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Schizophrenia is a severe and disabling illness of the brain that affects the way the mind works often causing disturbed behaviour and disrupting normal living. It will affect about 1 in 100 of the population and starts mainly in late teens and early twenties, at the very time that most people are starting out on their adult life and beginning to realise their plans and ambitions. Today in the UK almost a quarter of a million people are being treated for schizophrenia: it affects men and women alike and cuts across all social classes and ethnic backgrounds.

Schizophrenia is one of the major public health challenges facing us today and yet its true impact is very poorly understood by the general public. The cruelly high death toll from suicide and the higher vulnerability to physical ailments mean that people living with schizophrenia will die 10 to 20 years earlier than average
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Today in the UK , improved medications coupled with better access to talking therapies have led to better clinical outcomes but social outcomes still lag far behind. At the moment very few people who are diagnosed with schizophrenia will manage to get into work, drive or own their own home despite recovering a large part of their mental functioning. Recovery, true recovery, therefore remains an aspiration that we are yet to achieve

On this website we publish the views and experiences of people who have known schizophrenia from the inside and who do not believe that a diagnosis of schizophrenia need be a life sentence. We believe that the aim should be not simply to survive but to thrive.

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Read what Living with Schizophrenia has to say about topical issues in mental health

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Living With Schizophrenia | Information & Support

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Schizophrenia is a severe and disabling illness of the brain that affects the way the mind works often causing disturbed behaviour and disrupting normal living. It will affect about 1 in 100 of the population and starts mainly in late teens and early twenties, at the very time that most people are starting out on their adult life and beginning to realise their plans and ambitions.

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FC MHA Lesson 10 Homework Assessment 10 "schizophrenia" 

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Psychosis and how early intervention can help...

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Psychosis: Bending Reality to See Around the Corners | Paul Fletcher | TEDxCambridgeUniversity

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This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

© Copyright 2008-2019 GreenMedInfo.com, Journal Articles copyright of original owners, MeSH copyright NLM.

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Bergamot Improves Schizophrenic Brain Function

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Bergamot oranges are bitter fruits that grow in one of the world's most beautiful coastal regions. Could the scenic ocean vistas be responsible for the calm, relaxing effects we derive from smelling and ingesting the bright, citrus essence of this amazing fruit?

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answer sheet

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FC MHA Lesson 9 answer sheet "Myth or Fact Quiz" unit 9.pdf

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This section covers what schizophrenia is, what the symptoms are and how you can get treatment. You might find it useful if you have schizophrenia yourself, or if you care for someone who does.

Schizophrenia is a mental illness that affects the way you think.

It affects about 1 in every 100 people.

Schizophrenia may develop during early adulthood.

You can have 'positive' and 'negative' symptoms of schizophrenia.

Positive symptoms are experiencing things that are not real (hallucinations) and having unusual beliefs (delusions)

Negative symptoms may be a lack of motivation and being withdrawn. They often last longer than positive symptoms.

There are different types of schizophrenia.

There are different causes of schizophrenia including genetics and environment.

You can get medication and psychological treatments for schizophrenia.

This section covers:

1. What is schizophrenia?
2. What are the symptoms of schizophrenia and how is it diagnosed?
3. What are the types of schizophrenia?
4. What causes schizophrenia?
5. How is schizophrenia treated?
6. Is it possible to recover from Schizophrenia?
7. What if I am not happy with my treatment?
8. What are self care and management skills?
9. What risks and complications can schizophrenia cause?
10. What if I am a carer, friend or relative?

These pages are created by the Rethink Mental Illness Advice Service in accordance with the Information Standard. Last reviewed in April 2017. Next review April 2020.

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Need practical advice & info? We can help.

Contact our Advice team about mental health & related issues

0300 5000 927 Monday - Friday 9.30am - 4pm, not including bank holidays

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This section covers what schizophrenia is, what the symptoms are and how you can get treatment. You might find it useful if you have schizophrenia yourself, or if you care for someone who does. Schizophrenia is a mental illness that affects the way you think. It affects about 1 in every 100 people.

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Learn about schizophrenia. Find out what the misconceptions, symptoms, treatments, and self management techniques are.

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I Am Not A Monster: Schizophrenia | Cecilia McGough | TEDxPSU

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Node Smith, ND

A recent research study has confirmed a significant link between common symptoms of schizophrenia and childhood trauma. ¹ The findings could help develop a more tailored approach, and open the question whether this, and other psychotic disorders, may be recovered from in the future.

The study was conducted at the National Centre of Excellence for Youth Mental Health, in collaboration with the University of Melbourne, Port Phillip Prison, and University Hospital of Gran Canaria Dr Negrin, in Spain. The researchers looked at 29 separated studies of childhood trauma and psychotic symptoms. The study was published in the journal Schizophrenia Bulletin.

Alarmingly, all types of childhood trauma had associations with hallucinations

The overarching, and most significant finding was that all types of childhood trauma had associations with hallucinations like those seen in psychotic disorders. Sexual, physical and emotional abuse, all were linked to severe hallucinations and diagnoses of schizophrenia and other psychotic disorders. More specifically, the study showed that childhood sexual abuse is associated with delusions.

There has been a long-held theory that childhood trauma is linked to hallucinations and delusions, however, there has been limited research to confirm this idea.

Symptoms of Psychotic Disorder

Roughly 1 percent of the population experience a psychotic disorder. Usually, symptoms appear between the ages of 18 and 25. Symptoms include detachment from reality, hallucinations, delusions, disorganized thinking, and/or a lack of emotional sensation or motivation.

Study hopes to help target treatment approaches to trauma visible in psychosis

The hope of the study is that it will help inform more targeted treatment approaches to the trauma seen in psychosis - which have largely focused on PTSD, as opposed to the more specific symptoms of hallucinations and delusions. It is also intended that this research will help benefit young patients by increasing self-empowerment. The researchers also suggest that young people presenting with a history of trauma be assessed for psychosis so that symptoms may be caught as early as possible.
Source

Bailey T, Alvarez-jimenez M, Garcia-sanchez AM, Hulbert C, Barlow E, Bendall S. Childhood Trauma Is Associated With Severity of Hallucinations and Delusions in Psychotic Disorders: A Systematic Review and Meta-Analysis. Schizophr Bull. 2018

Photo by delfi de la Rua on Unsplash

Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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Childhood Trauma Could Change the Way We Look at Schizophrenia and its Treatment

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Node Smith, ND A recent research study has confirmed a significant link between common symptoms of schizophrenia and childhood trauma. 1 The findings could help develop a more tailored approach, and open the question whether this, and other psychotic disorders, may be recovered from in the future.

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A woman roasted her pet chihuahua to death in an oven because she believed it had been possessed by the spirit of her ex-boyfriend.

Noelle Georgia Moor, 28, baked seven year-old Bolt to death at her home in Warrenton, Or. on Tuesday.

Bears are looking after their cubs for longer to protect them from humans

Cops who attended the scene afterwards noted 'The smell of burnt hair and flesh was still in the air,' The Oregonian reported.

A woman called Heather Lessard who said she was Moor's sister explained how she thought the dog had been possessed on The Astorian's website.

She said: 'This is my sister and she is struggling with schizophrenia.

'Please understand that she didn't know what she was doing.

'She had been asking professionals for help.

'She turned herself into the institution and they threw her out onto the street when she was in the middle of an episode and needed help.

Heather continued: 'When she comes to and realizes what she did she is going to be heart broken.

'Her dog was her best friend and I am disgusted by what she did, but she believed her abusive ex boyfriend had possessed him and she was terrified.

'They never should have THROWN her out of the institution.

'She knew she needed help and now we are all suffering.

'Please keep her in your prayers. Shes the sweetest women I've ever met.

'When in her right mind she would never hurt a fly.

'My heart goes out to Bolt and my helping hand and compassion goes out to my beautiful sister.'

Moor was detained at a local psychiatric unit and now faces first-degree animal abuse charges.

Mental health professionals were reported to have had multiple encounters with Moore over the past month.

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Woman roasted chihuahua to death in oven because she thought it was possessed by her ex

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A woman roasted her pet chihuahua to death in an oven because she believed it had been possessed by the spirit of her ex-boyfriend. Noelle Georgia Moor, 28, baked seven year-old Bolt to death at her home in Warrenton, Or. on Tuesday.

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SHADEAN McPherson woke up to a screwdriver punching down on her again and again - the first of 17 blows over the course of a few seconds which would change her life forever.

Above her was her husband of 12 years and the father of her two children, he covered her mouth and told her "you're going to die tonight".

She thought of her son and daughter and focused on surviving as the weapon plunged into her, something she describes as an "out of body experience".

What made it worse was she'd seen it coming, but says she was fobbed off as she watched the love of her life descend from paranoia into an explosion of violence.

Matthew McPherson - who was sectioned with schizophrenia after the attack - was convicted of attempted murder on the grounds of diminished responsibility in June 2014.

Shadean, 38, doesn't blame the man who tried to kill her and now casts her trauma aside to come face-to-face with him in custody and give her kids the chance of a family life.

