Tag Archives: psychosis

Cognitive Pearl #087 Sivan 20, 5775 Schizophrenia, Cognitive Therapy, & Possibilities

All truth Schopenhauer












Over the last 25 years of work with adults suffering from schizophrenia in all of it’s manifestations, I’ve seen some wonderful turn-arounds. By turn-around, I’m speaking of individuals who either made full recoveries or who made unexpected improvements in their functioning.

Let’s consider two of the full recoveries (1). In both cases the clients resumed their previous vocational activity (students) and social functioning. They remained in some form of aftercare and continued to take low maintenance doses of antipsychotic medications; as of this writing they still do. Interestingly and not surprisingly, both were young women in the early twenties. Both experienced a sharp descent into psychosis which lasted about six months; during this time there was increasing paranoia, irritability, depression, and then florid psychosis leading to hospitalization. In one case, there was heavy use of marijuana as a way to self medicate away anxiety; predictably it had  negative effects as well.

That’s the bad news. Now the good news.

Both of these women were fortunate to have parents who they were close with. Both had access to high quality hospitalization, well trained clinicians, and great aftercare. Both had social networks and extended family relationships so that their care didn’t fall only on their parents. Both had vocational arrangements which by law and basic human decency they could return to as they became more and more capable.

In addition to all of these blessings, both of these women participated in a ‘first break’ group, an educational program for young adults going through their first episode of severe psychiatric illness. Along with the manic, the severely depressed, and one soul terribly tortured by obsessions and compulsions, these two women learned skills to reduce stress, increase mastery, and intensify focus.

Cognitive therapy was an integral part of that. 

More on that in my next post!

Shavua tov to all!


(1) Aside from the fact that I met both of these individuals while I worked in various day treatment programs in the United States, all of the details have been obscured.

Cognitive Pearl #066 Iyar 8, 5775 April 27, 15

The words You Speak Become The House You Live In

Most of us think of cognitive therapy as a way of understanding and relieving depression, anxiety, and whatever else we use it for by focusing on the thoughts that underlie the disorders.

That is all true.

Yet, for me at least, cognitive therapy is about approaching the processing system that is the human mind. Whether it’s depression, joy, psychosis, impulsivity, concentration, love, pain, and all the rest, (and there’s a whole lot more!) the mind takes in information, processes it, and then uses those processes to guide how it navigates its existence. Cognitive therapy seeks to alter cognitive processes by illuminating them and by upgrading them.

The end result is a better life. 

While some mistakenly claim that cognitive therapy is superficial, it isn’t at all. It’s just that we cognitive therapists have found that not every single cognitive process needs to be illuminated and upgraded to make things better. Generally speaking, chronicity and severity are the best guides to how much we need on the table. 

More on that in the next post.