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Can Psychotherapy Be Used to Treat Schizophrenia?

Updated on September 12, 2012
Schizophrenia is a disorder that directly impacts the brain and what it interprets as reality.
Schizophrenia is a disorder that directly impacts the brain and what it interprets as reality. | Source

Psychotherapy and Treating Schizophrenia

There are several different types of schizophrenia and it should be noted first and foremost that whatever the type, it's not an easy mental disorder to treat.

Schizophrenia evidences itself usually sometime between the ages of 18 and 35, though it can happen at other ages as well.

There are many theories as to the origins or causes of schizophrenia but to date, there are no real "cures."

Schizophrenia occurs more in males than in females and at the time of diagnosis, it can be devastating to the person experiencing it--and to the family or loved ones trying to understand the disease process.

Can psychotherapy be used to treat the different types of schizophrenia? The answer is yes but not alone.

The standard of treatment for schizophrenia is a medication regime to dilute the dangerous symptoms of the mind disorder and get the person suffering back to square one. However, psychotherapy is a positive (and often necessary and recommended) adjunct to medical treatment for the disorder.

It should be emphasized though that medication is the first line of treatment and the most immediately effective.

What is Schizophrenia and What are the Symptoms?

In all of its different forms, schizophrenia is a severely disabling brain disorder that is never cured. If patients remain faithful to their medication routine, they can and will usually live a fairly normal and well-ordered life. It is a chronic condition and as stated, there is no known cure.

However, usually relapses occur because patients with schizophrenia feel better or are doing well. They think that the disease has been cured and inevitably go off their medication--or cut back on it. Without chemical stabilization of their thought processes, most schizophrenics relapse fairly quickly and the relapses can have serious consequences.

This author has had experience with several schizophrenics. One was a friend of mine, a girl in her late teens who decided that God had healed her. She was so full of life and so excited to embrace her life without medication. She very quickly decompensated and had to be emergently hospitalized because she became suicidal right in front of me. It was like watching a horror movie play out to see her change so quickly.

Another friend of mine had a son who was diagnosed with schizophrenia in his late 20s. He decided to go off his medications one day unbeknowst to anyone and just "disappeared" rather than arriving home one night. He was in his early 30s by then. He boarded a train and traveled some 2000 miles before his family found him--on the street, living out of trashcans and high on drugs--whereas he had 2 weeks before been working at a prestigious law office in the Seattle area.

This illustrates how quickly a schizophrenic without medication can decompensate.

Symptoms of Schizophrenia

  • Delusions--misinterpretation or misperception of reality
  • Hallucinations--seeing people, hearing voices that do not exist--in some cases, the voices tell the person to harm themselves--or others
  • Derangement of thoughts--unable to think clearly or speak clearly--speaking in jibberish or word salad
  • Behavioral disruptions--extremely provocative behaviors, violence or extreme agitation and uncontrollability

Repercussions of Schizophrenia

  • Loss of motivation--to do anything

  • Loss of interest in everyday activities

  • Lack of emotions or heightened emotions

  • Neglect of personal hygiene

  • Social withdrawal or isolation

  • Reduced or impaired ability to plan or complete tasks


Worst Outcomes for Schizophrenics

  • Homelessness
  • Unemployment--or inability to keep a job long
  • Devaluation of self
  • Substance abuse
  • Suicidality or homicidality
  • Institutionalization
  • Loss of family and friends

Effective Therapies for Schizophrenia

If anyone has seen the movie Beautiful Mind, this is a glimpse into the everyday life of the untreated schizophrenic. (Watch the trailer below) It's the true story of Nobel Laureate John Nash and his painful struggle with paranoid schizophrenia that nearly ruined his life.

As the film illustrated, reality becomes distorted in some victims of this disease to a severe degree and the only way to get them back is through treatment.

