Proactive Intervention for the Emergence of Psychosis




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It is known that mental illness – and serious psychotic disorders in particular – tend to afflict young adults who are socially, vocationally and academically disadvantaged individuals. While this is not always the case, it is true that those people who emerge with psychotic disorders tend to be isolative individuals who have social difficulties in the arenas of junior high and high school.

It is much less likely that young people who are fully integrated academically, vocationally and socially with their primary peers groups will emerge with schizophrenia and other psychotic disorders generally. Intuitively congruent with this is the assertion that young adults and adolescents who engage in academic and social activities in junior high and high school may be able to ward off the expression of mental illness and psychotic disorders themselves. In fact, social involvement, whether this is constituted by belonging to the Latin Club or the Soccer Team, may provide a buffer against the emergence of mental illness, in spite of  individuals  having a genetic predisposition to psychosis.

It has been asserted that diagnoses of schizophrenia in identical twin studies demonstrate an approximately 50% concordance rate. This means that environmental factors are as much complicit in the emergence or lack of it of schizophrenia as biological factors and genetic factors in particular.  It is obvious that there exists a synergy between the mind, the brain and the environment.  Attributions about one’s experience of the material world alters how the environment is perceived by the individual.  Mental experience is unique to the individual, whether that individual is an identical twin or not so.  Based upon these facts, identical twins will differ to some extent in whether psychosis will emerge.

This fact bodes well for the potential of all persons who may or may not emerge with schizophrenia in spite of genetic predispositions. It is obvious that an adolescent’s academic and social involvement activities with peers in young adulthood will impact social his skills as a mature adult.

This does not mean that, if psychotic disorders do emerge, there is no reason to expect that the adult with a psychotic disorder will not be able to pursue and achieve social, academic and vocational success. Most if not all individuals have resources and avenues to success.  However, positive academic, vocational and extracurricular involvement with peers in junior high and high school will provide the individual who genetically predisposed to schizophrenia with a foundation for success in later life, regardless of whether that individual emerges with schizophrenia.

It has been stated by one of my mentors that, if a child has one adult in his life who supports him in ways that may approach unconditional validation, that child will emerge as resilient. Unconditional love and support may, however, be a myth.

Nevertheless, a good enough role model may be able to guide and and support the psychotic individual and work with his strengths in all or even one area. This might make a considerable difference in individual’s ability to cope with schizophrenia and emerge as successful in areas of love and work in spite of it.

Image via Antonio Diaz / Shutterstock.

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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