Dr. Clancy D. McKenzie M.D.

SUMMARY:

The view of the present author is that genetic factors represent predisposition to Schizophrenia and other disorders, and eventually the precise level of contribution will be determined.

Pre and perinatal factors along with obstetric and birth traumas represent antecedent traumas, setting the stage for subsequent traumas to be more severe, and they also can impact directly on brain development. Infant separation traumas—because they represented death to the mammalian species for 150 million years—are much more significant than previously suspected, and set the stage for the later development of delayed Posttraumatic Stress Disorders.

In delayed PTSD, a second trauma, similar to the first, partially awakens the entire earlier gestalt, setting the process in motion. The flashback is to the earlier mind/brain/reality/feelings/behavior/chemistry/physiology and neuroanatomical sites that were active at the time/age of the original trauma, and from this reactivation of earlier sites there is a release of neurotransmitters produced by those sites or through the reactivation of those sites; there is the development of aberrant neuronal pathways which interconnect the new areas of activity; and there is disuse atrophy of the later developmental structures and their interconnecting pathways—as would occur in any other part of the body not used.

Any stressor can cause intensification of the original trauma or of the subsequent trauma that reactivates the earlier gestalt. This can include anything in the environment that causes stress. Viral factors might fit into this category or might be non-causally related.

The important research findings presented in San Diego (1997) and in Davos (1998) are more meaningful when viewed under one roof and in relation to one another. There has been an explosion of knowledge in recent decades, with each particle moving farther from the core. Without a unified working model, professionals and lay persons alike are left with isolated concepts that Schizophrenia is a chemical imbalance, or a genetic disorder, or a brain disease, or a biopsychosocial disorder, or many diseases with many causes. Each finding instead must be integrated within the framework of one unified construct in order to bring understanding to a new level. Genetics can be viewed as predisposition, with biochemical, structural and psychosocial change viewed primarily as the result of a single disease process. The concept of delayed Posttraumatic Stress Disorders from infancy, with a partial shift of activity to earlier mind/brain/reality/feelings/behavior/chemistry/physiology and neuroanatomic sites, and the resultant interaction of that earlier gestalt with adult brain functions/structures, may be the best working model we have at the present time for integrating and understanding all the complexities of the disease process. O. Spurgeon English, in his Foreword to McKenzie and Wright (1996), referred to this model as “the new unification theory of mental illness.”

It is hoped that this work, in addition to bringing fourth new understanding to serious mental/emotional disorders, will help unify the field and bring the many disciplines together. The process of unification already is taking place slowly, one study at a time, as newer studies coregister PET with MRI and bring in neuropsychological testing, for example, but the field can advance exponentially, with the pieces of the puzzle rapidly falling into place, if there is a structural framework that enables each researcher to maintain a larger view and understand his or her contribution in relation to the entire disease process. The new Unification Theory, backed by research studies and references in the literature, is the most inclusive model at the present time, and provides a clear, equal and logical place for each discipline.