'Matthew was different to anyone I'd ever met. We loved each other.'

Shadean met Matthew outside a KFC in Brixton, South London, in 2001, and the couple started dating a short time later.

They fell in love and embarked on a whirlwind romance which saw them married within six months.

She said: "We hit it off. We thought about things in the same way.

"He was different to anybody I'd met before, he was really in tune with me and we loved each other.

"It was such a fun time of my life, I have a lot of fun memories with Matthew.

"We moved in together and decided we just wanted to start our lives together."

'He changed. He was seeing men under the table and talking about people trying to kill me'

Shadean and Matthew had two children in 2003 and 2009 and moved to Birmingham to raise their family.

Matthew worked as a mechanic in the Aston area of the city and Shadean, now an NHS community worker, was studying at university while working part-time.

But six months before the attack in November 2013, Shadean began to notice changes in her husband's behaviour as their relationship broke down.

She said: "He would accuse me constantly. He was phoning 999 saying there was something wrong with me.

"The door would knock and there'd be ambulance, police, everything - they'd say 'is everything alright? Because your husband has rang us to say people are trying to kill you.

"He accused me of being involved in drug dealing and local gangs.

"It was ridiculous but when they arrived he'd be calm and composed and I'd be the one getting angry and frustrated.

"I tried to tell them what was going on but they wouldn't listen. They think the one that's calm is the one that's telling the truth."

Shadean says one police officer - who a few weeks later stood over her as she lay in a pool of blood - told her she was being "neurotic" and to move on from her marriage.

When she convinced Matthew to see a psychiatrist he was diagnosed with schizophrenia but he left his medication untouched in a box.

She says doctors and community nurses dismissed her pleas he was ignoring his treatment, telling her he "seemed fine" and to stop calling.

She said: "He was under the impression that I was trying to get him sectioned - that there was nothing wrong with him and I was evil and trying to get him.

"I knew he wasn't well but when he was in front of the police or the health workers he was very manipulative.

"When you're the one losing their cool and begging for help they think you're the problem but they should have been the ones able to see through it. I still can't believe they didn't."

'I woke up to sudden movement and he was stabbing me everywhere. He said I was going to die.'

Matthew had been sleeping in his car in the nights before the attack and returned to the house after picking their son up from football practice.

The children, then aged nine and four, were sleeping upstairs as their dad's paranoia reached a brutal tipping point.

Shadean said: "He'd been going on and I was just ignoring him, that he'd seen me with other men. He said that he'd seen other men under the table... I knew he wasn't well.

"I gave him something to eat, we put the kids to bed, I sat on the sofa to do an assignment and I dropped asleep.

"I woke up to sudden movement and he was stabbing me everywhere. He put his hand over my mouth and he said I was going to die tonight.

"It was like I was a third person. It was like it wasn't me, like I was looking down from above on what was happening.

"I had this sense that I wasn't going to die, that I had to keep calm, and I basically acted my way out of the situation.

"I kept saying things like 'I'm going cold, I need water' so that he got off me. I got the screwdriver and I jammed it right underneath the setee.

"He came back out of the kitchen with my water and he was like 'oh my God' and he phoned the ambulance.

"He told them somebody has come in and stabbed my wife and I said to him 'it was you'. He looked at his clothes and he saw that there was blood everywhere.

"It was like he was taken over by something else - this is what mental illness does."

'I love him for the life we built together and our children deserve to have their dad. It wasn't him that attacked me, it was the illness...'

Matthew was arrested at the scene and sectioned in a secure mental health unit at the Tamarind Centre in Birmingham.

Miraculously, the 17 stab wounds did not hit any organs or arteries and Shadean was discharged from hospital after four days.

On May 7, 2014 - less than six months after the attack - Matthew was convicted of attempted murder on the grounds of diminished responsibility and detained indefinitely.

Shadean said: "I felt hate, anger, resentment. I was so, so angry that he could do that to me and he could do that to our children. My children could have been left with no-one."

She ignored her husband's phone calls for eight months as she struggled to come to terms with the attack and refused to see him until more than a year after his sentencing.

She said: "It was making me ill. I just didn't want to have to face him... but then I also understood Matthew was always a good dad - he was my kids' dad.

"I made a decision I would take my children, that was the best thing I could do for them as their mum.

"I want to be able to look my children in the eye and say I've done everything right by them."

Coming face-to-face with the man who tried to kill her on sofas at the mental health facility was a distressing experience.

She said: "I hadn't been coping. There were days when once my daughter had gone to school, I would just go back to bed and stay there all day.

"I just felt angry. He wanted to sit near me but I would sit on the other side of the sofa.

"I could feel my son's eyes burning into me, he was watching my reaction towards his dad.

"I blanked my feelings because I wanted my children to enjoy their time with him."

But after those first meetings, Shadean slowly began to forgive and Matthew has now been allowed to meet his family for monitored visits outside of hospital.

Shadeen said: "We go for coffee and cake and we've done a bit of shopping.

"I feel sadness for him now, because he was such a strong guy. He was a good provider, a strong man, brilliant dad. It's sad, it's really sad that this has happened to him.

"He's my kid's dad so I'll always have that love for him and as a friend we grew together. He's been a big part of my life.

"I'm fully aware that it was his illness. It's not their brain or their thoughts, it's the mental illness that takes over."

'I was the one who knew him best but no-one listened to me - that needs to change'

Shadeen believes it took her stabbing for police, social services and health workers to take Matthew's condition seriously and the attack could have been avoided.

She said: "Partners and families are the ones who really know what's going on. There should be separate appointments where they come and speak to them alone.

"I was only spoken to when Matthew was in the room and obviously that changes the whole dynamic.

"The doctor would be there talking to him and I would have to be at the door mouthing that this and that's happening.

"I felt petrified but I wasn't getting through to anyone. The only way I got through was when it was too late."

West Midlands Police said they were called to two domestic disturbances involving the McPhersons but no mental health concerns were reported or noted.

The force said on one occasion Matthew McPherson was arrested on suspicion of domestic assault but the allegation was withdrawn.

A spokesman said since 2013 officers now respond to incidents involving suspected mental health episodes with a psychiatric nurse and on-the-spot assessments are made to determine if the individual needs psychiatric treatment.

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Mum bludgeoned by husband forgives him to give kids their dad back

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SHADEAN McPherson woke up to a screwdriver punching down on her again and again - the first of 17 blows over the course of a few seconds which would change her life forever. Above her was her husband of 12 years and the father of her two children, he covered her mouth and told her "you're going to die tonight".

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An Oxford university student who brutally murdered a woman in the grounds of Harrow public school, is being prepared for release after serving just 11-years in a secure hospital.

William Jaggs, 34, an ex-drug addict, was sent to Broadmoor high security mental hospital in 2007, after he admitted stabbing fashion student, Lucy Braham.

But the former Harrow schoolboy - who recently began cross-dressing and changed his name to Gillian - has now been allowed out of his secure unit for regular shopping trips as part of a phased release.

At his Old Bailey trial the court heard how Jaggs became obsessed with Miss Braham, 25, who lived just a few doors from him in the grounds of Harrow, where both of their fathers were teachers.

He killed her in a sexually motivated attack after forcing his way into her home, stabbing her 66 times.

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Killer allowed out on shopping trips despite judge warning he might never be released

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An Oxford university student who brutally murdered a woman in the grounds of Harrow public school, is being prepared for release after serving just 11-years in a secure hospital. William Jaggs, 34, an ex-drug addict, was sent to Broadmoor high security mental hospital in 2007, after he admitted stabbing fashion student, Lucy Braham.

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Read about symptoms of schizophrenia, including hallucinations, delusions, confused thoughts and changes in behaviour.

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What are positive and negative symptoms?

People sometimes describe the symptoms of schizophrenia as 'positive' symptoms or 'negative' symptoms. This doesn't mean they are good or bad.

Positive symptoms are experiences or behaviours that you start having as part of schizophrenia. They can include hearing voices, seeing things that others don't, believing something is real or true when it isn't, or believing your thoughts are being monitored or controlled.

Negative symptoms are experiences or behaviours that you stop having (or have less) as part of schizophrenia. You might find people or activities less interesting or enjoyable, that you move your body less, feel disconnected from your emotions or have less motivation to do things.

What was real and what was not? I couldn't tell the difference any longer and it was exhausting.

Misconceptions about schizophrenia

Many people have heard of schizophrenia, but this doesn't mean that they understand the diagnosis. You might find that some people have negative ideas about schizophrenia or have misconceptions about you.

A diagnosis of schizophrenia does not mean someone has a 'split personality', but many people wrongly think this. Some people think hearing voices means someone is dangerous, when voices are actually more likely to suggest that you harm yourself than someone else. It's also important to remember that people have a choice in whether they do what the voices say.

Schizophrenia in the media

Misconceptions about schizophrenia often come from the media, including newspapers and TV. There is more media misinformation about schizophrenia than about any other type of mental health problem.

Sensational stories in the press often wrongly present people with schizophrenia as being dangerous, even though most people with schizophrenia don't commit violent crimes.