Unlike years ago when shock therapy and massive doses of sedating medications were given, today's medications are better at restoring normal brain function while not turning the person into a zombie. John Nash was lucky to have survived the horrific treatments of his time and still retain his brilliance in Economics.

This author lived with a schizophrenic grandmother who went untreated and who was never "right" until the day that she died. She was eventually committed to a home because she could not care for herself. She raised my sister and I because at that time, there were no medications available and she was in danger of being institutionalized. My mom wanted to give her a place to stay and take care of her. There were good days and there were very, very bad days as she regularly had hallucinations and saw people that weren't there. She reacted to some of them very violently. It was painful watching someone trapped inside their mind to put it mildly.

My aunt also suffered from the disease and was put through many rounds of shock treatment and heavy sedation for years while she was institutionalized. She was able to eventually get out and led a "semi-normal" life when she was released. She even married, but she developed agoraphobia and other mental disorders as a result of it later in life. For her, the medication side effects also proved to be severely incapacitating.

Today, with the help of medications that stabilize schizophrenics, the option of psychotherapy is more palpable and more probable to be of help.

It has to be said though--merely talking over their mental condition with schizophrenics won't "solve" the disorder nor are there "issues" that can be worked out per se.

In the simplest of terms, schizophrenia is a short circuit in the brain and it's helpful when trying to understand what happens to keep that in perspective. The effort is there but there is a cog missing in the wheel to make the gears go around.

How Does Counseling or Psychotherapy Help Mental Disorders?

  • Once stabilized, psychotherapy can keep patients on the right track--by doing reality checks and keeping someone focused on what's real and what isn't
  • Many schizophrenics turn to drugs and alcohol as a way of coping with their mental condition because it becomes "just too hard" to live in their skin--and their mind. Counseling or therapy can help them stay sober--and also make sure they are taking appropriate medicines and not self-medicating with substances
  • Activities of daily living--holding a job, family or interpersonal relationship, finances, planning, even personal hygiene are all huge issues for schizophrenics at times and the structure of counseling or therapy can help them stay on task and remember the "rules" necessary to live a healthy and satisfied life
  • Schizophrenia almost always affects other people within the person's circle--it can lead to repercussions of anxiety, anger, fear, or even depression in other members of the immediate circle. Therapy and counseling can help everyone involved understand the disease and cope with its complicated outcomes and/or relapses
  • People with schizophrenia at certain points in their diagnosis and eventual understanding of their disorder experience a tremendous sense of loss--psychotherapy and counseling can be one of the greatest gifts to help them manage their justifiable grief or anger at what has happened to them
  • Role playing and cognitive behavioral therapy have shown great promise in schizophrenics because it gives someone tangible "what if" scenarios to deal with and trains the person in ways that are appropriate to respond in certain situations. This is cognitive retraining in many people after their mind has shut down in some areas and they have forgotten what to do
  • Therapists along with qualified medical personnel are the most reliable members of a treatment team for schizophrenics and should be part of the routine monitoring process necessary for someone diagnosed with this disorder. It's the same as being a diabetic--schizophrenics must adhere to a specific medication regimen to remain functional and they must also be evaluated from time to time--for physical and mental checks
  • Some people with schizophrenia must be on injectable medication because the risk of them going off it is too great--this usually occurs with people who have been involuntarily hospitalized and can prevent dangerous violent behaviors from occurring
  • Going off medication is the most common occurrence for many schizophrenics and the leading cause of relapses and/or life-threatening situations--an attuned therapist (or family members) will pick up on things like a preoccupation with religion or changes in behavior and be able to act quickly to assure the person stays on their medication or reinitiates it quickly
  • Group therapy, self-help groups and family therapy are tremendous treatments to help the schizophrenic learn to cope on his own and within society--whether it's in his or her own family or the workplace. It can mean the difference between failure and success in these people

Why Do Some People Get Schizophrenia?

There are many theories as to why some people get it and some don't...from what part of the continent you live on to what nationality a person is.

