[rendx]

> once that's done its done

"As such, the hippocampus and hippocampal neuroplasticity may also play a key role in resilience and recovery from stress. This is supported by the current finding that hippocampal volume increased following psychological therapy."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943737/

"we found a significant [hippocampal] volume expansion during a 12-week treatment period, which correlated with clinical improvement"

https://www.biologicalpsychiatryjournal.com/article/S0006-32...

Increased hippocampal volume and gene expression following cognitive behavioral therapy in PTSD

https://www.frontiersin.org/journals/human-neuroscience/arti...

[sterlind]

All those articles are for PTSD. PTSD is not the same as schizophrenia. Just because psychotherapy helps with PTSD doesn't mean it'll help with schizophrenia. Mental illnesses, and their treatments, are not fungible!

[rendx]

1. See my other reply in this thread about the potential link between and high comorbidity of PTSD and schizophrenia.

2. The argument brought up was that brain 'damage' "just is", and cannot be reversed; which is where any neuroplasticity research can be used to show that it is not that simple, and that even brain structures can and do continue to change over the course of a lifetime, not only on the level of transmitters.

3. The positive effects of psychotherapy for schizophrenia are well researched.

[rendx]

Hardy, A., Keen, N., van den Berg, D., Varese, F., Longden, E., Ward, T., & Brand, R. M. (2023). Trauma therapies for psychosis: A state‐of‐the‐art review. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12499

Schäfer, I., & Fisher, H. L. (2022). Childhood trauma and psychosis-what is the evidence? Dialogues in clinical neuroscience. P. 360 – 365. https://doi.org/10.31887/DCNS.2011.13.2/ischaefer

[asveikau]

Psychotherapy does in fact help with schizophrenia. It's been a while since I was steeped in reading sources that backs this up, but one thing I came across was the notion that therapy alone is actually more effective than antipsychotics alone for certain symptoms. (If memory serves, therapy is better than drugs for persistent delusions.)

However, I think the best treatment involves both.

[none4methx]

I’d like to call you both right on the basis that a working brain at age 40 retired with less than a working brain from age 27 or whenever schizophrenia tends to present.

Outcomes are what we’re hoping to improve. Your data looks like we get brain recovery, which is an improvement to outcomes. Necessary, maybe not sufficient.

[creatonez]

No one mentioned PTSD?

[rendx]

I did!

When you look at the studies I posted initially, one theory is that schizophrenia is a result of posttraumatic stress caused by childhood trauma, and a coping strategy (flashbacks, intrusions, dissociation). It may not be in all cases, but in the cases where that is, PTSD treatment seems to work to fundamentally heal schizophrenia.

Remission of schizophrenia after an EMDR session https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820797/

Applications of Trauma Treatment for Schizophrenia https://www.tandfonline.com/doi/full/10.1080/109267710037051...

Making meaning of trauma in psychosis https://www.frontiersin.org/journals/psychiatry/articles/10....

Even if you believe schizophrenia to be first and then lead to traumatic experiences (which it certainly will), it makes total sense to do a trauma assessment and heal the maladaptive strategies and broken beliefs related to these traumatic experiences, which is where again PTSD treatment comes in.

"In the last 2 decades, it has become obvious that child abuse, urbanization, migration, and adverse life events contribute to the etiology of schizophrenia and other psychoses. […] I expect to see the end of the concept of schizophrenia soon." (Murray, R. M. (2016). Mistakes I Have Made in My Research Career. Schizophrenia Bulletin, sbw165. doi:10.1093/schbul/sbw165)

[froh]

yes, there are indications for this to be true, however, it's _extremely_ hard to find clinicians willing to and courageous enough to work with patients with psychotic experiences on trauma.

basically admitting psychotic episodes kicks you out of most programs before you can even start, because the anticipated overreaction to slight triggers can only be handled by the most experienced counselors, or so they believe.

In that sense I appreciate you sharing these papers while pointing out that it's still a looong way to have this currently "esoteric" knowledge mainstream.

[47282847]

Trauma therapy has three components: safety from continued abuse, stabilization/resource building/(co)regulation, and confrontation. It would be ill-advised indeed to start confrontation when the other two are not in place, however it is perfectly possible to use trauma therapeutic methods for stabilizing, also for patients with psychoses.

Build a stable base camp. No need to go in deeper yet. But if you are preparing to go in and face the truth, you cannot do it with meds that blind you.