What diagnoses are related to schizophrenia?

There are several diagnoses that share many of the same symptoms - such as schizoaffective disorder, schizotypal personality disorder and schizoid personality disorder. (See our information on schizoaffective disorder and personality disorders.)

Different views about diagnosis

Views on schizophrenia have changed over the years. Lots of people have questioned whether schizophrenia is actually one condition or a few different conditions that overlap.

Some people argue that because psychiatric experts cannot agree on the exact definition of schizophrenia, it shouldn't be used as a diagnosis at all. Others think the name of the condition doesn't matter and that it would be more useful to focus on what helps with specific symptoms and individual needs.

The reality is that many people are still given a diagnosis of schizophrenia. If you are one of them, it might be helpful to think of a diagnosis as a tool for treating what you're currently experiencing, rather than a definite condition or label that you will have to live with forever.

Some people find getting a diagnosis helpful and some don't. For more about diagnosis, see our information on seeking help for a mental health problem.

More recently my symptoms have included voices outside my head, feelings that people are talking about me and spying on me.

How can I make people more aware of schizophrenia?

If you find that people don't understand or know about schizophrenia, you could:

Show them this information. This can help them understand more about your diagnosis.

Get more involved in your treatment. Our page on seeking help for a mental health problem explains more about having a say in your treatment, getting your voice heard and steps you can take if you're not happy with your care.

Know your rights. Our pages on legal rights have more information.

Take action with Mind. See our campaigning page for details of how you can get involved. For more about campaigning, visit the Time to Change website.

This information was published in February 2017. We will revise it in 2020.

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What are positive and negative symptoms? People sometimes describe the symptoms of schizophrenia as 'positive' symptoms or 'negative' symptoms. This doesn't mean they are good or bad. Positive symptoms are experiences or behaviours that you start having as part of schizophrenia.

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FC MHA Lesson 9 "The Metro" unit 8:2.1.pdf

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FC MHA Lesson 9 "The Telegraph" unit 8:2.1.pdf

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FC MHA Lesson 9 "hearing voices activity" unit 8:4.pdf

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FC MHA Lesson 9 "Living with Schizophrenia" unit 8:4.2.pdf

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FC MHA Lesson 9 "Ways a family and friends can help a person with schizophrenia" unit 8:5.3.pdf

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AGM Anti-Stigma Conference Critical Psychiatry Diagnosis Hearing Voices Hearing Voices Groups Intervoice Job Local Event Peer Support Personal Experience Psychosis Recovery Research Schizophrenia Training Trauma World Hearing Voices Congress Young People

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To reduce the length of time young people are left without any treatment

To give people a positive first experience of mental health services

To reduce symptoms and support recovery after a first episode of psychosis for up to three years

To help young people reach their potential

To prevent or reduce the severity of relapses

To support and inform families and carers and involve them as much as possible

To improve awareness of the symptoms of psychosis and the need for early assessment amongst other professionals and the public by working closely with a range of other organisations and services

To use evidence based treatments and promote these to others working with young people experiencing psychosis.

After contacting the service, if an assessment is required, we will try and arrange this in a place of your choice. This might be your home, a café or youth centre. You're welcome to attend with family, a friend, or a carer if you want to.

We will work with you to create a detailed assessment of your needs which will look at all aspects of your life. This will include your thoughts and feelings but also practical issues too.

If, after talking to you, we find the service could help you, you will be allocated a worker, known as a Lead Practitioner, who will work with you to identify your needs and create a care plan (you might hear this referred to as a Care Plan Approach or CPA).

The plan will include the targets you discussed with your Lead Practitioner, contact details for people who can help and information on what to do if you have a crisis or something unexpected happens.

The plan will be regularly reviewed to suit your needs and to check that it's helping you to get better.

We offer one-to-one talking therapies, like counselling and cognitive behavioural therapy (CBT), which may help you to explore thoughts and feelings that can affect behaviour and develop ways of coping with those experiences.

We can also offer practical help with housing, benefits and finances, support you in getting back to work, studies and other social and leisure activities and also work with friends and families.

We may use low doses of medication to help reduce the frequency, intensity and distress associated with unusual experiences. If we feel that medication might be appropriate, you will be offered an opportunity to discuss options with a doctor and the pharmacist from the team.

We believe it is important for you and others involved to have the right information to make choices about your care.

Mental health and illness could be influenced by many different areas of your life, for example emotional, genetic or social. Because of this, our six teams across Sussex are made up of professionals from a variety of backgrounds including doctors, nurses, social workers, occupational therapists, psychologists, pharmacists and community support workers.

You might find talking to your GP a good first step. They can offer support and guidance and, if they think it's appropriate, they can refer you to us.

Alternatively, you can call your local team on the numbers below to talk about your concerns and what you're going through. We can meet with you and offer time to assess what is happening and explore ways of helping. We're here from 9am - 5pm Monday to Friday.

If you need to speak to someone out of these hours please call the Sussex Partnership Mental Healthline on 0300 5000 101.
Bognor Regis: 01243 841041 Brighton and Hove: 01273 718682 Hailsham: 01323 446062 Hastings: 01424 726500 Horsham: 01403 223200 Worthing: 0300 304 0067

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To reduce the length of time young people are left without any treatment To give people a positive first experience of mental health services To reduce symptoms and support recovery after a first episode of psychosis for up to three years To help young people reach their potential To prevent

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Mental Health Rapid Response service (MHHRS)

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A mental health rapid response service for people living in Brighton & Hove.

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We provide NHS care and treatment for people living in south east England. Our vision: outstanding care and treatment you can be confident in.

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East Brighton Community Mental Health Centre

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East Brighton Community Mental Health Centre

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© Sussex Partnership NHS Foundation Trust, Trust HQ, Swandean, Arundel Road, Worthing, West Sussex BN13 3EP. Tel +44 (0) 1903 843000

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Location - East Brighton Community Mental Health Centre

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We provide NHS care and treatment for people living in south east England. Our vision: outstanding care and treatment you can be confident in.

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We provide NHS care and treatment for people living in south east England. Our vision: outstanding care and treatment you can be confident in.

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Cognitive-behavioral therapy (CBT) in schizophrenia was originally developed to provide additional treatment for residual symptoms, drawing on the principles and intervention strategies previously developed for anxiety and depression. In the 1950s, Aaron Beck ¹ had already treated a psychotic patient with a cognitive approach, but thereafter the research in this specific area lay dormant for decades. Only after cognitive therapy had been firmly established for depression and anxiety, in the 1990s, did the research into psychological treatments for psychotic conditions gather force-again, with Beck in the forefront.

Pharmacologic therapy can leave as many as 60% of psychotic patients with persistent positive and negative symptoms, even when the patients are compliant with their medication instructions. ² Furthermore, medication compliance remains a major problem despite the introduction of modern atypical antipsychotics. Studies have shown treatment discontinuation in an estimated 74% of patients in both outpatient and inpatient settings. ³

The evidence for the efficacy of CBT in treating patients with persistent symptoms of schizophrenia has progressed from case studies, case series, and uncontrolled trials to methodologically rigorous, randomized, controlled trials that include patients from both the acute ⁴ and the chronic end of the schizophrenia spectrum. ⁵⁻⁷ Subsequent meta-analysis ⁸ and systematic reviews have further strengthened the evidence base.

CBT is now recognized as an effective intervention for schizophrenia in clinical guidelines developed in the United States ⁹ and in Europe. ¹⁰ In spite of the evidence base and absence of side effects, however, the general availability of this treatment approach within community settings is still low. ¹¹ This article will examine the procedure of CBT for psychosis, the evidence for its use, and the implications for practicing psychiatrists.

PROCEDURE

The therapeutic techniques used for patients with schizophrenia are based on the general principles of CBT. Links are established between thoughts, feelings, and actions in a collaborative and accepting atmosphere. Agendas are set and used but are generally more flexibly developed than in traditional CBT. The duration of therapy varies according to the individual's need, generally between 12 and 20 sessions, but often with an option of ongoing booster sessions. CBT for psychosis usually proceeds through the following phases.

Assessment

The assessment begins by allowing the patient to express his or her own thoughts about his experiences while the therapist listens actively. The use of rating scales-both specific and general-is encouraged to monitor progress, and the results are shared with the patient. Diagrams and written material can be most useful, especially for patients with chaotic lifestyles. The formulation of symptom causation and maintenance is also shared with the patient and evolves throughout the therapy as new information is considered.

Engagement stage

Initially the therapist will state clearly what the therapy is about (including a safe and collaborative method of looking at causes of distress). Throughout the therapy, the use of Socratic questioning is emphasized. This involves drawing out the person's own understanding of his situation and ways of coping with it through a process of guided discovery. Attempts are made to empathize with the patient's unique perspective and feelings of distress and to show flexibility at all times. A vulnerability-stress model is used, so that the patient can understand that vulnerability is a dynamic concept that can be influenced by many factors, such as life events, coping mechanisms, or physical illness. The therapist stresses that he or she does not have all the answers but that useful explanations can be developed in cooperation. The typical nonspecific therapeutic factors of warmth, genuineness, humor, and empathy are of great value in this type of therapy, as in all other therapeutic encounters.