Some of the current thoughts on causes:

  • Family history puts someone at much higher risk (I worry about this a lot!)
  • Babies who did not get adequate nutrition in utero
  • Exposure to high levels of stress or violence
  • African American descent but other nationalities as well
  • Older paternal age
  • Substance abuse at an early age
  • Exposure to viruses or toxins while in utero
  • Genetic disposition
  • Environmental influences

Best Treatments for Schizophrenia

The most important fact about schizophrenia to remember is that it's a disease--like diabetes or like cancer. No one wants to get it and for those who do get it, it's horrible. They would no more like to be that way than someone would like to get cancer.

Today there are more treatments available than there were 50 years ago and they are much more effective. However, that isn't to say that the medications no matter what form don't have their own set of side effects.

The most important things about schizophrenia, like so many other things in life today, are no brainers but seem to escape some people---tolerance and understanding go a long way to helping people survive this devastating mental disorder.

Especially in a stricken economy, there are more and more people without benefits or who go without medications for all kinds of conditions--schizophrenia is not one of the conditions you can cure or treat without medication.

Social programs that are cut directly impact schizophrenics who are trying to learn job skills or just get by in society.

There are no easy answers when it comes to schizophrenia. It's a hard disease to be exposed to especially if you don't understand it.

But for the victims, there is one phrase that always stands out in my mind--no play on words intended--and so very true in my case..."There but for the grace of God go I."

It truly can happen to anyone and the more we can do to promote adequate treatment for its victims, the better we are as a society.


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    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      Pauline-thanks so much for stopping by and for your insightful comments as well. It is a sad, sad disease and it made me feel awful writing it to tell the truth because I thought of how much more could have been done for my grandmother and my aunt--but that was then and this is now. I'm only glad I could write it because I do believe people should understand it and give people their attention and their empathy~

    • Pauline Davenport profile image

      Pauline Davenport 

      6 years ago from Isle of Man

      Mental illness has always, sadly been the 'Cinderella' of the Health Service, and mental illness of any kind has always carried a dreadful stigma. I only truly realised the devastation and sheer loneliness of schizophrenia when I was on my psychiatric placement as a student nurse in the early 1980s.

      This Hub is wonderfully factual, sympathetic, educational. I would like to see it on every wall in every doctor's surgery, in every public library -everywhere, where the general public can see it and read it and thus gain some understanding of this illness.

      From what you say akirchner, the drugs and treatment seem a lot lot better than in the eighties, and in snswer to you question, a resounding 'yes' - supportive psychotherapy must be a tremendous help to keep these poorly folk on track

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      Thanks, Maddie--it was kind of therapeutic to write I suppose but a hard topic for me---it made me kind of sad remembering my own family's experience but the good news is that it's "better" treated these days---for that I'm very thankful and I do see the validity in owning certain things in life that you know about personally. Who knows who it can help down the road?

    • Maddie Ruud profile image

      Maddie Ruud 

      6 years ago from Oakland, CA

      I, too, have watched a friend with schizophrenia unravel before my eyes. It's a very frightening experience. Thank you for sharing your own experiences and wealth of knowledge on the subject with us.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      Thanks for stopping by, Eddy - definitely much to think about when it comes to this disease.

      Nettlemore--How sad indeed--I do think the effects the disease can have on the family (and friends) is the hardest part of all. It's tough to love someone who can bring such chaos into your life--I know this from growing up like I did. It was simultaneously absolutely frightening and embarrassing because I never knew from one moment to the next who I'd be "exposed to." However, underneath it all, when you love someone it's hard not to realize what life must be like for THEM and I guess that's what saved me. Wishing your friends calm winds and smoother sailing---it is a horrible disease to cope with and be exposed to.

    • Nettlemere profile image


      6 years ago from Burnley, Lancashire, UK

      Good to see a thorough article on this. I have a friend whose son was diagnosed with schizophrenia 20 yeas ago and as a result they have had many difficult times with him and been scared of him, which must be heart breaking to be afraid of your own son. Getting him to stick with the treatment is an ongoing challenge. I can certainly empathise with your worrying due to the inheritabilty of the disease.

