The Importance of the Emotional Meaning of Positive Events in the Severely Mentally Ill

A recent paper (Seeman, 2017) demonstrated that positive life events do not necessarily have any impact on schizophrenia. For example, receiving notice of winning a lottery did not impact in any positive way on an individual with schizophrenia.What is the reason why positive events which would produce at least a positive affect in other people do not have such an effect on those with schizophrenia? The answer seems to be that the negative self-esteem beliefs about being undesirable etc. are relatively impermeable to external stimuli. They are more or less deeply embedded in these individuals’ psyche. It takes a very strong, emotionally meaningful stimulus to activate positive attitudes behavior and emotions. For example, individual appear perfectly normal when they are bowling (had a cheerful affect and interacted with other members of the bowling team) but of course regressed into their psychosis when they returned to their facility. The emotional meaning of the bowling with staff and other individuals might be “I truly belong…. I am having a good time with other people…. and I am effective in what I do”. The main motive of our approach is to a) find the sweet spot so that the individual’s attention is mobilized and then b) either activate the individual’s investment in their aspirations, or engage the individual in emotionally meaningful activities such as helping other people. When these opportunities and actions are in line with the individual’s basic values and needs, then the positive aspects are activated. However, the kinds of interactions that work for the more normal population, such as positive reinforcement, giving tokens and/or giving compliments don’t really penetrate.

-ATB