward a Sociology of Standards and Standardization. Annual Review of Sociology 36:69-89.CrossRefGoogle Scholar
  92. Verdon, Michael 2010 “The Superorganic,” or Kroeber’s hidden agenda. Philosophy of the Social Sciences 40(3):375-398.CrossRefGoogle Scholar
  93. Young, Allan 2001 Our traumatic neurosis and its brain. Science in Context 14(4):661–683.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Psychiatry and Biobehavioral Sciences, Center for Health Services and SocietyUniversity of CaliforniaLos AngelesUSA
  2. 2.West Los Angeles VA Healthcare Center, Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC)Los AngelesUSA

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