In order to cultivate an understanding of what strategies lead to resilience, it is important to explore the mechanisms leading to excessive reactions in response to stress. We have already reviewed the large body of literature which indicates the diminishment of the cognitive triad (the negative view of the self, of others and negative expectations of the immediate or long term future). A typical stimulus that activates the negative cognitive triad generally has to do with the devaluation of the self; the meaning attached to the stimulus is centered on the notion of being deranged, inadequate, and undesirable and the expectation that this negative view will increase over time. The negative stimulus may often take the form of a challenge. For example, the individual is subjected to a psychological test or a psychiatric evaluation. These procedures lead to the activation of a sense of failure and subsequently, activate the most negative reactions (the individual becomes symptomatically worse by experiencing increased delusions and hallucinations, as well as performing poorly on the tests).
It is important to understand the pathway to the exacerbation of these symptoms: stress in the form of devaluation or challenge > activation of the negative cognitivetriad> activation of conditional beliefs (“if I am subjected to a test, I will fail”)> activation of positive symptom complex and negative symptom complex. The process of building resilience may be either global (i.e. providing the individual with corrective experience to build up self-confidence and self-esteem) or directed towards the specific conditional beliefs (i.e. demonstrating to the individual in a behavioral experiment that he is more competent than he believed or more sociable). These procedures can be initiated while the individual is still in the hospital or structured facility. However, it is very important to utilize this framework when the individual is out of the hospital because a whole new set of stressors may be encountered.