One of the things I began to notice years ago at a large residential facility for psychotic pts. was that the sz pts. who tended to externalize the causes of their problems (e.g.: realistically blame others who had been mean to them) but internalized (meaning “took” or “accepted”) responsibility for their solutions did “better” than those who tended to internalize the causes (e.g.: unrealistically blame themselves in a state of “learned helplessness”) but externalized responsibility for self-improvement (e.g.: onto their prescribers).
Moreover, those who tend to over-externalize were more likely to have positive symptoms (e.g.: anxiety) and those who tended to over-internalize tended to show negative symptoms (e.g.: depression).
It seems to me that I am seeing the same sort of trends here. Any comments?
I dunno, it’s all so intertwined for me that I can’t confirm or deny. I mean all of it: I can point to things in my childhood, both in my parents’ control and out of it, that undeniably set me back, but I can also point to ways I’ve adapted and tried to cope that have set me back as much or more. I can also point to a robust family history on both sides that includes bipolar, substance abuse, suicide, major depression, and “oddness” that is likely unacknowledged sz. Plus, on the epigenetics (if I understand this term correctly, just going on context) side, my heritage is pretty much all Irish. It’s difficult for me to isolate one culprit.
And likewise, I’ve spent nearly 20 years taking full responsibility for the outcome, and carefully monitoring my perceptions and reactions, and limping along mainly okay, only to find myself at almost a complete breakdown, and I can’t disentangle the anxiety from the depression in the slightest. At this point, saying that maybe I don’t have to take full responsibility for the outcome, maybe I need help, therapeutically or medicinally, feels like the only way back to shore.
I seem to be something of a hybrid in that I have had anxiety/social anxiety ,delusions, and paranoia (positive) but also depression. lack of drive,low motivation, difficulty thinking of and pursuing goals(negative).
I am not sure which would be seen as dominant. I would expect most patients with current or past psychosis have or have had a mix of positive and negative symptoms.
Pretty sure you’re right. It looks like it’s a mistake to think that most sz pts are either “totally” positive or “totally” negative. They’re just more skewed to one end of the polarity or the other most of the time, but will move towards the opposite end under some sort of stimulation or stress.