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The Role of Childhood Trauma in Psychosis and Schizophrenia: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858420/

"Childhood Trauma is probably the most important environmental factor associated with Schizophrenia. There is evidence of multiple paths between traumatic experiences and psychosis. Mental disorders are systems of interacting symptoms through a framework of networks. Psychotic symptoms in patients with a history of child abuse are more severe, persistent, and refractory to treatment. In developmental years, exposure to neglect and abuse reveals severe adverse effects on the average neurobiological growth, leading to vulnerable neurobiology preceding disadvantageous psychiatric outcomes."

https://www.theguesthouseocala.com/understanding-the-connect...

"The guiding principles of trauma-specific care can give you the space to uncover the root of your schizophrenia and trauma. Thus, understanding how your early traumas have impacted you opens the door to dismantling maladaptive coping mechanisms. As you deepen your self-understanding, it encourages you to lean into adaptive coping strategies to process your experiences and life stressors. Furthermore, with support, you can find a path to recovery from schizophrenia and trauma that considers you and your specific experiences."


i'm getting very argumentative on the internet today (under a pseudonymous account because as you might guess from my incessant posting, this issue is personal for me)

trauma (at any time), drug use, other experiences -- all can make schizophrenia more likely in those susceptible. absolutely true.

but it is a biological disease, and healing trauma won't stop its progression. as your source notes, the trauma causes differences in brain development, and once that's done its done.

i don't think coming up with a new drug, the main advantage of which is it doesn't numb you the horrible way existing antipychotics do, is a bad thing.

this is basically a drug that was only created to improve the QoL of people with schizophrenia. if society just wanted to numb them, we already have drugs for that and could just be much more aggressive in violently coercing treatment.

investing in these drugs isn't "looking away", it's putting in a huge investment of many billions of dollars to help the victims live better lives.


> 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...


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!

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.


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.


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.


No one mentioned PTSD?

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)


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.


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.


> but it is a biological disease

I want to be charitable because I think I know the point you're trying to make in your comment, and what I want to say is mostly to the side of that. But I think that this statement at best glosses over what's been a long, expensive, and heated (though sincere) scientific conversation about schizophrenia over the past century and change. It's one that not only includes a substantively fruitless search for any underlying pathophysiology, but a spirited conversation about the validity, reliability, and plain-English usefulness of the concept itself! Further, this conversation is far from the stomping grounds of cranks and scammers; it has taken place inside what you might call the most orthodox psychiatric and psychological institutions: the APA, the major high-impact journals, fancy universities etc etc.

So when an eminence like Robin Murray, knighthood and all, can go into Schizophrenia Bulletin (2017) and write something like ...

"I expect to see the end of the concept of schizophrenia soon. Already the evidence that it is a discrete entity rather than just the severe end of psychosis has been fatally undermined. Furthermore, the syndrome is already beginning to breakdown, for example, into those cases caused by copy number variations, drug abuse, social adversity, etc. Presumably this process will accelerate, and the term schizophrenia will be confined to history, like 'dropsy.'" [1]

... saying that we know it's a biological disease as part of broader claims about treatment effectiveness doesn't tell the whole story. (I encourage everyone to read Murray's reflections in the linked article, as it's a fascinating retrospective on an illustrious career in psychosis research and psychiatry.)

[1] https://academic.oup.com/schizophreniabulletin/article-abstr...


Excellent comment. A “symptom” of schizophrenia is thinking that one does not have schizophrenia. A “heads I win tails you lose” situation where the single doctor is solely and individually responsible for diagnostics and treatment, but not liable. Criminals are given more rights and protection from abuse, and the legal systems has known and documented failures. For those who are labeled mentally ill there have not been established effective safeguards to protect and support those who might speak out, and by definition of competency their perspectives are not valid. Those who are economically incentivized to argue in favor of a biological explanation can be expected to do so, despite no personal expertise in the matter, and regardless of reproducible evidence.

i think we would agree a lot about the brutality and incompetence of the current system of psychiatric institutions.

however, the reality is, psychosis frequently prevents people from recognizing their own impairment. it's just true that this is very common, and maybe shouldn't be so surprising, since in many other cases (alcohol, drugs, dementia, brain injury) people also are prone to underestimate how impaired they are.


