Improving Emotional Intelligence in Psychosis with Art Therapy

Emotional intelligence is defined as “the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them and to use this information to guide one’s thinking and actions.” Self-regulation of emotional intelligence is is vital to healthy emotional interactions.

Emotional intelligence is formed of interpersonal intelligence and intrapersonal intelligence. Interpersonal intelligence reflects competence in the context of social relationships, while intrapersonal intelligence reflects the ability to regulate one’s own emotions.

The degree of an individual’s emotional intelligence affects the degree to which that individual can deal psychopathological conditions such as schizophrenia. Although schizophrenics may be emotionally sensitive, the interpersonal and intrapersonal spheres of emotional intelligence of these individuals are likely to be negatively impacted for several reasons.

Due to the fact that schizophrenia emerges in late adolescence and early adulthood, it is likely that the Eriksonian stages of social development that correspond with this emergent pathology are negatively impacted by schizophrenia, especially the tasks of achieving independence and forming close relationships.

Much of what comprises emotional intelligence relies on self-permeable boundaries related to appropriate detachment and attachment with others. In terms of successful negotiation of the Eriksonian stages, “identity versus role confusion” may allow the individual to determine appropriate detachment from others by means of differentiating the self, and “intimacy versus isolation” may allow the individual to achieve appropriate attachment within the context of a relationship with another person.

Psychotic individuals have obstacles achieving this due to factors implicit to psychosis. These individuals are both socially alienated and overly involved in their mental realms, stemming partly from stigmatization that may not allow them to find what they perceive as accurate reflections of their internal states in the external world and their understanding of other people. Empathic reflection, in the tradition of Roger’s Person-Centered Therapy, is seldom understood to be available to schizophrenics, perhaps simply due to the fact that most clinicians cannot relate to the psychotic experience of a schizophrenic.

In addition, auditory hallucinations — the internal or intrapersonal experience of a schizophrenic — may be represented by an amalgamation of perceptions of “self” and “other”. This experience does not necessarily allow the schizophrenic the ability to self-regulate her emotions, primarily because she does not entirely own her mental experience. Due to the representation of hallucinations in the minds of psychotic individuals as “entities”, there is also a lack of apparent privacy in the mental realm of the psychotic individual, and the type of experience implied by this perceived lack of privacy can be punitive.

If people with psychosis cannot distinguish boundaries in their own mind, how can they be expected to demonstrate effective intrapersonal intelligence? If stigma causes impenetrable interpersonal boundaries between the psychotic mind and the minds of those who are not psychotic, how can psychotic individuals demonstrate effective interpersonal intelligence?

So this brings us to an essential question: How can the schizophrenic individual negotiate both the intrapersonal and the interpersonal realms in a healthy way? The schizophrenic requires some means of healthy self-expression that allows for symbolic representation of the self that can be at least partly understood by others.

It is suggested that artistic self-expression is a means of creating a personal stance in the social arena that will allow for healthy regulation of emotion. Art therapy could be an important avenue toward increased mental health in the psychotic individual. Engaging in art not only allows the psychotic individual to express his own emotions to others, but the canvas (whether a poem, song or literal canvas) can reflect back to him his internal state. This dialogue between the artist and his work serves an important therapeutic function.

  • I found the theories in this piece interesting. However I find it disturbing to read about people who experience psychosis defined as ‘a psychotic’ and people who experience schizophrenia as ‘schizophrenic’. It indicates that the writer has conflated the symptoms of the condition with the person themselves. I find it quite frightening to contemplate that professional people are still confused about this.

    • I know that I use terms that stigmatize people. However, I believe that each new politically correct term acquires the capacity to stigmatize people as it is invented. I feel defeated in this regard.

      It has been suggested to me that dealing with stigmatizing terms is one aspect of dealing with unique perceptions (schizophrenia). And I sincerely wish that people with these differences were more accepted.

