Schizophrenia is a severe mental illness characterized by psychosis, disorganized personality and thinking, and loss of contact with reality. It has multiple potential causes including biochemical, genetic, stress, and physiological factors. Symptoms can be positive such as hallucinations or negative such as reduced emotional expression. Treatment involves medications, therapies, and programs to help patients function independently. The film A Beautiful Mind accurately portrayed some experiences of schizophrenia including obsessive hallucinations, and showed that those with the illness can still live normal lives with treatment and awareness of their condition. Nurses must understand schizophrenia from the patient's perspective to effectively support them.

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Schizophrenia: Internal Suffering
Tiffany Becerra
California Baptist University
Author Note
This paper is presented to Professor Phillips in partial fulfillment for the requirements of
Mental Health, NUR355A on February 8, 2016

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Internal Suffering
The term schizophrenia is derived from the Greek language “skhizo” which means split
and “phren” which means mind (Townsend, & Angelo, pp. 420, 2015). The breakdown of this
word is the most simplistic definition one can use to describe schizophrenia. A major dimension
of schizophrenia includes psychosis, which can be described as:
Schizophrenia is a severe mental condition in which there is disorganization of the
personality, deterioration in social functioning and loss of contact with, or distortion of, reality.
There may be evidence of hallucinations and delusional thinking. Psychosis can occur with or
without the presence of organic impairment. (Townsend, & Angelo, 2015, pp.420)
Experts contest than schizophrenia is not from a single cause, but multiple ones that
include biochemical dysfunction, genetic predisposition, stress and physiological factors
(Townsend, & Angelo, pp. 420, 2015). The configurative growth of this illness is further
divided into four phases, which include: the premorbid and prodromal phases, schizophrenia and
lastly, the residual phase. Because of the complexity of schizophrenia in the active phase, this
illness it is often very difficult to treat. Unfortunately, the prognosis of schizophrenia, as it
relates to normal functioning pre-illness, is poor and is dependent on several factors.
Nurses must take a multifaceted approach when establishing a care plan for a patient with
schizophrenia, due to the intricacy of the illness and the variety of symptoms the patient presents
with. Initially, nurses begin with the assessment, which means gathering data from all sources
available, including the family and the patient’s medical records. The nurse should be aware that
in the case of schizophrenia, the patient’s own testimony may not always be the most reliable
source for information (Townsend & Angelo, 2015). It is during the assessment phase that the
nurse can gather objective and subjective data from observation and interaction with the patient.

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Symptoms can be described as either positive or negative depending on the patient’s affect,
including form of thought, perception, sense of self, etc. (Townsend, & Angelo, pp. 429, 2015).
The outcomes are dependent of the specific type of nursing diagnosis the patient has, but in
general, include correction and recognition of the patient’s thought process along with
improvement of communication with others. Treatment of schizophrenia mainly include
psychopharmacology, several different types of therapies including individual/family, and
increasing the adaptive functioning, allowing the patient to be integrated back into the
community and obtain control over their lives independently (Patel, Cherian, Gohil, & Atkinson,
pp. 640, 2014).
The movie A Beautiful Mind (Howard, 2001) portrayed the main character, John Nash, as
having obsessions about completing certain tasks that he was receiving from his visual
hallucinations, which happened to be people with whom he communicated. This is an accurate
portrayal of the signs of schizophrenia in that some of those who suffer from this illness may
obsess about their hallucinations, without knowing that it is in fact a hallucination. Those
suffering from schizophrenia are not rendered totally incapable of living a normal life nor do
they have a lower level of intelligence. As depicted in the movie, Nash was a luminous
mathematician and was also a family man. A Beautiful Mind encompasses the illness from the
patient’s perspective, which is an exclusive insight to the so called other side of schizophrenia.
Once Nash becomes aware of his hallucinations, he is abashed that he has been working and
obsessing about things that are not real for such a long time. This realization can be a difficult
process when it comes to acceptance of this fact and regaining control over their lives. Knowing
this enables nurses to approach their patients gently when the patients are beginning to
differentiate between what is reality and what is false. This realization can be extremely

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emotional for a patient with schizophrenia, especially if they are becoming aware of these
hallucinations for the first time. As illustrated in A Beautiful Mind, and mentioned literature, a
multitude of mixed feelings and emotions come to the surface as these patients become mindful
of their illness. These emotions include: embarrassment, confusion, denial and shame (Edwards,
2014).
Incorporating the humanbecoming model, as part of treatment for the patient with
schizophrenia, must be applied for optimal outcomes. For many patients, they may not know
much about their illness or sincerely understand what schizophrenia is at first. Therefore, it is
essential that the nurse focus on teaching-learning with the patient, which is a co-created journey
of coming to know, not a destination (Parse, pp. 153, 2014). With education about the illness
and recognition of its symptoms, the patient will have better results in response to treatment.
Nurses must also adhere to true presence while with their patients because schizophrenia not
only affects the individual, but those closest to them. Nurses do not attempt to calm uneven
rhythms, but instead go with the rhythms of the patient (Parse, pp. 96, 2014), which can aid in
gaining the patient’s trust, further yielding positive results.
Upon researching schizophrenia, my knowledge of the illness was limited. A Beautiful
Mind was exceptional in allowing the viewers to see the relentless struggle those with
schizophrenia have. Coincidently, when I was writing this paper, I participated in the auditory
hallucination simulation at California Baptist University, which was composed of about one hour
of listening to auditory hallucinations while attempting to complete what would be menial tasks
for a person who was not experiencing these hallucinations. I believe that the combination of
researching and reading articles, watching A Beautiful Mind and the simulation, really put
schizophrenia in perspective for me. It is with this knowledge that I now have that I can truly

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empathize with my patients who are suffering from schizophrenia. A nurse must not only treat
an illness, but also express genuine understanding, compassion and kindness when it comes to
those with any type of mental illness. Although schizophrenia and mental illnesses in general
may have a stigma and be seen as socially unacceptable, we must look at all of our patients as
being uniquely made as individuals. Even though we may not always understand the illness, as
nurses, we have an obligation to accept these people with loving arms, despite them differing
from social and cultural norms.

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References
Edwards, J. (2014). Schizophrenia. Retrieved from http://www.mentalhealth.org
Howard, R. (Director). (2001). A Beautiful Mind [Motion picture]. United States.
Kotowski, A. (2014). Case study: a young male with auditory hallucinations in paranoid
schizophrenia. International Journal of Nursing Knowledge, 23(1), 41-43.
Parse, R. R. (2014). The humanbecoming paradigm: a transformational worldview.
Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and
Treatment Options. Pharmacy and Therapeutics, 39(9), 638–645.
Townsend, M. C., & Angelo, L. (2015). Psychiatric mental health nursing: Concepts of care in
evidence-based practice (8th ed.). Philadelphia, Pennsylvania: F. A. Davis Company.