ABC model

The ABC model, which was originally developed by Ellis and Harper, ¹² can be used to give the patient a way of organizing confusing experiences. It involves slowly and thoroughly moving the patient through the various steps using Socratic questioning to clarify the links between the emotional distress the patient is experiencing and the beliefs he holds ( Table). It includes the following steps:

Based on a scale of 0 to 10, the patient rates the intensity of distress.

The consequence (C) is assessed and divided into emotional and behavioral Cs.

The patient gives his own explanation as to what activating events (As) seemed to cause C; and the therapist ensures that the factual events are not "contaminated" by judgments and interpretations.

The therapist provides feedback to the patient to acknowledge the A-C connection.

The therapist assesses the patient's belief, evaluations, and images and communicates to the patient that a personal meaning is lacking in the A-C model; simple examples can be provided to facilitate understanding.

The patient's own belief (B), which is actually the cause of C, is then discussed; often, this can be rationalized, and a B such as "nobody will like me if I tell them about my voices" can be disputed and changed to "I can't demand that everyone likes me. Some people will and some won't...Maybe some friends might find it interesting." This may lead to a change in C, ie, less sadness and isolation.

Goal-setting

Realistic goals for therapy should be discussed early in the therapy with the patient, using the distressing consequences (C) to fuel the motivation for change. It is the therapist's job to ensure that the goals are measurable, realistic, and achievable. The goals are revisited both during and at the end of therapy.

Normalization

A normalizing rationale 11,13 is helpful in decatastrophizing psychotic experiences. Education regarding the fact that many people can have unusual experiences in a range of different circumstances (stressful events, hyperventilation, torture, hunger, thirst, falling asleep, etc) reduces anxiety and the sense of isolation. By having the psychotic experiences placed on a continuum with normal experiences, the patient will often feel less alienated and stigmatized. As a consequence, the possibility of recovery seems less distant.

Critical collaborative analysis

To proceed to this stage, the therapeutic relationship must have developed a degree of trust. The therapist uses gentle Socratic questioning to help the patient appreciate potentially illogical deductions and conclusions:

"If your voices came from the radiator, why can't anyone else hear them?" or

"Hold on for a moment, this puzzles me. How do you explain your rape by this famous actor, since we know for a fact that he has never been to this country?"

Testing the evidence for and against maladaptive beliefs can safely be carried out without causing distress as long as the therapist remains nonjudgmental, empathic, and open-minded. An assessment is made of how the beliefs occurred-through inferences or cognitive distortions (eg, dichotomous thinking, selective inference, emotional reasoning, jumping to conclusions). Reviewing antecedents (stress, trauma, loss) that prepare the ground for psychotic change can be an eye-opening exercise for both patient and therapist. Identification of misattributions and attempts to reattribute are as productive as homework tasks.

Developing alternative explanations

It is of crucial importance to let the patient develop his own alternatives to previous maladaptive assumptions, preferably by looking for alternative explanations and coping strategies already present in the patient's mind. It can be dangerously tempting to force the therapist's readymade explanations onto the patient. The patient's own healthier explanations might just be temporarily weakened by either external factors or dysfunctional thinking patterns. If the patient is not forthcoming with alternative explanations, new ideas can be constructed in cooperation with the therapist. Certain seeds might have been sown earlier in the therapy (from leaflets and previous discussions) that can now be used as building blocks.

1. Beck AT. Successful outpatient psychotherapy of a chronic schizophrenic with a delusion based on borrowed guilt. Psychiatry. 1952;15:305-312.
2. Harrow M, Carone BJ, Westermeyer J. The course of psychosis in early phases of schizophrenia. Am J Psychiatry. 1985;142:702-707.
3. Lieberman JA, Stroup TS, McEvoy JP, et al, for the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005;353:1209-1223.
4. Lewis S, Tarrier N, Haddock G, et al. Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes. Br J Psychiatry Suppl. 2002;43:s91-s97.
5. Sensky T, Turkington D, Kingdon D, et al. A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Arch Gen Psychiatry. 2000;57:165-172.
6. Tarrier N, Yusupoff L, Kinney C, et al. Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. BMJ. 1998;317:303-307.
7. Turkington D, Kingdon D, Turner T, for the Insight Into Schizophrenia Research Group. Effectiveness of a brief cognitive-behavioural therapy intervention in the treatment of schizophrenia. Br J Psychiatry. 2002;180:523-527.
8. Pilling S, Bebbington P, Kuipers E, et al. Psychological treatment in schizophrenia: I. Metaanalysis of family intervention and cognitive behaviour therapy. Psychol Med. 2002;32:763-782.
9. Torrey EF. PORT updated treatment recommendations. Schizophr Bull. 2004;30:617-618.
10. National Collaborating Centre for Mental Health. Schizophrenia: Full National Clinical Guideline on Core Interventions in Primary and Secondary Care. NICE. Available at: http://www.nice.org.uk/page.aspx?o=289559. Accessed April 5, 2006.
11. Kingdon DG, Kirschen H. Who does not get referred for cognitive behavior therapy for schizophrenia? Experience from an area where availability has not been limited. Psychiatric Serv. In press.
12. Ellis A, Harper RA. A Guide to Rational Living. Chatsworth, Calif: Wilshire Book Co; 1961.
13. Kingdon DG, Turkington D. The use of cognitive behavior therapy with a normalizing rationale in schizophrenia: preliminary report. J Nerv Ment Dis. 1991; 179:207-211.
14. Gould RA, Mueser KT, Bolton E, et al. Cognitive therapy for psychosis in schizophrenia: an effect size analysis. Schizophr Res. 2001;48:335-342.
15. Hansen L. The Influence of Cognitive Behaviour Therapy on Suicidality in Schizophrenia [doctoral thesis]. Southampton, UK: University of Southampton; 2004.
16. Dickerson FB. Cognitive behavioral psychotherapy for schizophrenia: a review of recent empirical studies. Schizophr Res. 2000;43:71-90.
17. Turkington D, Kingdon D, Weiden P. Cognitive behavior therapy for schizophrenia. Am J Psychiatry. 2006;163:365-373.

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The ABCs of Cognitive-Behavioral Therapy for Schizophrenia

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Cognitive-behavioral therapy (CBT) in schizophrenia was originally developed to provide additional treatment for residual symptoms, drawing on the principles and intervention strategies previously developed for anxiety and depression. In the 1950s, Aaron Beck 1 had already treated a psychotic patient with a cognitive approach, but thereafter the research in this specific area lay dormant for decades.

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Trailer: "OPEN DIALOGUE," alternative Finnish approach to healing psychosis

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This is a guest post written by Daniel Mackler the filmmaker. His three films show alternative methods of healing people with psychosis. In all the films relationships are ultimately what heal. Loving, healing relationships. Please visit these posts to look at the trailers and read a bit about each of his films. . You can purchase the films here.
All the films are now available for free viewing on youtube now as well. If you've not seen them yet, it's well worth taking the time to do so. The below article was written as a result of a conversation that Daniel and I had. He revealed that the psychiatric hospital he visited when making his last film, built in the 1950s was mostly empty. They don't need the beds because their success rate is so high! I started asking particulars about this issue given that in the United States all we hear about is how there are never enough psychiatric beds in hospitals. The fact is if we were healing people like the Finnish people are, we might end up with mostly empty hospitals too.
My Reflections on the Finnish Open Dialogue Project

In June of 2010, I visited Western Lapland in Finland for two weeks. My goal was to make a documentary film on the Open Dialogue project. Although the film is now complete, and I feel it tells their story fairly well, there remains a lot that I left out - things I somehow, for one reason or another, couldn't capture on camera.

I want to share a few of those missing things here. I first want to share my impressions of arriving at the Keropudas Hospital in Tornio, Finland, which is the nerve center for Finnish Open Dialogue. It all began there, almost thirty years ago. I actually stayed on the hospital grounds for my two weeks in northern Finland, so I had a lot of time to spend wandering around the hospital, talking with patients, and just watching how life unfolded on a day-to-day basis, and in the evenings too. Because of the Finnish confidentiality rules, however, I was not allowed to film patients - which was very disappointing and frustrating for me - but the administrators did let me talk with whomever I wanted, ask whatever questions I wished, walk freely inside the hospital without a pass or escort, and even visit their locked ward whenever I wanted, which I did often. Oddly, no one seemed to mind what I did there, or where I went - they really let me go free. I also sat in on many Open Dialogue therapy sessions, which, again unfortunately, I couldn't film, but I did come away with impressions. Many.

Meanwhile, my first impression of arriving at the hospital: it was shocking. The reason: the first people I saw when I arrived at the hospital were several - maybe six or eight - very troubled looking, middle-aged or elderly men and women shuffling around outside the hospital entrance and inside the hospital lobby looking quite drugged, and some seeming to be experiencing serious long-term neurological side-effects from anti-psychotic drugs. Also, some were mumbling to themselves, and a few immediately recognized me as a new visitor, approached me, and begged for cigarettes.

