I have given this part quite a bit of thought, not because it merits more attention than the other three A’s, but because I was unsure (ambivalent?) how to approach it. I’ve had one mental health professional tell me that people with schizophrenia bask in the glow of white light and plunder into the abyss of black darkness. There is very little in-between. I’ve had another mental health professional tell me that persons with this disorder are in a perpetual state of ambivalence. It is thought that Bleuler borrowed the term ambivalent from theoretical physics (atomic theory) and used it to describe people with schizophrenia.

In psychology, ambivalence means “the existence of mutually conflicting emotions or thoughts about a person, object, or idea.” That’s the quote from Webster’s Dictionary. In simpler terms, what does this mean? And, more importantly, which of the seemingly conflicting ideas from two very competent mental health professionals is correct?

The first question is pretty easy, and rather than type out a dissertation on the definition of “ambivalence,” I’m going to assume that we all understand what this definition means. In short, ambivalence = uncertainty/indecision.

This brings us to the second question. Which of the two ideas about how ambivalence pertains to schizophrenia is correct? Is it that people with this disorder tend to be ambivalent, unable to make up their minds about things? Or is it that people with this disorder believe the world is black-and-white and that ambivalence, or uncertainty, is beyond their scope.

As an example, let’s take the belief in the supernatural, more specifically in God. This is a subject that many people with schizophrenia struggle with on a daily basis. Some eschew the idea as ludicrous; some embrace the idea with the zeal and vigor of a lion whose last meal was two weeks ago, even going so far as to believe that they are the reincarnation of the Messiah or the Virgin Mary. There is very little, if any, middle ground for most of us, especially when we are not being properly treated with medication and psychotherapy.

This would lead one to believe that people with schizophrenia tend to look at the world in black-and-white terms. Score one for my first therapist! But wait a minute. Those same people who once embraced the idea that there is a god often do a complete 180-degree switch and completely disavow the idea that the supernatural exists. They flip-flop. I’ve known people with this disorder to do it, myself included. Score one for my second therapist, right? Not so fast.

Evidence shows that people with schizophrenia, especially those not being treated adequately, tend to have very strong opinions, beliefs, and even delusions about this subject. There is a reconciliation between the two theories. My first therapist is correct. People with this disorder, from what I have seen, heard, read, and experienced, do have a tendency to choose sides. One moment, God is real; the next moment, God is a myth. One moment, they are the Messiah or the Virgin Mary; another moment they aren’t. The middle ground doesn’t exist.

My second therapist is also correct. People with this disorder tend to have a difficult time making up their minds, not only with this particular subject but with a whole host of subjects that could include whether to begin their walk by stepping with their right or left foot, whether or not to go back to school, or whether or not to take a shower on a particular day.

The point is that there are often more than two solutions to a given problem. People with schizophrenia, at least the ones I know and have read about, have trouble with that concept. The world is black-and-white, which supports my first therapist’s theory. People often waffle between those two concepts. They are ambivalent about which of the two they espouse, which supports my second therapist’s theory. The two theories are not mutually conflicting. In fact, they support each other quite nicely.

Since I have been on my current medication regimen and have been getting excellent psychotherapy from trained professionals, I have, to a large degree, been able to discard the black-and-white thinking. I still struggle with it sometimes, but not nearly as often as I did before I began taking medications and seeing good therapists. I feel fortunate to be able to start my walks by not having to think about what foot I’m going to start with. I feel fortunate to be able to recognize that regular showering is in my best interest. As for God…some things are better left to the imagination.

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