As I read it, the parent comment is making a point about the classification of schizophrenia. It is not disputing that the condition (psychosis) is real, or claiming that people are frequently misdiagnosed with some form of psychosis.

well, okay, then we can say that a lot of people diagnosed with schizophrenia now, even if the concept of schizophrenia is not viable, do have biological disease(s) that cause psychosis alongside what we now call the negative symptoms of schizophrenia. I'm fine with that claim.

it's very different than the common anti-psychiatry claim that the schizophrenia diagnosis is a social construction that gets applied to healthy people who violate social norms.


Are there any consistent biomarkers for people with schizophrenia?

> with support, you can find a path to recovery from schizophrenia

They misspelled "medication". There are narrow situations where very skilled psychiatrists have successfully treated schizophrenics using non-pharma (read: traditional) psychotherapy, but they are truly exceptional cases.

Being schizophrenic is not a lack of "deepening your self-understanding" that blocks them from "uncovering the root of " their illness! That is absolutely horse shit and belongs in a new age Homeopathy boutique.

Schizophrenics firmly believe their delusions and paranoia. In fact, one of the worst things you can say to them is "it's all in your head! The voices aren't real!". Commonly, they split the world into allies and suspects, so the moment you try to invalidate them, they add you to the list of agents/spirits/whatever is after them.

This disease requires a psychiatrist and medication, full stop, and is fully orthogonal to child abuse.


Great if this happens, since it uncovers ongoing unhealthy relationship patterns, and makes them more visible. It does absolutely nothing to enable them.

To label it "abuse" immediately is modern, but not necessarily the most beneficial perspective if you want to grow with each other. You may also not always be in the position to choose who you interact with (e.g. relatives). Then you can still work on why (and how) you would care about _their_ problem, and not make it yours. Seems to be a confusion here about who has the "condition"/problem?


Now that's some gaslighting here.

These products give false hope and are triggering for people susceptible for it which leads to abuse.


Can you explain what do you mean by "gaslighting" in this context? We seem to have a different understanding of what that term means?


Gaslighting is when someone manipulates you into questioning your own perception or reality. By dismissing the concern, minimising the abuse, and subtly shifting blame, you're continuing to do just that - making me question whether the emotional manipulation described is valid, which is exactly what gaslighting is.


Gaslighting is not simply someone sharing a different perspective than you. It requires an ongoing relationship with dependencies, and orchestration. By using the term for simple situations like this, you are minimizing what actual gaslighting entails, and how destructive it can be for someone's psyche.

https://time.com/6262891/psychology-terms-misused-gaslightin...

How are you reading my comment as something where I make you doubt your perception? Can we not simply disagree, and share our different perspectives? Can we not hold different opinions about things, even concurrently, in our minds? I can unfold, and explain my position more, if you're interested. This is a place of discussion, after all. How would you say should I describe my opinion so you don't receive it as gaslighting?

I did not mean to imply that the emotional manipulation is not "valid". I was trying to say that it can be handled in a way where the person with the problem, which is the person consciously or unconsciously trying to employ manipulation (likely because they were raised like that) can be provided with an opportunity to learn and grow. We all were raised more or less in manipulative ways, so we all are carrying it inside. A relationship can be the place to heal it, if both partners want to do that.

It's not the gadget that enables abuse. Abusers will find whatever "tools" and situations to do that. This was my point. A hammer is a hammer, and it's not the hammer's fault if someone uses it to smash in my head.

https://en.wikipedia.org/wiki/Karpman_drama_triangle


Yes, dude, keep gaslighting. I think you need therapy if you are like this in real life.

You are using techniques of diversion instead of engaging with the content of the discussion.

I have an ACE score of 6. I vastly benefit from trauma therapy: EMDR, IoPT (constellations), hypnotherapy, somatic experiencing, nonviolent communication. It helped me get out of most of my previous addictions, and I do not need to take any medication. I consider myself to be quite happy, and was able to build secure attachments and bonds.


Which was most helpful? Or if you can't pick one then what were the best two?


I think it's really a matter of personal preference, experience and circumstance. For a successful therapy and healing, one needs three components: stabilization/resource building (people, things, locations), safety (no or at least reduced contact with abusers; typically there is no conscious awareness of ongoing and continued abuse and boundary violations!), and then, finally, confrontation with past trauma. The three areas need different tools and all need to be balanced with each other.