What shocked me was that I had trouble believing that this was Open Dialogue, the place supposedly getting the best results in the world for the treatment of psychosis. To be frank, this looked like one of the worst hospitals I'd ever been to!

Interestingly, I'd come to Finland armed with questions and criticisms, and ready to really "get to the bottom" of Open Dialogue - to find out, at some level of confidence for myself, if they were really any good, or if their great results and reputation were really all a fantasy. But I certainly wasn't expecting this. I thought I was going to have to dig, and dig hard. Instead I found the criticisms right on the surface.

Meanwhile, I talked with several of these patients - in their broken English, as I spoke no Finnish (except for the word "neuroleptic," that is, "antipsychotic," which sounds similar in Finnish). I shared a few cigarettes, and found them friendly, but still, quite disabled, presumably by the drugs.

What I found out later, however, was fascinating, and quite the opposite of my first impression. These folks had been long-term hospital patients at Keropudas Hospital back from the days prior to Open Dialogue. Some of them had been around since the 1970s - back when Western Lapland, I have since been told, was getting some of the worst outcomes for schizophrenia in Europe, back when there was no Open Dialogue, and back when everyone with issues labeled as psychotic was getting heavily medicated. These folks I met were the people who didn't recover - and hadn't been able to integrate living in the community. These were the people labeled as "failures" of a failing and quite traditional psychiatric system.

I also learned that in recent years, since the development of Open Dialogue, the therapists and psychiatrists had tried, sometimes several times with different people, to help these long-term patients taper off their neuroleptics, with often terrible results. They simply were too neurologically impaired by the drugs themselves, over too many decades, to be able to get off them. So presently they were on the lowest doses they could tolerate.

That was the first point: that these people were actually no reflection whatsoever on the success of Open Dialogue, but instead reflected the horror of the previous system. But over time, when I thought about it more, I actually learned that they were a reflection on the Open Dialogue system, in some key ways. First, they were not kept on locked wards. They could come and go as they pleased. They were not confined. This was their home, and they actually had a lot of freedom in it. Second, I talked with many of them more over the subsequent two weeks, and many said they liked it here - because people were kind, because they felt respected, and because they felt safe and secure.

Also, I realized that for a short-time visitor, someone who only came for a day or two, who couldn't get a chance to explore the significance and history of these people who were a product of the old system, these folks risked being, in a way, terrible public relations for the Open Dialogue system. Had I only visited Western Lapland for the day, I would have been left with the impression that these neurologically damaged people were the face of Open Dialogue. Certainly the Open Dialogue clinicians recognized this too, and recognized that these people were the first people their many visitors met when they arrived! (And they get a lot of visitors. For example, there were eighteen Danish clinicians visiting the day I arrived.) And yet they did nothing to hide them, or to warn people about them, as I suspect many other programs might do, for political or promotional reasons. These folks were as welcome there as anyone else - welcome to interact with you or me, welcome to ask for cigarettes, welcome to talk, welcome to hang out and do whatever they wanted. I became quite friendly with several of them over my two weeks there. And we shared a lot of smokes.

Doing a little digging, I asked the clinicians if they felt any motivation to keep these folks out of the public eye, and they looked at me horrified. "Why would we do that?" they replied. "They have as much right to be here as anyone else!"

I smiled. I agreed.

A second key thing I learned about Keropudas Hospital, which, like most mental hospitals, is placed on the far outskirts of town (in their case, on the edge of the forest), is that it's a rather large hospital that is relatively unused. There are one or more whole wards that are unused. I remember visiting one. It looked like an average, spacious hospital unit, but it was silent - and empty. It was dusty. Nothing was happening there. And the reason: they no longer have patients for them. They've developed such an effective system of helping people get well from psychosis, and get permanently out of the psychiatric system, that they no longer need so many beds. (No wonder they have some of the lowest per capita spending for psychosis anywhere in Finland - at least that's what I've heard. When people get fully well, and are able to get off all their psychiatric drugs, they save the system a lot of money.)

Also, much of the work they do helping people with psychosis, most of it, in fact, has nothing to do with the hospital itself. In most cases they don't prefer that people in crisis come to the hospital, and they don't even do much therapy in the outpatient clinic that is located at the hospital. In fact, their hospital outpatient clinic has only one therapy room - one therapy room to serve a population of around 70,000 people!

Granted, the Open Dialogue clinicians do have an outpatient therapy clinic in each of their catchment area's two largest towns (Tornio and Kemi), but they even prefer to avoid using these clinics for therapy, if at all possible. Their best preference is to meet in people's homes. The therapists, usually a team of two or three trained family therapists, travel to the homes of the people in crisis. The clinicians made a point of telling me repeatedly that they saw no value in having people come to the hospital for therapy, because of the stigma. They felt that if they could help people get better at home, in their natural environment, then it was all for the good. Also, the clinicians told me repeatedly that they learned far more from people by seeing them in their homes than they could ever learn by seeing them in such an artificial place as a hospital or clinic.

So, although some of what I'm writing overlaps with the content of my film, I feel this is important enough to bear repeating. In two weeks of staying in Western Lapland, I really came to believe that this program is what it claims to be: a program that helps a lot - a lot - of people get well from psychosis, without meds. Although in one sense I gained this belief by talking with clinicians, who said things that people who have never watched someone go through the process of recovery (or who hadn't lived it themselves) could have known, I gained it more from talking to the people they worked with.

As I said, I sat in on many Open Dialogue sessions, and although they were mostly in Finnish (sometimes, when the people coming for help felt comfortable, they adjusted and spoke in English for me), I still was able to gather a surprising lot - about their openness, their humanity, and their respect. Also, sitting in the sessions gave me an entrée to talk afterward with the people coming for help, the so-called clients and their families. One thing that struck me profoundly, even in really complicated and sticky emotional situations - situations that would have ended up with someone getting heavy medicated almost everywhere in the United States, but weren't ending up that way here - was that I didn't meet a single person seeking psychiatric help here who was bitter, or even unhappy, about the treatment they were getting. In fact, I didn't find "treatment" to be a dirty word in Western Lapland. Nor was "psychiatry." That struck me as bizarre, because for me both of those words have an inherent dirtiness for me, the second especially. And that's entirely because of my own experience with each, both personal and professional.

What I heard from the Finnish people seeking help was that they felt the Open Dialogue system was fair - and honest. They also told me repeatedly that it felt "normal" to them. They used those words repeatedly. Interestingly, most of them seemed to have no idea that psychiatry was commonly hated and mistrusted in many other parts of the world, and even in parts of their own country. In fact, when I explained this to them many were genuinely surprised, as it contradicted their experience. This led them to tell me other things they liked best about their system. And they liked many things.

They liked the openness and frankness of the therapists. They liked it that above all else their own voices were heard and valued. They liked it that they had a key say in the decision about whether or not psychiatric drugs might be of benefit to them or not. They liked it that they had alternative options to drugs presented to them. They liked it that when they were in crisis they could invite their family and friends and other important people from their lives into therapy meetings - if they wished.

They also liked it that the therapists worked in teams, right in session - because they liked listening to what the therapists had to say to each other, in the middle of session. They told me that they felt they deserved to know what the therapists were thinking! And doesn't it make logical sense?

They also told me that they liked it that their therapists met with them immediately in their crises, and didn't put them off for months on endless, bureaucratic waiting lists. They liked it that therapists gave them the choice of meeting in their own homes or in clinics. They liked it that hospitalization was only used in cases of dire safety issues, and that hospitalizations were generally quite short. And they also liked it that visitors like me were so interested in what was going on with Open Dialogue - and were also interested in their lives. Many of them wanted to know what I myself thought of their lives, their situations, and of their therapy too. And, because it was Open Dialogue, and because I felt safe there, I shared my opinion. And they valued it. And it even felt therapeutic - which felt good to me.

One young Finnish man, who, along with his family, sought help in an emotional crisis, shared something interesting with me after I asked him what he thought of their Open Dialogue psychiatric system. He replied, "Well, it's kind of like the town's water-works - they do a good job. When you turn on the faucet in your kitchen sink, you know that good, clean water comes out and you can drink it or cook with it. You trust that it will work, and that you won't get sick from the water. It's the same with psychiatry here - we trust them. When we have problems, we go to them. They are reliable, they care about us, and they do a good job. They help us. They make our lives better. It's just normal. But really, we don't think about it too much. Mostly, it's really just like the water-works - we expect it to work, and it does."

For a collection of articles on Open Dialogue see here.
A personal response to the news in this post here. The Open Dialogue trailer:

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Finnish Open Dialogue: High recovery rates leave many psychiatric beds empty

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This was written as a result of a conversation that Daniel Mackler and I had. He revealed that the psychiatric hospital he visited when making his last film, built in the 1950s was mostly empty. They don't need the beds because their success rate is so high!

