Schizophrenia in pop culture is more than a mental illness. It is a diagnosis for monstrosity.

The word “schizophrenia” was coined in the name of medical enlightenment. Thought up by Swiss psychiatrist Eugen Bleuler in 1911, it was meant to be a more precise, scientific word than the extant term, “dementia praecox.” As Bleuler understood it, this disease was characterized by a splitting of the mind—the word literally means just that. A learned and humane man, Bleuler strove to create a set of diagnostic tools to account for the varied symptoms of a misunderstood and frightening disease.

But in pop culture, the “splitting” aspect came to be something unmistakably evil. In fiction and film, a “normal” person would be found to have an evil entity living inside their head, something that comes into power and soon gets violent. By the latter 20^th century, countless books, plays, and movies featured dangerous characters with “split personalities.” A synonym for schizophrenia, one even used by doctors, was “the Jekyll-Hyde personality.” A monster literally informed popular understanding of a common psychiatric diagnosis.

In 1960, the spit personality got a major Hollywood boost with the film "Psycho." In this movie, Norman Bates is two people in one. He first appears to be a mild-mannered motel manager. But someone else is inside. Norman hears the voice of his evil and controlling mother, and in the big twist, he “becomes” her, entering murderous rampages wearing a dress and wig. The success of the film inspired—and continues to inspire—many horror flicks built around murderers who have Jekyll-Hyde personalities.

Compounding the horror film misguidance was the fact that medicine did not have any consensus about the disease. Was schizophrenia one illness or many? Were doctors looking at symptoms of different etiologies, or a singular disease that took different symptomatic forms? Was it caused by nature or nurture? Was medicine or talk therapy the best treatment? Could it even be treated at all?

One unfortunate step in this process of understanding was the disastrous idea that mothers caused schizophrenia. Influential Freudian psychiatrist Frieda Fromm-Reichmann argued that the “schizophrenogenic mother” was the problem. Domineering American mothers, she reasoned, created paranoid, fearful children, who in turn developed schizophrenia.

Despite the fact that the term “schizophrenogenic mother” appears only once in all of Fromm-Reichmann’s writings, the argument took flight in Cold War America. It easily dovetailed with masculine fears that educated, assertive women posed a unique threat to social morals and the family structure.

Influential books like Generation of Vipers (1942) by Philip Wylie and Modern Women: The Lost Sex (1947) by Marynia Farnham and Ferdinand Lundberg argued that mothers were becoming monsters, afflicted with “penis envy” and taking out their frustrations on their kids. Even feminists like Betty Friedan conceded that mothers, repressed and brainwashed by society, had a hand in “produc[ing] latent or overt homosexuality” in their sons, and even in creating “schizophrenic children.”

Thankfully, this bad idea has left us, but even today, pop culture rarely deals with schizophrenia in accurate ways. Happily, for readers, a recent book offers a nuanced, accessible treatment of the disease. Hidden Valley Road: Inside the Mind of an American Family by Robert Kolker is a rare combination of popularly written, medically- and historically-sound writing.

Hidden Valley Road follows a single family, in which half of the twelve children are afflicted with schizophrenia. Kolker digs deeply into the family’s trials and tribulations and the ways that the disease was mishandled by the parents and by society. At the same time, Kolker presents a history of the treatment of schizophrenia over the course of the twentieth century. Ultimately, we learn that new genetic research offers perhaps the best hope for a future cure.

Books like this one go a long way to correcting some of the stigmatic residue that pop culture and outdated, problematic theories have encrusted upon us. May such reporting continue.