A common image of schizophrenia is the person who spends all day staring at the wall. Such loss of motivation and social withdrawal are known as negative symptoms. These are the most disabling features of this condition, and have been considered virtually permanent—no treatment has been discovered that would help to alleviate them.
In the late 1990s, we decided to see if we could understand negative symptoms better and find a way to improve them. The prevailing belief in the field has been that the observed social withdrawal and inactivity is based on impairment of brain function, specifically, attention, memory and executive function. However, we could not comprehend how these impairments could translate into the profound inactivity we saw in the person staring at the wall.
After conducting many interviews with individuals experiencing negative symptoms, we came to a startling conclusion: these individuals appeared to have a system of negative beliefs that could account for their low functioning.
Specifically, we speculated that defeatist and asocial beliefs reduce access to the motivation needed to initiate and sustain activity. The defeatist beliefs consisted of attitudes such as “there’s no sense in trying anything, I’m only going to fail,” and “failing at one thing is the same as being a total failure.” The asocial beliefs included "people are better off if they stay aloof from emotional involvements with most others,” and "making friends isn’t worth the energy it takes.”
We conducted a series of studies and found, as predicted, that these negative attitudes had a direct impact on the negative symptoms, while the impairments in attention, memory, and executive functioning had only an indirect effect. It stood to reason that if we could modify these disabling attitudes, then we could relieve the disabling behavior.
Not a big fan of CBT.It is grossly overhyped by CBT fanbois and its benefits for psychosis highly questionable .