Marriage and Family Therapist
Cyndi Sarnoff-Ross is a licensed psychotherapist with almost twenty years of clinical experience in the fields of clinical psychology and organizational management. She has worked extensively with a wide variety of…
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Can Talk Therapy Help Schizophrenia?
Posted in Mental Challeng... by Cyndi Sarnoff-Ross on May 27, 2008

Recently I received a very good question from a DS member about the topic of therapy and chronic mental illness. With the member's permission I have reprinted the question here:


Many people (even psychiatrists) act like therapy won't help people who are schizophrenic or showing those signs and symptoms. They act like medication is the only option, the only thing that can help. But I've read in books and online, that therapy as well as medication had the best success rate than just medication alone. What are some options (in addition or perhaps in place of) to treating people who hear voices, experience paranoia, delusions and confusion, etc? And would therapy be helpful?



At the beginning of my career, I worked in a hospital setting and in various agencies that worked with patients who were chronically mentally ill. The type of work I did was exclusively talk therapy which, with these patients, was primarily behavioral therapies to help improve the quality of their life.


Since I am not a medical doctor, I am not able to prescribe medication but all of these patients were on some type of medication on a consistent basis and being seen regularly by a psychiatrist. Chronic mental illness, such as schizophrenia, is marked by an extreme departure from reality and an inability to function effectively in everyday life. There are wide variations in the type and severity of this illness but it usually includes some type of hallucination, such as auditory or visual hallucinations or some distortion in cognitive abilities.


The appearance and diagnosis of this illness is devastating and life-altering and, in many cases, alienating. I can say with great certainty from my own professional experience, as well as the knowledge I have gleaned from the work of other therapists, that in conjunction with medication, talk therapy is a crucial part of the treatment and management of any chronic mental illness.


To date, I have not encountered any professionals, psychotherapists or psychiatrists, who feel differently about this although I am sure there are those who doubt the efficacy of talk therapy. Most psychiatrists welcome the addition of a therapist to the treatment team because it is typically the therapist who helps the patient remain consistent with their med protocol. There are also many life skill issues that can be quite difficult for the chronically mentally ill such as hygiene issues or basic household management. These are all important topics for discussion during a therapy session.


For those of you who are unfamiliar with the illness, it is important to know that there is no correlation between intelligence and the presence of a chronic mental illness. In fact, I have met some brilliant and talented individuals who suffer from schizophrenia but this type of disease can make social interactions trying and loneliness can be a factor that exacerbates symptoms. A regular meeting with someone who is familiar with the disease and who is knowledgeable about the patient's needs and aversions can go a long way to normalizing the patient's life and helping that individual feel cared about and understood. I have personally seen great progress in individuals who are consistent about coming to therapy.


In addition to individual therapy, group therapy can also be very effective and serve as life-affirming and spirit-lifting experiences for those who suffer from a chronic mental illness. It has been my experience that these therapies are most effective when combined with skillfully monitored medication and a treatment team consisting of different types of mental health professionals.

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CONDITIONS AND COMMUNITIES: Mental Challenged  •  Multiple Personalities  •  Personality Disorders  •  Schizophrenia
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I suffer from paranoid schizophrenia and have found talk therapy helpful because it helps bring me back to reality. On really bad days nothing does, but often I go to may therapist and tell her that people on the bus look into my eyes and know what I am thinking, as an example and she constantly reminds me that this is delusional thought. I have plenty of days where I am gung ho in my beliefs and no one can talk me out of them completely but a constant reminder keeps at least a part of me in check. On a day I can't be convinced she helpfully suggest that I wear dark glasses on the bus so no one can see my eyes and make contact. This is a suggestion that has proven to be quite helpful. She also has given me some practical suggestions on how I can distract myself from the voices and has given me some good self-help articles to read and some stress reducing CD's to listen to as well. Also for someone like me who tends to isolate oneself, just being in contact with another human being once a week alone is helpful.
By schizoclaud  May 30, 2008
7
I think that talk therapy can help just about anyone as long as the therapist can develop trust with the client. It is a common mistake to believe that people with schizophrenia are always out of touch with reality and donít want help. Like any disease process it fluctuates, sometimes the symptoms are acute, the hallucinations are severe and the person cannot connect with others, but medication can usually reduce or even eliminate symptoms. We have a patient now who is schizophrenic and I told him the other day if I did not know his diagnosis I would never guess he had ANY mental illness. He sadly is the exception, but he is a prime example of what can happen if a patient stops taking their meds. He is completely functional, there are no signs or symptoms of the disease and he is very intelligent. He thought as so many do that since he was doing so well he could taper off his meds without consulting his doctor. Had he been in therapy I am sure the therapist would have been aware of it, even if the client didnít disclose it, his behavior would have and the therapist could have talked with him about the risks and possibly avoid the client being arrested and charged with eluding and resisting with violence. Luckily for him the state attorney here does not pursue charges vigorously against people with mental illness but the outcome could have been far more serious, someone especially the patient could have been severely harmed.
Also, as pointed out people with schizophrenia are sometimes not able to perform the activities of daily living consistently or well and a therapist can help with those issues too. they also have the same emotions and conflicts we all face but often are less able to process and deal with them effectively, making a bad situation worse. Like any illness the prognosis depends on the individual situation but I think that as long as the client has some contact with reality talk therapy can be useful if only to offer support and guidance.
By ThePeople  May 28, 2008
6
I agree with you a 100 percent.
Thankfully , tho I have a good doctor and therapist.
By BipolarEmperess  May 27, 2008
5
thank you for posting this
By poohscorner  May 27, 2008
4
I have been seeing shadow demons & hearing voices for 30 years. My current pdoc thinks therapy & addiction services is my best option. That only my anti-depressants & anti-anixety medication is sufficient. I will admit, these things have rarely affected my day-to-day life except for the suicide attempts and self-harming. Very few people knew or know of this about me. It wasn't until a couple friends on here convinced me to seek medical attention that I admitted to things.
By blue13  May 27, 2008
3
CherWic, your comment is a bit off topic and arguably disinformational. As for therapy for schizophrenia, we have examples on our board of bipolar people being told they don't need therapy. So of course it happens. Considering that (I've read that) schizophrenia is getting better understood and likely to be classified as a neurological disease in the (distant?) future, I can imagine psychiatrist being even less likely to prescribe therapy for it. But behavioral therapy benefits anyone with any disease, so why not chronic mental disease?
By cb72  May 27, 2008
2
I have also heard of many cases of schizophrenia and bi-polar disease among others, that have been improved or completely resolved using specific ratios of nutritional supplements, usually in high doses until the issue is solved. Because these diseases are caused from chemical imbalances, nutritional deficiencies and nerve malfunction, it makes so much sense to give the body and the BRAIN what it really needs to function properly. Some people are just naturally low in certain minerals and vitamins and will develop a disease because of it. In a lot of cases, it's just as easy as that.
By CherWic  May 27, 2008
1
Thank you for addressing this topic.
By SearchingforSolace  May 27, 2008
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