Learned Helplessness as a Correlate of Psychosisby Ann Reitan, PsyD | September 25, 2013
Various types of schizophrenia are distinguished by certain symptoms that, while relating to affective, social, physical and intellectual functioning, indicate consequences of extreme emotional suffering. This suffering results in apathetic behavior reflected in diminished emotional expression. Most prominently, schizophrenics may display “learned helplessness”, a condition that has also been tied to depression. Could various forms of learned helplessness be primary characteristics of schizophrenia?
Learned helplessness was first demonstrated by Martin Seligman and his colleagues. They identified conditions under which dogs would demonstrate apathetic behavior when they were punished by means of electric shock. In the experiment, dogs were continually electrocuted to the point where they simply accepted electrocution and did not try to escape it. The dogs learned, correctly, that electrocution was unavoidable, and with this acquired knowledge, they simply lay down on the surface of their cages and took the shocks. By doing so, they demonstrated what we mean by learned helplessness.
There are certain areas of diminished functioning, as reflected by negative symptoms, that are of interest in terms of learned helplessness:
- Reduced affect, including absence of emotions and absence of initiative, toneless vocal expressions, restriction in the range and intensity of emotional expression, loss of concern for everyday things, anhedonia or an inability to experience pleasure, lack of enthusiasm, loss of basic drives and avolition or lack of goal-directed behavior.
- Social withdrawal, including emotional and interpersonal withdrawal, lack of responsiveness to social stimuli, social isolation, avoidance of eye contact, neglect of work or school, and poor attention to personal hygiene.
- Catatonic behavior, including rigid bodies, expressionless faces and mutism, slowed movement, inattention, staring straight ahead, nonresponsiveness, i.e. the person is content to just sit, unmotivated and unmoving.
- Poverty of thought, including restrictions in thought, speech and attention. Absence or reduction in mental processes, poor problem-solving abilities, failure to filter out irrelevant stimuli, lack of communication, alogia and labored speech, and an overall absence of normal cognition.
Apathetic behaviors — such as those listed in the first bullet point above — characterize schizophrenia, and these behaviors seem to be related to diminished emotion that are essentially a kind of emotional burnout. Diminished emotional expression is not due to a lack of emotion, but rather, a reaction to a prolonged intensity of emotional experience in the form of psychological suffering.
Symptoms of social withdrawal, as cited in the second bullet point, indicate a lack of motivation regarding interpersonal activity. In schizophrenia, this may be due to the social isolation imposed on schizophrenics, consequent to stigmatization, and the inability of the schizophrenic to find in others the ability to relate to his personal experience. It may also indicate some aspects of emotional blunting and anhedonia.
People with schizophrenia have problems in the areas of social and vocational functioning. This social and occupational dysfunction is defined by one or more areas of diminished functioning in areas such as work, interpersonal activity, or self-care, as opposed to that achieved prior to the onset of the illness. Clearly, motivation on these dimensions receives its momentum from emotional experience, and a lack of motivation would be expected in a person who is experiencing or has experienced learned helplessness.
There are other less obvious symptoms of schizophrenia that may also relate to emotion and learned helplessness. These include physical catatonia and reduced frontal lobe activity. The catatonic type of schizophrenia may be characterized by motoric immobility as evidenced by cataplexy (a sudden loss of muscle tone that can cause collapse of the entire body), including waxy flexibility ( person’s limbs preserving any position in which they are manipulated by another person) or stupor. The catatonic schizophrenic also demonstrates extreme negativism or apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved, as well as mutism or a lack of speech productivity.
These symptoms could be indicative of learned helplessness. The fact that repetitive behaviors such as rocking, grimacing and other stereotyped movements also define catatonic schizophrenia may indicate attempts on the part of the catatonic schizophrenic to deal with strong emotions in a way that alleviates or, essentially, interferes with her negative emotional experience. This would explain what is cited to be apparently unmotivated stereotyped movement that is sometimes manifested by the catatonic schizophrenic.
Reduced frontal lobe activity is also been cited to afflict those individuals who suffer from schizophrenia. Impoverished thought processes can be characteristic of types of schizophrenia. The lack of meaningful cognitive activity in schizophrenics may have to do with the fact of the non-normative quality of their experience. They may simply lack any traditional basis for thought about their experience. Although this is not the case of all forms of schizophrenia, reduced frontal lobe activity may be a cause or a consequence of schizophrenia. Diminished capacity for thought may be an aspect of depression, and, similarly, it may be an aspect of psychosis.
Although certain psychiatric medications can impact emotional expression by reducing it, the reality of schizophrenia can be an essential cause of reduced emotional expression, as well. Clearly, reduced emotion in terms of facial expression most obviously reflects this kind of learned helplessness, as does diminished social activity. However, catatonic schizophrenics may exhibit this quality, as well. Finally, diminished cognitive activity may reflect the inability or lack of motivation to think about psychotic experience. This lack of motivation may result from the experienced futility of one’s effort to think productively about psychotic experience.
Although this discussion represents merely a tentative attempt to apply the concept of learned helplessness to schizophrenia generally, it is hypothesized that learned helplessness is a concept that perhaps should be a focus in understanding schizophrenia. Learned helplessness is not simply a reaction, or lack of reaction, to physical pain. The quality of learned helplessness in schizophrenics is reflected in significantly diminished emotional, social, physical and cognitive functioning. Learned helplessness reflects exhausted psychological activity.
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