How, other than pharmacotherapy, can those diagnosed with thought disorders be treated?

Question

In general, major depressive disorder is treated with pharmacotherapy, and talk therapy, as well as other little things written below:

People know what the little things you can do if you're depressed are:

• exercise often
• make sure your eating is sufficient/not excessive
• make sure your sleep is sufficient/not excessive
• don't engage in "depressive" behaviors such as isolation, rumination etc.
• get involved more socially
• separate yourself from stressful situations

But, I can't think of any of the little things associated with thought disorders, like schizophrenia...

For some reason the only thing I can think of is Cognitive Remedial Therapy...

What are the corresponding little things that are the counterpart of the list shown above for thought disorders?

Answer 1

Research by Josef Parnas and others has resulted in the Examination of Anomalous Experience, a philosophical structure for examining cognitive disorders. The research, between philosophers, neuroscientists, and psychiatrists indicates commonalities of disordered thought, especially anomalous self-experience. The EASE is designed to be used as a treatment aid for educating psychiatrists on how to recognize and respond to patients attempting to explain their thought disorder symptoms.

http://easenet.dk/

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Handest P, Parnas J. Clinical characteristics of first-admitted patients with ICD-10 schizotypal disorder. British J Psychiatry, 2005; 187 (Suppl. 48): 49-54.

Moller P, Husby R. 2000, The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior, Schizophr Bull, vol. 26, no. 1, pp. 217-32.

Parnas J, Jansson L, Sass LA, Handest P. Self-experience in the prodromal phases of schizophrenia: A pilot study of first admissions. Neurology, Psychiatry and Brain Research. 1998; 6: 97-106.

Sass L, Parnas J. Self, consciousness, and schizophrenia. Schizophrenia Bulletin, 2003; 29/3: 427-444.

Parnas J, Handest P, Sæbye D, Jansson L. Anomalies of subjective experience in schizophrenia and psychotic bipolar illness. Acta Psychiatrica Scandinavica. 2003, 108:126-133.

Parnas J, Handest P. Phenomenology of anomalous self-experience in early schizophrenia

Comprehensive Psychiatry. 2003: 44 (2); 121-34.

Parnas J, Bovet P, Licht D. (2005) Cluster A personality disorders: A review. In M. Maj, H. Aksiskal, JE Mezzich, A Okasha (eds.) Personality Disorders. WPA Series: Evidence and Experience in Psychiatry. Chichester, John Wiley & Sons.

Parnas J, Handest P. Troubles de la conscience de soi: importance pathogénique et clinique dans la schizophrénie debutante. Psychiatrie, Sciences Humaines, Neuroscience. 2005: 3 (suppl. 1) ; 17-29.

Parnas J, Handest P, Jansson L, Sæbye D. Anomalies of Subjective Experience among First-admitted Schizophrenia Spectrum Patients: Empirical Investigation. Psychopathology. 2005: 38; 259-267.

Skodlar B, Tomori M, Parnas J. Subjective experience and suicidal ideation in schizophrenia.Comprehensive Psychiatry. 2008, in press, avaiable online.

Vollmer-Larsen A, Handest P, Parnas J. Reliability of measuring anomalous experience: the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Psychopathology, 2007, 40; 345-348.

Answer 2

Dialectical Behavior Therapy (DBT) is a unique skills training that consists of four modules: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Originally, this set of therapeutic skills were developed as treatment for the extremely unmanageable Borderline Personality Disorder. However, after immense success, the treatment group expanded vastly.

The modules were carefully and specifically designed to help individuals manage their behaviors, emotions, and thoughts. Each module includes a number of 'little things' intended to assist the afflicted in their area of need.

For example, the core mindfulness module teaches individuals to (with practice) slow their thoughts, bring themselves into the present moment, how to regain control of their thoughts by training the mind to focus on only one thing--on the one moment. This particular training is typically introduced in the form of deep breathing exercises where the focus of the exercise is to think of only the breath entering and leaving the lungs/body.

The other modules offer similar skillful training techniques specific to both the individual as well as the given module. I imagine that you will find the answers you seek by delving into the curriculum, techniques, and purposes that lay just beneath the surface of the DBT modules.

Answer 3

For a long time now I wanted to write a book on the subject of states of mind. Here are my findings:

People are normally prone to experience different states of mind throughout the day. From love to anxiety to anger to creativity. Each one distinctly colors Cognition and affects the outlook on past, present and future. For a certain time only. The state of mind affects the kind of action people are likely to take.

For example, romantic love is a state of motivation towards a specific individual. It is characterized by perceiving over-idealized image of a that person, desire to talk and be close to that person. Fantasies and thinking of that person. In case of love, there is clear, irrational thinking pattern of "putting that special person on the pedestal". The state of love would affect the lovers outlook on marriage and children.

Each state has a certain onset time and duration. In your question you mentioned avoiding reminiscences, as they are likely to pull the person into some of the more negative states of mind.

Same kind of definitions can be obtained for other cognitive states of mind that can "pull wool over ones eyes"- anxiety, fear, creativity, happiness, etc. The little thing that can be done is remembering what different states feel like, what kind of actions they prompt and how they affect the outlook on the past, present and future. This removes the fear of unknown.

The most important thing to remember is that each state is temporary, but yet it feels so seamless, that it is common to think this is how things would be forever.

Of course persistent cognitive disorders like schizophrenia can produce much more intense and bizzare states than an ordinary person would experience, but the mechanism of onset-experience-change should still be the same.