Schizophrenia is a neuro-cognitive disorder or in simple terms be referred to as a mental illness. It usually strikes during early adulthood or late adolescent periods of one’s life. However, the time of occurrence may vary and it is not necessary that it occurs in the above mentioned time periods of a person’s life. Also, the symptoms of this disorder vary from one individual to another.
The most important and common symptoms of Schizophrenia are delusions and hallucinations. Persons with schizophrenia typically experience hallucinations, delusions, incoherent speech, and thought. In most cases this disease leads to social isolation due to the fallout of these factors. Delusions are beliefs which are not actually true but are an imagination of the person who is suffering from this disorder. Similarly, hallucinations are a state of mind wherein the person hears sounds and voices which do not exist in reality. A few other symptoms of this disorder bizarre speech and behavior, and disorganized speech. Disorganized speech can be further explained as the speech of the person suffering from this disorder is difficult to comprehend.
There are also a few symptoms that are referred to as ‘negative symptoms’ of Schizophrenia. They include decreased cognitive function, plummeting emotional expression etc.
Thesis Statement – An analysis of the Cognitive Behavioral Therapy (CBT) in treating a neuro-cognitive disorder – Schizophrenia.
The Brain in Schizophrenia
Most of the parts of the brain and quite a few regions of the brain operate in an abnormal fashion in a person who is suffering with Schizophrenia. A few of the abnormally functioning parts in a Schizophrenic brain are Basal Ganglia, Auditory system, Occipital Lobe, Frontal Lobe, Limbic System, and the Hippocampus.
Abnormalities of the Brain parts – A brief synopsis
Basal Ganglia are a part of the brain which is involved in movement and emotions and also in integrating sensory information. It is in this part of brain of a schizophrenic patient that hallucinations and paranoia is ought to occur and the same is considered as the abnormality related to this particular part of the brain. Similarly, the Auditory System enables human beings to hear and interpret speech. In people having Schizophrenic disorder, over activity of the Wernicke’s area which is also called as the speech area is tend to create hallucinations of speech. This can be further explained as a state of auditory illusion according to which the person tends to feel as if thoughts and real voices are coming from outside but in reality the same are being created internally.
Another important part of the brain where abnormality happens is in the Occipital Lobe. This part of the brain processes information concerning the visual world. People suffering with “Schizophrenia rarely have full-blown visual hallucination. However, disturbances in this particular area of the brain result in complications like interpreting complex images, recognizing motion, and reading emotions on others’ faces (Kamajian, 2010).”
The Frontal Lobe of the brain helps people in problem-solving, approach, and other critical reasoning. The perturbations resulted by Schizophrenia consequently result in difficulty in planning and organizing actions and thoughts of individuals. Likewise, the Limbic System is the part of the brain that involves emotions. Frequent agitation which is common in most Schizophrenic patients are a result of the abnormal condition of this part of the brain. Lastly, the Hippocampus is the part of the brain that mediates learning and memory. Both these functions get intertwined in Schizophrenics due to disturbance caused in this part of the brain (Kamajian, 2010).
Schizophrenia – Causes and Treatment
Numerous factors contribute to this ailment. Expert opinion states that it is a result of interaction of biological, psychological, and social factors. This is called the bio-psycho-social model of schizophrenia (Janssen Pharmaceutica, 2009). “Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease (NIMG – National Institute of Mental Health, 2010).” Few Antipsychotic Treatments/Medications those are currently in existence for treating this disorder.
“Chlorpromazine (Thorazine), Haloperidol (Haldol), Perphenazine (Etrafon, Trilafon)
Fluphenazine (Prolixin) (NIMG – National Institute of Mental Health, 2010).”
Medications that are advised for Schizophrenics have a few side-effects like excessive drowsiness, skin rashes, blurred vision, sensitivity to sun, menstrual problem in women, and dizziness.
Cognition in Human Beings
Many pioneering theorists in the field of cognitive psychology stated that cognitive learning consists of a relationship between cognitive environmental cues and expectations. The same theory has also been tested by conducting controlled experiments on white rats. The experiment resulted in a conclusion that cognitive maps of the environment are developed by rats and other animals used in the experiment. Hence, the theorists of cognitive psychology considered learning as developing a pattern of behavior from bits of knowledge about and cognition of the environment ((ICMR), 2003).
