By Dr David Laing Dawson
Childhood deprivation and childhood trauma, severe and real trauma, can lead to a lifetime of struggle, failure, depression, dysthymia, emotional pain, addictions, alcoholism, fear, emotional dysregulation, failed relationships, an increase in suicide risk, and sometimes a purpose, a mission in life to help others. But not a persistent psychotic illness. On the other hand teenagers developing schizophrenia apart from a protective family are vulnerable, vulnerable to predators and bullies. So we often find a small association between schizophrenia and trauma, but not a causative relationship.
The human brain/mind has a large variety of mechanisms to protect itself when under threat: Avoidance, denial, withdrawal, anger, rage, fainting, fantasy, suppression, repression, derealization, depersonalization, and dissociation. Some of these may appear to be brief psychotic episodes, but they are not the same thing as persistent psychotic illness. In fact, as I have witnessed many times through the past forty years, well meaning therapists who push their patients emotionally, who “dig for underlying traumas and conflicts”, who try emotionally-laden or unstructured group therapy with patients who suffer from severe psychotic illness, invariably cause a relapse in the illness. And a relapse in schizophrenia or bipolar illness is not a benign event. This was often justified by the old psychoanalytic dogma “they have to get worse before they can get better.” Again no, no, no.
Having a psychotic illness, in itself, and the consequences of that illness, can be traumatic to both the sufferer and his or her family. People with psychotic illness do not need someone probing the wells of their psychic discomfort; they do not need (no matter how well-intended) a therapist scouring their childhood memories in search of an unhealed wound. They need support, safety, security, grounding, and satisfying routine before they can get better. And good medical treatment.