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FC MHA Lesson 9 "Ways a person can help manage their schizophrenia" unit 8:5.2.pdf

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FC MHA Lesson 9 "overwhelmed and upset" unit 8: 4.3.pdf

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FC MHA Lesson 9 "help for family memebers" unit 8:4.2.pdf

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FC MHA Lesson 9 "Hit a wall and don't know how to handle it." unit 8:4.2.pdf

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FC MHA Lesson 9 "Caregivers having trouble with friendships" unit 8:4.2.pdf

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FC MHA Lesson 9 "lonliness and isolation" unit 9:4.2.pdf

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This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

© Copyright 2008-2018 GreenMedInfo.com, Journal Articles copyright of original owners, MeSH copyright NLM.

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60 Years of Research Links Gluten Grains to Schizophrenia

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This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

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This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

© Copyright 2008-2018 GreenMedInfo.com, Journal Articles copyright of original owners, MeSH copyright NLM.

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'Gluten Brain': Wheat Cuts Off Blood Flow To Frontal Cortex

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Wheat consumption has been linked to psychiatric conditions like schizophrenia for over 60 years, but recent research indicates the mind-altering properties of this popular food are, in part, caused by it cutting off blood flow to the frontal cortex of the brain.

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This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

© Copyright 2008-2018 GreenMedInfo.com, Journal Articles copyright of original owners, MeSH copyright NLM.

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Single Dose of CBD Resets Schizophrenic Brains

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Treatments for sufferers of schizophrenia have not advanced significantly in the last fifty years. But there is new cause for hope in the form of a plant-based treatment that can reset the brains of psychosis sufferers back to normal levels in a single dose

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Despite being simple and inexpensive to address, vitamin D deficiency is epidemic around the world, and evidence suggests vitamin D deficiency during pregnancy plays an important role in the development of several chronic health problems, and raises the risk of complications for the mother as well.

For example, research by GrassrootsHealth shows 40 to 60 percent of preterm births could be prevented by raising pregnant women's vitamin D to a level of 40 nanograms per milliliter (ng/mL). Vitamin D optimization also reduces the mother's risk of preeclampsia, gestational diabetes and prenatal infections by approximately 50 percent.

Research also confirms there is a lifelong impact for children born of vitamin D deficient mothers, ranging from childhood allergies and more frequent colds and flu, to a greater risk for diabetes, autism, strokes, cardiovascular disease, and, as recently confirmed, schizophrenia - a mental condition characterized by hallucinations, delusions and cognitive impairment.

Schizophrenia Is Caused by Faulty Brain Construction

Last year, research concluded schizophrenia might have its origins in pregnancy; the groundwork being laid as early as the first trimester. The scientists were able to demonstrate that schizophrenia has a physiological basis, beginning with improperly distributed neural progenitor cells in the developing brain.

As a result, few mature neurons appear in the cortex - an area associated with memory, attention and processing of language - in the schizophrenic brain. One of the researchers explained:

"Our research shows that the disease likely starts during the first trimester and involves accelerated cell divisions, excessive migration and premature differentiation of the neuroectodermal cells into neurons.

Neurons that connect different regions of the cortex, the so-called interneurons, become misdirected in the schizophrenia cortex, causing cortical regions to be misconnected, like an improperly wired computer.

We now can state that schizophrenia is a disorder of faulty brain construction that occurs early in development, corresponding to the first trimester, and involving specific malformation of neuronal circuits in the cortex."

Schizophrenia Linked to Vitamin D Deficiency in Utero

Knowing that schizophrenia has its roots in abnormal brain development during early pregnancy, it makes sense to look at what might influence brain development. Vitamin D appears to be one crucial factor.

The human brain contains vitamin D receptors, suggesting vitamin D is important for proper brain development and function, and recent research appears to confirm suspicions that vitamin D plays a role in this tragic and difficult to treat condition.

More than 2,600 individuals with schizophrenia were included in the study, which concluded that children who were vitamin D deficient at birth had a 44 percent increased risk of developing schizophrenia as adults. According to the researchers, vitamin D status could account for 8 percent of the schizophrenia cases in Denmark, where the study took place. As reported by Science Alert:

"The clue was a previously identified link between being born in winter or spring in high-latitude regions such as Denmark - a time when there is considerably less sunlight, which promotes vitamin D production in the body - and an increased risk of schizophrenia.

They hypothesized that the reason might be a vitamin D deficiency, and used the Denmark database to investigate ... Previous studies have also identified a genetic link between schizophrenia and autism, and a link between autism and prenatal vitamin D deficiency."

The research team, led by neuroscientist John McGrath, is now planning randomized clinical trials to determine whether vitamin D supplementation during pregnancy might lower the incidence of schizophrenia in the offspring. McGrath told Science Alert:

"The holy grail is to prevent individuals going on to get schizophrenia in the first place, and I think the experience with the links between folate and spina bifida is a good example that sometimes safe, simple, cheap public health interventions can prevent brain disorders."

The idea that vitamin D might play a role in schizophrenia is not entirely new. A clinical review published in 2016 noted that "Vitamin D deficiency is common in patients with severe mental illness such as schizophrenia," and that "The biological mechanism is most likely related to vitamin D's action on the regulation of inflammatory and immunological processes, consequently affecting the manifestation of clinical symptoms and treatment response of schizophrenia."

B Vitamins Are Also Important for Psychiatric Health

Several vitamin B deficiencies also have the ability to produce symptoms of neuropsychiatric disorders and can be a valuable adjunct in the treatment of everything from attention deficit disorder (ADD) and anxiety to schizophrenia and dementia. This includes vitamins B1, B2, B6, B9 and B12.

B12 deficiency can trigger mania, psychosis and paranoid delusions, and research has shown high doses of vitamins B6, B9 and B12 in combination are very effective for improving schizophrenic symptoms - more so than standard drug treatments alone, and particularly when implemented early on. Low doses were ineffective.

Previous research and work by the late Dr. Abram Hoffer linked psychiatric disorders such as schizophrenia with severe and chronic niacin (B3) deficiency or niacin dependency specifically - a state that necessitates far more niacin on a regular basis than normal.

To learn more, see my interview with Dr. Andrew W. Saul (above), who cowrote an excellent book on this topic, " Niacin: The Real Story," with Hoffer. As noted by Saul:

"When vitamin B3 or niacin was first added as an enrichment or as a fortification to flour, about half of the people in mental institutions went home. This is not a well-known fact. They were there not because they were mentally ill - because of genetic, environment or social reasons - but because they were malnourished ...

He wondered about the half that didn't go home. What about the people that had a little bit of niacin, but didn't get better? ... [H]e started giving what at the time were preposterously high doses of niacin: 3,000 milligrams a day.

And he was curing schizophrenia in 80 percent of the cases. This is astonishing. The cure rate for schizophrenia with drug therapy is not particularly good. Hoffer saw again and again that niacin worked."

One of the reasons for B vitamins' effect on a wide range of mood disorders and neurological and psychiatric conditions relates to the fact that these vitamins have a direct impact on the methylation cycle, and are required for the production and function of neurotransmitters and the maintenance of myelin, the fatty sheath surrounding your nerve cells.

Without this protective coating, nerve signals become slow and sporadic, which can lead to motor function problems, cognitive losses and changes in mood. B8 also aids in cell communication, allowing your cells to properly interpret chemical messages and respond accordingly.

Meanwhile, B6, folate (B9) and B12 (in combination with S-adenosylmethionine or SAMe) regulate the synthesis and breakdown of brain chemicals involved in mood control, including serotonin, melatonin and dopamine. Hence, a deficiency in one or more of these B vitamins can also play a role in depression.

Vitamin B3 (niacin) is also an important precursor of NAD+ which helps redox regulation as explained in the next section. This is likely why Hoffer's high dose niacin therapy was so effective in schizophrenics.

Mitochondrial Dysfunction and Schizophrenia

Another recent study points out links between schizophrenia and mitochondrial dysfunction, which also makes sense, considering these energy-producing organelles inside your cells are crucial for the normal functioning of cells, including your brain cells.

More specifically, schizophrenia is associated with high oxidation in cells, which impedes cellular energy production and triggers inflammation and adverse immune responses. As explained in the abstract:

"Balance between the redox pair of nicotinamide adenine dinucleotides (oxidized NAD+ and reduced NADH), reflects the oxidative state of cells and the ability of biological systems to carry out energy production.

A growing body of evidence suggests that an "immuno-oxidative" pathway including oxidative stress, mitochondrial dysfunction, neuroinflammation and cell-mediated immune response may contribute to disruption in brain activity in schizophrenia ...

We found a significant reduction in the NAD+/NADH ratio in chronically ill schizophrenic patients compared to a matched healthy control group ... These findings provide evidence for redox imbalance in the brain in all phases of schizophrenia, potentially reflecting oxidative stress."

The answer here is part and parcel of my metabolic mitochondrial therapy (MMT) detailed in " Fat for Fuel." My MMT program specifically focuses on strategies that optimize mitochondrial function and minimize oxidative stress.

Prenatal Vitamin D Deficiency Linked to Autism

According to a 2013 report by the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC), data collected from the 2007 and 2011-2012 National Survey of Children's Health suggested 1 in 50 children between the ages of 6 and 17 had autism spectrum disorder (ASD).

