While neuroscientists look for the cause of schizophrenia in the brain, psychologists
are looking for ways other than medication to help people make sense of and
deal with the voices they hear.
And as this ScienCentral News video reports, a therapy adopted in Britain seems
to have the answer.
Reality Check
Unreal but strongly held beliefs, delusions and hallucinations are characteristic
of someone suffering from schizophrenia. This devastating mental illness distorts
the thinking processes of its victims. Schizophrenics may hear voices telling
them that someone is out to harm them, or they may feel that their thoughts
are being broadcast for everyone to hear, according to Richard Warner, medical
director at the Mental Health
Center at Boulder County in Colorado.
Currently, the most widely available treatment is a variety of medications.
But Warner says they are not completely effective for everyone, and in fact
can be ineffective for many. He points out that, “only one of the newer
drugs really works on what we call ‘treatment-resistant schizophrenia’—[for
which] the other drugs don’t work—and that’s Clozapine.”
But he adds that like all other schizophrenia drugs, even this has negative
side effects like weight gain, seizures and diabetes.
Now some psychologists in the United Kingdom have shown that schizophrenics
can get a reality check by talking in detail about their feelings and experiences.
They found that, when combined with medication, a therapy known as cognitive
behavioral therapy (CBT) can help schizophrenics make sense of their experiences.
Philippa Garety, professor of clinical psychology at King’s
College in London, says that the most disturbing thing about schizophrenia
is that “your own thoughts become experienced as not your own thoughts.”
She explains that CBT, which incorporates in-depth discussions with behavioral
therapy techniques, has been found to be more effective than any other type
of psychotherapy for treating schizophrenia. Behavior therapy works under
the premise that abnormal behavior is learned and therefore can be unlearned.
So they help the patient gain confidence and become more assertive and at
the same time they train them to relax. Behavioral therapy, when combined
with in-depth discussions, helps patients to make sense of their strange experiences,
think about them in a different way, and gradually become less fearful of
them.
While CBT is used to treat
depression and anxiety in the United States, Warner says that so far it
is not a treatment option for schizophrenia.
Making Sense of Experiences
Garety and her colleagues in the U.K. have been using CBT alongside medication,
and have seen much better results in those patients compared with others who
were only taking medication. CBT works on the general principal that everyone
has to make sense of his or her experiences. Garety says, “We can talk
with people about their delusions and hallucinations and help them make more
sense, perhaps, of what’s been happening to them. Help them develop
ways of dealing with [their hallucinations] and thinking about them.”
So therapists have in-depth discussions with patients about their experiences
and the voices they hear and “help them explore alternate interpretations”
of the beliefs they have already formed in their minds.
Since the therapy has shown a lot of success in the U.K., Warner has invited
Garety and her colleagues to train the staff at the Mental Health Center at
Boulder County. Warner is confident that the positive results of CBT will
soon lead to more widespread use of the therapy in the United States.
Garety’s research appeared in World Psychiatry and was supported by United
Kingdom Department of Health and The
Wellcome Trust.