      • sharron

        Hi Ann. My point wasn’t that the diagnosis stigmatizes people. I was trying to say calling people ‘schizophrenics’ or ‘depressives’ etc is confusing the person with the condition ! The terms themselves only describe a condition that the person has been given a label for. I find it important to do this not because it makes anybody less than to be called this, but it isn’t accurate! It says more to me about the person saying ‘schizophrenics’ than the ones they speak of. I think it happens less now, not because of political correctness, but because people realise this difference.

        • Dr. Ann Reitan

          I realize now what you are saying, and I think that it is important to look at the characteristics underlying the term that signifies an illness. It is the characteristics and etiology behind the terms that is obscured by calling someone, for example, a “schizophrenic”.

          My father told me once that diagnoses can amount to name-calling. Diagnoses are essentially stereotypes that convey additional meaning (i.e. prejudice.)

          It is important to remember, as well, that the characteristics and behaviors of schizophrenia, for example, precede the diagnosis, instead of the diagnosis causing the behaviors and characteristics. This is especially true regarding diagnoses such as Borderline Personality Disorder.

  • Paul

    Anything that can get a schizophrenic to get in touch with his/her emotions is good. Schizophrenics can become so fearful that they become petrified to feel because of the lack of ‘privacy’ as this post puts it. When the schizophrenic cannot ‘feel’ , they unfortunately cannot assess accurately every day emotions in other people. Delusions of control , largely manifest in this way. Robustness , wit , intellectual sparring , eccentricity , egotisim is now interpreted in a paranoid manner.

  • Paul

    And when a person becomes detached from their sense of humanity they interpret traits like egotism as manipulative, challenging and persecutory whilst oblivious to the fact that people expressing those same traits want to be confident , want to be heard , want to be expressive , etc , etc . The tragedy of schizophrenia is when people talk sh*t and they invariably do , you can’t call them out , in a jest-full , good natured way.

  • Paul

    Thanks for your posts on psychosis. Are you going to do anything on psychoeducation with a future post. I think I recall you saying in another thread or post(could be wrong) that this was something you were going to do.

    • Paul,

      Yes, an article of mine dealing with psychoeducation will be posted in late August. Like your comments, by the way–thought provoking.

  • Rach

    This is fascinating to read, love your points on psychosis and schizophrenia. This is a topic that has always fascinated me.

  • This is fascinating to read, love your point on psychosis and schizophrenia. This is a topic that has always fascinated me.

  • Pingback: Humanistic theory and therapy, applied to the psychotic individual | Free psychology()

  • This is very informative. If artistic self-expression is a form of art therapy, can it consider blogging as a therapy? It is a self-expressing activity.

  • vicky

    Let’s not call it stigma. Let’s call it others inability to accept that personal experience can run on a much broader spectrum than the ecstatic to grief stricken. I wonder what would happen to psychotics/schizophrenics if their experiences were accepted as another expression of themselves? Maybe they could then move through these experiences were they met with acceptance and love and kept safe? How about there is nothing wrong with them but something wrong with us ‘normal’ types for even thinking so?

  • deshan


  • Yeah, I for one would love a post on psychoeducation as I think it is a topic that is vastly understudied. We definitely tend to stigmatize people in this broad category of mental health issues so I thank you for your unbiased article.

  • Hmm, interesting article. So what your saying is to improve mentality is through this art therapy. You having interesting points on psychosis and schizophrenia. Anyways great article.

Ann Reitan, PsyD

Ann Reitan, PsyD, is a clinical psychologist and well published essayist of fiction and creative nonfiction. She holds a Bachelor of Arts in Psychology from University of Washington, Master of Arts in Psychology from Pepperdine University, and Doctorate of Clinical Psychology from Alliant International University. Her post-doctoral research at Washington University in St. Louis, MO, involved personality theory, idiodynamics and creativity in literature. She recently published Illuminating Schizophrenia: Insights into the Uncommon Mind.

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