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Still, drug therapy has been essentially a holding action to stabilize the troubled. Tranquilizers such as Valium and Librium are good at reducing anxiety and tension, but they may interfere with thinking and can become habit-forming. The antidepressants, called tricyclics, are increasingly effective, but also can have adverse side effects. The stronger antipsychotic drugs like Thorazine are useful for handling schizophrenics, whose behavior is characterized by hallucinations and severely disordered thinking, as well as other forms of severe mental disorder. But while these chemicals produce a rapid return to normal, or at least socially acceptable behavior, in some patients, they also act as chemical restraints: they calm the schizophrenic but often turn him into little more than a zombie in the process. As Psychologist Steven Matthysse of the Mailman Research Center explains, while agitation and disordered thought diminish in the drugged patient, the drugs do very little to move the patient toward recovery or to help him relate to other people. Says Matthysse: "It's a sad thing, but a schizophrenic [on drugs] is very rarely motivated to do anything really consequential."
Though available drugs are still crude, pioneer work in brain research may lead to some astonishing new ones. A crucial discovery came when researchers located what are known as the brain's opiate receptors. These are the specific sites in the brain and spinal cord where such drugs as opium and morphine act. These and other recent discoveries open up the possibility of aiming artificial drugs at specific receptors, and perhaps duplicating the body's natural internal "drugs" that help keep normal people normal. Says Solomon Snyder, a psychiatrist and pharmacologist at Johns Hopkins University: "As a result of psychopharmacology, psychiatry has come from behind the other medical sciences to a position of leadership. We've got a whole new psychiatry."
Much of this new psychiatry centers on schizophrenia, the most disabling and puzzling of mental illnesses. There are dozens of contending theories to explain it. The leading behavioral one derives from Anthropologist Gregory Bateson's concept of the double bind, which holds that schizophrenia arises from a prolonged dose of conflicting instructions, as, say, when a mother tells a child not to eat sweets, yet is constantly rewarding it with candy. But studies of identical twins and adopted children by Biochemist Seymour Kety strongly suggest a genetic base for schizophrenia. According to Kety, the flaw, contained in the cells' DNA, the master genetic molecules, may possibly be transmitted by viruses. In any case, the new pharmacological researchers no longer regard schizophrenia as a single ailment but, like cancer, as a collection of different malfunctions. In schizophrenia, the common denominator is the brain, and many scientists are convinced that a neurotransmitter, or chemical brain-signal carrier, called dopamine is the prime culprit.