In April 2016, the CDC reported an ASD rate of 1 in 68. However, that rate is based only on 8-year-olds in 11 states. Despite that limitation, the 1 in 68 prevalence is the one listed on the CDC's Autism Data and Statistics website, and the one most frequently reported in the news. Meanwhile, a government survey issued in 2015 claims the ASD rate may be as high as 1 in 45 children between the ages of 3 and 17.

Stephanie Seneff, Ph.D., a senior research scientist at MIT, projects that within the next two decades, half of all children born will have some form of autistic disorder if the current trend continues unabated. Here, vitamin D may again turn out to be a crucial piece of the puzzle.

A large multi-ethnic population-based cohort study published in 2016 found that vitamin D deficiency during pregnancy was associated with an increase in autism-related traits in 6-year-old children. McGrath was also part of this investigation, which was the first study examining the association between gestational vitamin D deficiency and autism in general population samples. According to McGrath and his coauthors:

"[T]hose who were 25OHD [25-hydroxyvitamin D] deficient had significantly higher (more abnormal) SRS [Social Responsiveness Scale] scores.

The findings persisted (a) when we restricted the models to offspring with European ancestry, (b) when we adjusted for sample structure using genetic data, (c) when 25OHD was entered as a continuous measure in the models and (d) when we corrected for the effect of season of blood sampling ...

It is feasible that a safe, cheap and publicly accessible vitamin D supplement in at risk groups may reduce the prevalence of this risk factor. Just as prenatal folate supplementation has reduced the incidence of spina bifida, we speculate that prenatal vitamin D supplementation may reduce the incidence of autism."

How Vitamin D Influences Autism Risk

Biological scientist Rhonda Patrick, Ph.D., has published two papers in which she presents a hypothesis for how vitamin D may influence autism. In summary:

* Vitamin D gets converted into a steroid hormone. As such it regulates over 1,000 different physiological processes, and is thought to control at least 5 percent of the human genome. When you have enough vitamin D in your body, it binds to vitamin D receptors located throughout your body, thereby acting like a key that opens the proverbial door.

The vitamin D receptor complex can go deep inside the DNA, where it recognizes the telltale sequence of code that instructs the vitamin D receptor complex to either turn the gene on (making it active), or off (making it inactive).

* There's a vitamin D-regulated gene that encodes tryptophan hydroxylase (TPH), an enzyme responsible for converting tryptophan (which you get from dietary protein) into serotonin, a neurotransmitter involved in mood regulation and brain development.

You have two different TPH genes in your body - one in your brain and one in your gut. The one in your brain makes serotonin in the brain, and the one in your gut converts tryptophan into serotonin in the gut.

Here, scientific opinion is mixed: Some, including Patrick, claim serotonin made in your gut is unable to cross the blood-brain barrier to get into your brain and therefore cannot influence brain function. Others claim gut serotonin is released from the gut into your bloodstream, and that it does act on your brain, particularly your hypothalamus, which is involved in the regulation of emotions.

Be that as it may, gut serotonin has a number of important functions, but too much of it will activate T-cells, causing them to proliferate and promote inflammation. Gut inflammation, in turn, is a common symptom associated with autism, and is thought to play a role in its development by flooding the brain with toxins.

* What Patrick discovered is that, in the gut, vitamin D deactivates the gene responsible for making TPH (the enzyme that converts tryptophan into serotonin). In this way, vitamin D helps combat inflammation in your gut caused by excessive serotonin levels.

Meanwhile, in the brain, the TPH gene has a sequence that causes the opposite reaction. Here vitamin D activates the gene, thereby increasing serotonin production. In other words, when you have sufficient amounts of vitamin D, two things happen simultaneously that improve brain function:

Since the publication of Patrick's first paper in 2014, an independent group at the University of Arizona has biochemically validated her findings, confirming that vitamin D does activate the tryptophan hydroxylase 2 (TPH2) gene in a variety of neuronal cell types.

Prior to the publication of that paper, this simply wasn't known, and it's a significant finding that can help shed a great deal of light on vitamin D's influence in autism, as a majority of autistic kids have not only brain dysfunction, but also gut inflammation. Her research clearly shows how important it is to have enough vitamin D to prevent and treat both of these problems. To learn more, please listen to Patrick's interview, included above for your convenience.

Optimizing Vitamin D During Pregnancy Is a Simple, Inexpensive Way to Safeguard Your Child's Health

Based on the evidence, it seems clear that optimizing your vitamin D is one of the easiest and least expensive ways to reduce not only your risk of pregnancy complications but also your child's risk of brain disorders such as autism and schizophrenia, not to mention a number of other chronic health conditions.

So please, make sure you get your vitamin D level tested - ideally before you get pregnant and routinely during pregnancy and breastfeeding - and take whatever amount of vitamin D3 you need to reach and maintain a level of 60 to 80 ng/mL. Certainly, it should be no lower than 40 ng/mL.

Although vitamin D testing is not yet a routine part of prenatal care, you can request a vitamin D blood test from your health care provider or enroll in GrassrootsHealth's Protect Our Children NOW! project, which seeks to resolve vitamin D deficiency among pregnant women and children, and raise global awareness about the health risks associated with vitamin D deficiency.

While sunlight is the ideal way to optimize your vitamin D, winter and indoor work prevent a large majority of people from achieving ideal levels without supplementation. Just remember to also increase your vitamin K2 and magnesium intake (either from food or supplements) when taking oral vitamin D3, as these nutrients all work in tandem.

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Linked to Schizophrenia, Easy-to-Fix Nutrient Deficiency

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Despite being simple and inexpensive to address, vitamin D deficiency is epidemic around the world, and evidence suggests vitamin D deficiency during pregnancy plays an important role in the development of several chronic health problems, and raises the risk of complications for the mother as well.

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FC MHA Lesson 10 In Class Assessment 10 schizophrenia

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Welcome to the Soteria Brighton website. Soteria Brighton was formed in 2011 with the aim of establishing a Soteria House and related services in Brighton for people experiencing 'psychosis' (including what is sometimes referred to as 'schizophrenia').

Promoting Choice

We believe that it is time to establish a greater diversity of services for people experiencing 'psychosis', alternatives to traditional psychiatric services which more closely reflect what service users say they need, and which do not rely on coercion/compulsion, or on such extensive use of antipsychotic medication, but rather on collaboration. The Soteria model provides this, with supporting evidence from Soteria projects and other similar approaches around the world.

The Soteria model originated in the early 1970s in the US, a residential community established by Loren Mosher for people experiencing psychosis for the first time, in order to research how they fared in a psychosocial environment with minimal medication, but substantial interpersonal support. What they found was that people did just as well, if not better, and with significantly less medication. Further details about our aims, as well as the Soteria model and the evidence base for it can be found on our About page.

Soteria Brighton

As yet we do not provide any services, but we are currently looking at ways of developing the Soteria approach in the community, such as a managing medication support-group, a Soteria Café project, and we hold regular "Soteria in the Pub" events.

Soteria Brighton consists of a core group of around 20 members who meet regularly to develop the group, and a growing mailing list of those who wish to keep up with developments and support us in other ways. The core group consists of individuals with a personal and/or professional interest in developing the Soteria approach. We believe that it is healthy to have a mixture of professionals, carers, and those who have experienced 'psychosis' in our group, and welcome anyone who has an interest in seeing a greater variety of mental health services in Brighton to our meetings. If you are interested in becoming a member, or finding out more about it, do please get in touch (details on our Contact page above) or by coming along to meet us at one of our "Soteria in the Pub" events.

"Soteria in the Pub" events

Our regular "Soteria in the Pub" fund-raising events are aimed at promoting awareness of the issues surrounding the current state of Mental Health Services and in effecting change. The events are usually held every two months on a Thursday evening at The Brunswick in Holland Road, Hove. We invite speakers who are specialized in or have an interest in the subject and these are followed by an audience question and answer session. These events are proving to be a very popular and enjoyable way of finding out about current research and other developments in the field, sharing ideas and meeting others with a common interest. We would love to see you there! Details of upcoming events can be found on our Events page, or on the side bar of the website.

Supporting Soteria Brighton

Apart from becoming a member, other ways of getting involved are to subscribe to our mailing list. You will find a small form to do so at the top right of this page. Signing up to the mailing list means that you'll get notice of any forthcoming events. You might also like to support us by making a donation to the group. Making a donation helps us to develop our work. Currently we have set ourselves the target of raising £5000, primarily to support the work that we need to do, but also because we need to generate an income of £5000 to become a registered charity. If you would like and are able to help us meet our target then you can do so via our donation page, or by coming along to our fundraising events.

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Welcome to the Soteria Brighton website. Soteria Brighton was formed in 2011 with the aim of establishing a Soteria House and related services in Brighton for people experiencing 'psychosis' (including what is sometimes referred to as 'schizophrenia').

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How to forgive!

