Transformation: Recovery Oriented Cognitive Therapy for Schizophrenia

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firemonkee57

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A common image of schizophrenia is the person who spends all day staring at the wall. Such loss of motivation and social withdrawal are known as negative symptoms. These are the most disabling features of this condition, and have been considered virtually permanent—no treatment has been discovered that would help to alleviate them.

In the late 1990s, we decided to see if we could understand negative symptoms better and find a way to improve them. The prevailing belief in the field has been that the observed social withdrawal and inactivity is based on impairment of brain function, specifically, attention, memory and executive function. However, we could not comprehend how these impairments could translate into the profound inactivity we saw in the person staring at the wall.

After conducting many interviews with individuals experiencing negative symptoms, we came to a startling conclusion: these individuals appeared to have a system of negative beliefs that could account for their low functioning. Specifically, we speculated that defeatist and asocial beliefs reduce access to the motivation needed to initiate and sustain activity. The defeatist beliefs consisted of attitudes such as “there’s no sense in trying anything, I’m only going to fail,” and “failing at one thing is the same as being a total failure.” The asocial beliefs included "people are better off if they stay aloof from emotional involvements with most others,” and "making friends isn't worth the energy it takes.”

We conducted a series of studies and found, as predicted, that these negative attitudes had a direct impact on the negative symptoms, while the impairments in attention, memory, and executive functioning had only an indirect effect. It stood to reason that if we could modify these disabling attitudes, then we could relieve the disabling behavior.

http://www.nami.org/Blogs/NAMI-Blog/March-2016/Transformation-Recovery-Oriented-Cognitive-Therap#
 
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firemonkee57

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I am not sure what to make of the claim. I think it certainly underplays the effect of cognitive factors such as executive functioning. For me lots of tasks involving some degree of organising and planning and a multi step process( executive functioning skills) are ones that I tend to back away from hence the lack of motivation.
Perhaps this could be called defeatist but the fact is they are stemming from a real problem ie executive functioning difficulties. To say that it is just down to attitude of mind(a mainstay of CBT philosophy) glaringly misses the point.
Without help for those executive functioning difficulties I will always have difficulties with and tend to back away from certain tasks. The truth is we tend to be more motivated to doing those things we are good at. That applies to people with or without psychosis
 
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ramboghettouk

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I am not sure what to make of the claim. I think it certainly underplays the effect of cognitive factors such as executive functioning. For me lots of tasks involving some degree of organising and planning and a multi step process( executive functioning skills) are ones that I tend to back away from hence the lack of motivation.
Perhaps this could be called defeatist but the fact is they are stemming from a real problem ie executive functioning difficulties. To say that it is just down to attitude of mind(a mainstay of CBT philosophy) glaringly misses the point.
Without help for those executive functioning difficulties I will always have difficulties with and tend to back away from certain tasks. The truth is we tend to be more motivated to doing those things we are good at. That applies to people with or without psychosis
are they claiming removing peoples negative attitudes will cause them to recover? been there got the t shirt
 
blacksmoke

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I am not sure what to make of the claim. I think it certainly underplays the effect of cognitive factors such as executive functioning. For me lots of tasks involving some degree of organising and planning and a multi step process( executive functioning skills) are ones that I tend to back away from hence the lack of motivation.
Perhaps this could be called defeatist but the fact is they are stemming from a real problem ie executive functioning difficulties. To say that it is just down to attitude of mind(a mainstay of CBT philosophy) glaringly misses the point.
Without help for those executive functioning difficulties I will always have difficulties with and tend to back away from certain tasks. The truth is we tend to be more motivated to doing those things we are good at. That applies to people with or without psychosis
showing my ignorance now but what is executive functioning :redface:
 
blacksmoke

blacksmoke

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A lot of what is in your post I have as regular “normal” thinking. But I do not have schizophrenia
[I]observed social withdrawal and inactivity is based on impairment of brain function, specifically, attention, memory and executive function.

appeared to have a system of negative beliefs that could account for their low functioning. Specifically, we speculated that defeatist and asocial beliefs reduce access to the motivation needed to initiate and sustain activity. The defeatist beliefs consisted of attitudes such as “there’s no sense in trying anything, I’m only going to fail,” and “failing at one thing is the same as being a total failure.” The asocial beliefs included "people are better off if they stay aloof from emotional involvements with most others,” and "making friends isn't worth the energy it takes.”
[/I]
https://jonrappoport.wordpress.com/2015/01/27/a-whole-branch-of-science-turns-out-to-be-fake/
 
blacksmoke

blacksmoke

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thanks firemonkee57 gosh wow blimey i do a lot of this stuff on the how to manage..as normal everyday operating. i do constantly get frustrated in not being able to implement things spend loadsa time planning but still cant implement and then some arshole comes along and bobs yer uncle. cant help feeling really stupid and useless when this happens
 

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