While few outpatient, private practice therapists deal much with those diagnosed with schizophrenia, there are things therapists can do to ease the suffering of both client and family. Kim Mueser, a professor at Dartmouth Medical School has published a number of helpful research and popular writings designed to increase social and cognitive functioning and decrease family distress in people with schizophrenia. Click here for an Amazon.com list of his writings. His Complete Family Guide (#1 on the list) is probably the best though several other texts may be just as useful depending on the reader’s focus. And while medications are important in the treatment of schizophrenia, it is quite clear that when families and client learn to minimize family distress and conflict, they also reduce active psychotic episodes
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There are a number of interesting research angles on the pathways of Schizophrenia. One such hypothesis is that the croticostriatal loops do not work correctly in such patients. In lay terms this means that information doesn’t flow normally from the frontal lobe of the brain to some of the mid-brain structures and then back again. This seems to be part of the cause of apathy and lack of volition and/or planning. One wonders whether the longer time it takes for information to flow properly in order to make a decision or interpretation increases the likelihood of making random assumptions about the world. I know that when my children get stuck in a math problem, they are more likely to begin wild guessing to complete the task.
2 Comments
March 24, 2008 at 12:58 pm
I’ve not yet worked with a Schizophrenic person as a therapist, but I’ve spent considerable time around them as a residential treatment caretaker, social work case manager and as a neighbor. One of my former neighbors (and still a family friend) experienced brain trauma about 20 years ago, from an abusive incident with a former spouse, but oddly enough…the schizophrenic symptoms didn’t present until immediately after she’d extracted herself from a large local Wiccan coven (her account)! This woman seems to have the best handle on her symptoms of anyone I’ve known with the problem…she is generally able to distinguish between real and imagined visual and auditory stimuli, can do her own “cognitive” work, and takes her medications faithfully; she reports changes to her doctor immediately; she cares about how she impacts those in her world and takes special care to do rigorous and routine self-care to ensure the safety of herself and those around her. My wife has taken her on occasion to the local crisis center, at our friend’s insistence, when she’s felt herself on the verge of losing psychological control. I’ve never encountered another person with Schizophrenia who has been as concerned with managing her symptoms as this woman, and I think that aspect of caring (for self and others) is what propels her successful coping with it…lack of concern, adopting a “who gives a @#%” attitude is what I’m used to encountering, particularly with the homeless who experience these symptoms.
March 27, 2008 at 9:55 pm
Rather than the symptoms being a product of delay I would say that the symptoms would be more likely to be a product of dopamine uptake in the wrong neurons therefore leading to a disconnection of the pathway and formation of new pathways that the brain tries to make sense of in a way that presents itself as psychosis.