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The Healing Power of the Whales' Song

Words for the Soul

The Art of Simplicity

Ascending with Both Feet on the Ground

Anita Moorjani: The Power of Living Your Purpose

Deva Premal and Miten: Singing the World into Being

Daniel Horowitz: The History of the Happiness Movement

Dr. Saida Désilets: Claiming Your Sexual Sovereignty

When I first encountered the practice known as Ho'oponopono, it was in an interview with Haleaka Hew Len PhD, a Hawaiian psychologist and shamanic practitioner. I took on the simple yet profound forgiveness practice and found immediate benefits in my personal life.

Ho'oponopono: I'm sorry, please forgive me, thank you, I love you.

What is ho'oponopono?

On the surface level, many people have understood ho'oponopono to be a mantra where one repeats the words 'I'm sorry, please forgive me, thank you, I love you' as a form of mental and spiritual cleaning that could be compared to buddhist techniques for clearing karma. It has been defined as a forgiveness and reconciliation practice, cleansing of 'errors of thought' - the origin of problems and sickness in the physical world, according the the Hawaiian worldview. The literal translation is 'to put to right; to put in order or shape, correct, revise, adjust, amend, regulate, arrange, rectify, tidy up, make orderly or neat."

The mantra at the heart of Ho'oponopono

At first glance I found it hard to remember the order of the words or even discern if there was a specific order for them at all, so I tried them in every possible combination as well as repeating them on their own. I chanted them over and over in the hope of discovering whether they were useful in some way and if so, what was it about these words that made them helpful.

As I did so, I found that many questions arose, with different questions coming up depending on the order I said them. "Why should I be sorry? What do I have to be sorry for? What do I need forgiveness for, in this moment and in my life? What do I have to be grateful for? When I say 'I love you' am I really feeling it? If not, what is in the way?". I worked with these words both to directly address something I was finding challenging, as well as just chanting them with no purpose in mind at all.

I found that by simply chanting these words that my inner discordance, my stuff, would come up. Not only would it come up, but it was as if my inner disharmony was being tuned to the frequency of these words and the intention they carry. Over time I found these four simple concepts acted like tuning forks, each carrying a different tone of purity that I could use to tune the disharmonious parts of myself. Best of all, I found that applying this chant to the chaos of my mind brought about stillness and calm.

The only problem with human beings is that they are arrogant, because that's what thinking is. This is in essence 'I know'. Wisdom is being in the void. To be thoughtless. Only by being in the void can the Light come through. As long as I have something going on in my mind the Light can't come through. The Light can only come in when the mind is cleared - in a state of silence. - Dr Hew Len, Shamanic Wisdomkeepers

Forgiveness has the power to bring harmony within and with others

Why is Ho'oponopono powerful?

Throughout human history we have been divided by distance, language, cultural and religious beliefs, class and economic hierarchy. Whenever someone comes up with a perspective there seems to always be someone else there with an opposing opinion. To me the power of Ho'oponopono comes, in large part, from the fact that it's a really rare thing for the vast majority of humanity to be in agreement about anything.

Across all cultures practically all of us agree that the concepts of thank you, I'm sorry, please forgive me and I love you are all valuable and important. If there is such thing as a collective consciousness, as Jung and many eastern traditions have suggested, then the basis of the power of Ho'oponopono may come from the sheer volume of people throughout human history who have agreed that these concepts are valuable, important and useful to humanity. In this way, Ho'oponopono may be tapping into a level of awareness that extends far beyond its Hawaiian roots into perhaps every culture that has ever existed on Earth.

In common with other shamanic traditions, the Hawaiian tradition teaches that all life is connected. Ho'oponopono is, therefore, not only a way of healing ourselves, but others and our world as well.
- Timothy Freke, Shamanic Wisdomkeepers

Can Ho'oponopono affect more than our internal world?

At the core of Dr Hew Len's perspective is the idea of taking responsibility for more than your personal self because 'you are in me and I am in you'. His way of expressing Ho'oponopono contains an awareness that the discordance we find in others and in the world outside ourselves is due to 'errors' in thought stored in our personal and collective memories. The belief in these errors existing in some form of collective memory accessible to all allows for a person practicing Ho'oponopono to clean these errors, whether the error originated in their personal thoughts or not.

I don't see myself as a kahuna, I see myself as a garbage collector. I'm only here to be responsible and it's often very hard to do that. - Dr Hew Len, Shamanic Wisdomkeepers

The power to change the world around us

The paradox here is that he is advocating development of personal power to change the situation around us through increasing personal responsibility, which involves a willingness to take on responsibility for cleaning discordance that was not created by oneself, i.e doing other people's inner work for them (which doesn't seem like the other taking personal responsibility for them self). As usual, the paradox is resolved with the awareness that separation consciousness is not the only reality and an underlying unity also co-exists, after all: 'you are in me and I am in you'. This is where ho'oponopono truly steps into being a shamanic practice, where the reality not only within but around the practitioner can apparently be adjusted.

No one wanted the job I did with the criminally insane. They were averaging about one psychologist a month. But I got asked. We had about 25-30 people. Half of them would be in shackles at the ankles or the wrists because they were dangerous. They could either kick you or slam you. Everyone would walk with their back toward the wall so that they wouldn't get struck. They had no family visits. No one could leave the building. A year and a half later there was none of that. There were people going out on bus rides. Nobody in shackles. The level of medication dropped. What did I do? I worked on myself. I took 100% responsibility. - Dr Hew Len, Shamanic Wisdomkeepers

While the rational part of me would still like verification that this story really happened, it evoked enough curiosity in me to get me to try the technique and find out for myself if might be helpful to my life.

Ho'oponopono as a family therapy practice.

For people living in Hawaii today Ho'oponopono is less about it being a personal shamanic practice through chanting a mantra internally or externally, and more about a traditional system of dispute resolution. It's a practice that still holds the values of making things right and correcting errors, however in this incarnation it is focused on making things right with our relations; coming back into right relationship by correcting errors with living relatives, ancestors and deities.

Ho'oponopono as a family therapy practice

Today Ho'oponopono is just like family therapy. This has been really influenced by the Christians. But I'm talking about the real Ho'oponopono from before they came. [Back] then the Hawaiians didn't need to talk anymore. They could go straight to the Light. This is very ancient. It goes back to the start, because that's where Hawaiians came from. - Dr Hew Len, Shamanic Wisdomkeepers

The ritual for group reconciliation itself involves an elder in the family convening the process, or if this isn't possible an elder from the wider community. The ideal situation is for the ritual to be conducted by praying priest ( kahuna pule) or healing priest ( kahuna lapaʻau) particularly if illness was involved.

The process begins with prayer. A statement of the problem is made, and the transgression discussed. Family members are expected to work problems through and cooperate, not "hold fast to the fault". One or more periods of silence may be taken for reflection on the entanglement of emotions and injuries. Everyone's feelings are acknowledged. Then confession, repentance and forgiveness take place. Everyone releases ( kala) each other, letting go. They cut off the past ( ʻoki), and together they close the event with a ceremonial feast, called pani, which often included eating limu kala or kala seaweed, symbolic of the release. - Nana I Ke Kumu (Look To The Source) by Mary K. Pukui, E.W Haertig, Catharine Lee.

Creating space for confession, repentance and forgiveness to take place

Testing The True Power Of Ho'oponopono

Like many spiritual practices, such as meditation, it's not the practice you do while you're in the crisis, it's the practice you do on a regular basis between the crisis that makes it effective when the storm hits. A couple of years ago I was at a spiritual retreat where the practice I was engaged in triggered what I would now describe as a state of spiritual emergency. I use this term in the context that Stan Grof and other transpersonal psychologists might use it, as an alternative way of describing what others might call psychosis.

I was in a mindset where I felt emotionally and spiritually assaulted, and was by far feeling more threatened than I had ever experienced in my life. Upon the realisation that no-one was coming to help me, I knew that it was up to me to deal with the situation. I sat down on the spot and went into meditation. Out of the many chants and tools I have learned over the years, it was Ho'oponopono that came to me as the solution to my situation.

Within moments of implementing the practice the feeling of all out assault on my consciousness cleared as easily as the smell of burnt toast when one opens the windows on a day with a fresh breeze. When I was found I was meditating quietly in a state of peace and gentleness and the challenge of a potentially full blown psychotic episode had dissolved and has not since returned. I share this not to state what will definitely happen to others who choose to use this practice, but to simply illustrate what may be possible.

The Paris Response: Revenge or Forgiveness?

An Indigenous Approach To Healing Trauma

Healing Trauma with Wolves

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Understanding the ancient Hawaiian practice of Forgiveness

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The Healing Power of the Whales' Song Words for the Soul The Art of Simplicity Ascending with Both Feet on the Ground Anita Moorjani: The Power of Living Your Purpose Deva Premal and Miten: Singing the World into Being Daniel Horowitz: The History of the Happiness Movement Dr. Saida Désilets: Claiming Your Sexual Sovereignty When I first encountered the practice known as Ho'oponopono, it was in an interview with Haleaka Hew Len PhD, a Hawaiian psychologist and shamanic practitioner.