    • Eiddwen profile image


      6 years ago from Wales

      A very well written hub which leaves much food for thought.

      Take care and enjoy your day.


    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      BJ - Yes indeed, having observed it in a few people very close to me, definitely an imbalance and chemically makes all the sense in the world. It is tragic though when they go off their meds and go spiraling backwards. I can see the reasoning behind mandatory injections for some folks who don't have the "luxury" of being monitored by family, friends, etc.

      Terribly tragic mental disorder and I keep thinking perhaps I'm beyond the age that it can happen to me~~~ I think I've spent many decades waiting for the gene to kick in--or worried that it would. Hard thing to watch happen to people you care about and hopefully one day, like so many other diseases...we'll find a cure!

    • drbj profile image

      drbj and sherry 

      6 years ago from south Florida

      The answer to the question you pose with your title, Audrey, is Yes, of course psychotherapy can be used to treat schizophrenia. And the results may be positive if used in conjunction with appropriate medication. One of the problems, however, is that many schizophrenics stop taking the drugs they need believing they no longer need them, as you pointed out.

      We still do not know what causes this tragic mental disease but the most popular belief is that it may be caused when certain chemicals in the brain are not in balance. Not a very helpful diagnosis, I know.

      Regardless, you have written a very complete and helpful treatise on the disease and I commend you for it. Thank you, m'dear.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      Radhapriestess--Thanks for that interesting info--I haven't heard of that but I guess anything is possible. Will have to read about that.

    • radhapriestess profile image


      6 years ago from Minneapolis, MN

      There are cases of people with this condition which were completely cured by eliminating foods they are allergic to such as wheat, milk, eggs, etc. This is something to consider. People need to be medically evaluated. Another cause is mercury amalgam fillings. There are cases where people removed and replaced with bio-compatible substances for fillings and people greatly improved or were cured.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      MT - Isn't that the truth? That is the first light that goes off if you know someone with the disease---and it is so hard on them--and everyone else as well. Thanks for stopping in and adding your confirmation to the facts on the matter. Hopefully one of these days they'll find something that works to obliterate this horrid thing!

    • Minnetonka Twin profile image

      Linda Rogers 

      6 years ago from Minnesota

      Excellent information on the disorder of schizophrenia. I too have known friends that struggled with this painful disorder. We all figured out that when she told us she was talking to the dead and they were showing her things, she was off her meds. It does affect the whole family system, not just the person with the disease. Thanks for educating your readers.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      Rosario--having been there and done that and seen the devastation for sure....much more needs to be learned about these disorders. Great news on those therapies, too---having had EMDR myself and having found it very helpful in treating PTSD, I can say that I would imagine it would be very beneficial in treating some of these symptoms.

      Thanks so much for stopping by and for your helpful comments most of all!

    • profile image


      6 years ago

      Energy psychology is a relatively recent, vast field that has been explored with success for some tremendous problems such as PTSD but not so much, that I know of, for psychosis and schizophrenia.

      I sincerely think that there is hope in this field. We are talking EMDR, EFT, THE HEALING CODES, PSY-K, and others that I am not familiar with.

      These techniques are also a great help to the helpers --the parents, spouses, siblings, nurses, and other people who take care of the person with the disease.

      Thank you for talking about such a painful condition with such care.

    • akirchner profile imageAUTHOR

      Audrey Kirchner 

      6 years ago from Washington

      Carol - definitely not a "fun" disorder but then what mental disorder is really fun? Thanks for stopping by~

    • carol7777 profile image

      carol stanley 

      6 years ago from Arizona

      An eye opener...True we all know the disease but you went into the description and issues thoroughly. How sad to be happy one day and have this take over. Thanks for sharing this. Voted up.


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