Note to self : remember to go to this tuesday !
-“but you’re just a 3rd year, what are you doing here?
-“the voices made me come..*twitch*”
An abstract:
Emotional dysfunction and schizophrenia have long been uncomfortable bedfellows. It was Bleuler who first argued that problems of affect lie at the heart of schizophrenia and that the symptoms we all focus on, the hallucinations and delusions, are merely’accessory’ and common to many forms of disorder.
This view gave way to the now familiar distinction between affective and non-affective psychosis and to Jaspers’ hierarchical approach to diagnosis wherein affective symptoms are
‘trumped’ by the presence of schizophrenia in terms of diagnosis and treatment. Yet emotional dysfunction is pervasive in non-affective psychosis!. Sometimes (and
unhelpfully) referred to as ‘comorbidity’, these include: depression, usually accompanied by hopelessness and suicidal thinking; social anxiety, usually accompanied by
social avoidance and problems forming relationships; and traumatic (PTSD) symptoms. There is also the distress (fear, anger, shame) attached to the experience of psychotic symptoms themselves.
In this lecture I will argue that the distress from psychotic experience and the
disorders of emotion in first episode psychosis may arise from three overlapping processes including: those which are intrinsic to psychosis, those which are a psychological
reaction to psychosis and patienthood and those arising from anomalies of childhood and adolescent development, triggered by an emerging psychosis, childhood trauma or
both. Furthermore, in general, the distress occasioned by persisting symptoms has been shown to operate through a ‘psychological filter’: those patients with more positive
self-schema seem able to withstand the threat of voices or other persecutors (Birchwood et al, 2000b; Freeman et al, 2001).I will illustrate this with data from studies of
postpsychotic depression and suicidal Thinking and studies of distress arising from ‘voices’..