Cognitive and Perceptual Origins of Social Isolation and Psychosis in Schizophrenia


The American Journal of Psychiatry reviews recent research by three leading research groups that “provide intriguing evidence of the cognitive and perceptual impairments that lead to key difficulties” that “may lead to isolation and psychosis.” The papers  (one seen previously in MIA) suggest that “people with schizophrenia have a weakened tendency to be optimistic about future events” as well as “impairments in the ability to recognize the emotions of others.” The editors suggest a neuroplastic model of these deficits’ consequences: “… the path of least resistance may circle me back to a resting point of externally incorrect but internally rewarding thoughts and fantasies,” whereby “the more this path is engaged, the more solidified it will become.”

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Extremly interesting article in which the authors jump to insubstantiated conclusions about how the mind of a person, diagnosed with schizophrenia might work. They call “cognitive deficits” the fact that a person remembers and anticipates bad things rather than good ones. Their patient might have had a traumatic childhood and therefore is perfectly right to see life in this way.
    If they don’t recognise emotions of others it might also be due to the fact that they were traumatised as children by inconsistent adults who left them confused. It certainly happened to my friendly outgoing son, who got constantly slapped down by his insensitive father. He then wasn’t allowed to show his anger and upset, no wonder he got cofused about his own emotions too.
    If a person is constantly slapped down by perents, teachers etc, it might automatically lead to social isolation: you don’t trust the world around you anymore. It is not that the person is not able to process socially relevant information- quite the opposite-that person doesn’t want anything to do with two-faced society and retires in the much kinder and fairer world of one’s imagination or nature. In fact I suspect that the patient usually has much more insight than the psychiatrist in what is going on The psychiatrist has never bothered to ask because he sees things as cognitive deficits and can’t be bothered to inquire about the patient’s background. That is certainly my personal experience.

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  2. These were all thoughts I had while reading these papers. Although I did feel that the authors and the editorial were perhaps either heading in the direction you speak of, or the papers were potentially usable to substantiate the view in any case. So I decided to put the papers up in any case.

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