Often people get stuck in one of these areas; sometimes it may be out of their control. Without careful attention to all three areas, this then translates into a negative reenforcement of "This doesn't work", "I cannot be healed", "It's all my fault", "I'm just too much for anyone", "I'm never going to be good enough", etc.

There is a lot of pressure to try to get out of the trauma and the reenactment fast; patience is an unaffordable luxury for someone suffering and embedded in ongoing violence. If one pushes too fast for confrontation without safety or sufficient resources, they are going to pull stuff up and project it on the present experience, with a high probability of further retraumatization and confirmation of their own and other's "evilness".

The methods I mentioned are my favorites. They all play an important role in my own healing. There are many more.


The US national median salary is $59,384 per year as of Q4 2023.

https://www.sofi.com/learn/content/average-salary-in-us/


Right. How much would you pay for software that saved your $60,000 designer weeks per year?


And how many of those saved weeks are being spent fighting draconian licensing software? In a past life I had a few architectural firms as clients and actually getting AutoCAD licensing shit to work was a huge pain point.


You need to balance those weeks spent fighting licensing issue (seriously?) against the time that's lost by using a piece of software that is a nightmare to use... if it doesn't crash. Which it does all the time.

Admittedly, it's been 2 years since I last used FreeCAD, but I've spent literally more than a hundred of hours with it trying to make it do what I wanted it to do only to come to the conclusion that mechanical CAD probably just wasn't for me.

And then I tried Onshape and, surprise, it wasn't me after all.


Irrelevant; such a license would be purchased by the business and wrote off as a loss on the income/loss sheet.

Needless to say, for a business a few or even several thousand dollars a year is practically nothing if it's critical to business operations and ensuring productivity.

If you're buying this for your own personal use? Yeah, you're gonna need a lot of disposable income or some really good justification. For your own small business use? Yeah, you're gonna need to justify that cost against your estimated annual income and other losses.


What's irrelevant to what? The actual market for CAD software is well funded businesses that are buying it as a productivity tool, so of course their approach to the cost is very relevant when trying to understand the pricing.


The context was the cost of a Solidworks license within the purchasing power of an average salary. Meaning the question posed was whether an employee could buy a Solidworks license.

To that, I say that is irrelevant because just like you said: It's the company that buys and pays for the license, not a singular employee on a salary.


You realize you are telling me what I meant?

The salary of the employee provides the basis of their cost to the company, so any tool that increases their productivity for a small portion of that cost is something they are going to consider.

I wasn't imagining that the typical person making $60k year would enjoy blowing thousands of dollars on a CAD package. This is why they aren't cheap though, because typical people don't buy CAD packages, companies do.


Yeah, but probably not for someone who needs Solidworks for their job.


I like Daniel Kahn's version.

https://www.youtube.com/watch?v=XH1fERC_504


עס איז אַ גוט ליד :-)


> The Swedish government’s report proposed that the apathetic children were from “holistic cultures,” where it is “difficult to draw boundaries between the individual’s private sphere and the collective domain.” They were sacrificing themselves for their family by losing consciousness. “Even if no direct encouragement or directive is given,” the report said, “many children raised with holistic thinking may nonetheless act according to the group’s ‘unspoken’ rules.”

https://www.newyorker.com/magazine/2017/04/03/the-trauma-of-...


I am using Tolino readers completely offline. They show up as mass storage device, and cloud/shop/library connectivity is completely optional. I do connect them to wifi periodically for software updates, but that doesn't require any registration either.


If you were treated like shit when raised, you will believe being treated like shit later in life is something you need to accept.

Or, the other way round: If you were raised to develop healthy boundaries, you will not end up in an abuse relationship later on in life.


A "personality disorder" is also not static. The idea is that you work with it and heal aspects that make life (more) difficult for you, so you do not have the disorder any more. Not that you make it a part of your identity and demand others to accept your "unique style".


ICD11 is final and released (though not "adopted" in most countries yet?), so the restructuring is not a "plan" any more.


The restructuring is not complete, though: a concession was granted to allow borderline personality disorder to remain for the time being due to industry concerns related to reimbursement, but the plan remains to ditch it eventually.


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