Modern day cognitive psychology predominantly focuses on the structures and processes of human competence, like the role of memory and information processing in learning.
Paranormal beliefs can be defined as any kind of unusual experience which actually lacks a scientific explanation or logical reasoning. It can be further defined as experiences which signify the phenomena which can be comprehended only beyond the scientific abilities of today’s era. Paranormal beliefs can be considered as beliefs that are either intuitive or reflective and at the same time containing components of cognition, affection and occasionally behavior related (Irwin, 2009). There is also research that is happening in the recent past that vindicates the association between paranormal beliefs are being mediated by unique cognitive styles for Schizophrenics when compared to people who do not possess this disorder.
Cognitive Behavioral Therapy for Schizophrenia
Cognitive Behavioral Therapy (CBT) can be defined as a systematic psychological form of medical treatment. This treatment was originally developed for people suffering with depressions. However, CBT today is being used to treat a plethora of neuro-cognitive disorders and incidentally this treatment is considered to be the first line choice of treatment aimed at treating anxiety and depression (Massachusetts General Hospital – Department of Psychiatry, 2006).
“In recent years, CBT has become recognized as a promising psychosocial treatment in schizophrenia. Researchers in the United Kingdom and abroad have identified CBT as significantly reducing distress, psychotic symptoms, and negative symptoms for individuals diagnosed with schizophrenia and other psychotic disorders (Massachusetts General Hospital – Department of Psychiatry, 2006).”
The fundamental premise of the cognitive therapy is that beliefs, conjectures, and cognitive evaluation of one’s own self, the surrounding atmosphere, and the nature of individual problems surely have an impact on how things are perceived by that particular individual, and how problems are approached. This in turn decides the success factors in that individual achieving his individual goals.
The misapprehension of events in the world is a most common aspect that can be seen in patients suffering with schizophrenia. With the help of the cognitive therapy for treating schizophrenia, the psychologist needs to agree with the fact that the cognitive misrepresentations and confused or unsystematic thinking of schizophrenia are produced, at least partially, by a specific biological problem that will not stop just because the “exact” interpretation of actuality is explained to the patient.
Cognitive therapy can be successful if only the psychologist agrees to the perception of reality that the patient possesses in his mind, and then as a next step finds out how to exercise this “misperception” in order to help the patient in properly managing the problems that he has got in life. The primary objective of cognitive therapy is to assist the patient on using information from the other people, and other’ perceptions of events, etc, to make adaptive survival decisions. The goal of cognitive treatment is not to “cure” schizophrenia, but to help the patient in improving his or her ability to manage problems that he or she might be facing with in life, to function without other’s help, and to be free of severe anguish and other psychosomatic symptoms (The National Institute of Mental Health, 2004).
“CBTs all broadly attempt to bring a better cognitive, behavioral, and emotional adjustment to the psychotic experience by suggesting to the patient a new explanatory model of psychosis: the vulnerability-stress model. These approaches involve different levels and goals (A. Abdel-Baki, 2001).” A few cognitive therapies aim at correcting certain fundamental cognitive shortfalls or altering the psychotic symptoms and the distress caused as a result of such symptoms. Alternatively, meta-cognitive therapies are one more form of cognitive therapies that aim to revise and streamline dysfunctional self and situational schemas in order to facilitate the development of better-adjusted and commonly applied strategies of cognition.
There is no cure or treatment currently available for Schizophrenia. However, there is continuous improvements happening in terms of identification of permanent cure, advanced medications, etc. One aspect that is really interesting about Schizophrenia is that people suffering with this disorder improve well and react to medications, antipsychotic treatments and CBTs very well. They can lead independent and satisfying lives. Research on genetics, neuroscience, and behavioral science is of immense help for treating this ailment.
CBT has become a proven form of additive treatment that is being increasingly used in treating neuro-cognitive disorders like Schizophrenia. Cognitive Therapy has proved to enhance social adjustments and quality of living for people suffering from this disorder. This therapy also reduces psychotic symptoms and the distress caused by such symptoms. This form of treatment/therapy also addresses all positive, negative, cognitive, behavioral, and emotional symptoms while simultaneously considering the stage of the disease and the special needs of the person suffering with this disorder. However, further research is required to ascertain the time required, the best stipulation frequency, and the specificity of these advancements.