Imagine trying to live in society without the ability to understand facial expressions. Your sister frowns, but instead of guessing that she might be sad, you decide she is annoyed. And you're convinced that she must be angry with you.
Now imagine that in addition to this, you can't understand other people's intentions. One day your spouse says pointedly, "I'd like to wear this shirt, but unfortunately no one has done the laundry!" The hint is wasted on you, since you're immune to this kind of prodding.
The condition described above is schizophrenia, a severe brain disorder that usually emerges during young adulthood, and affects one percent of Americans, according to the National Institute of Mental Health (NIMH). People with this condition are typically treated with a variety of drugs and various group and individual therapy sessions.
But now a new non-drug therapy called Social Interaction and Cognition Training (SCIT) is generating interest from clinics across the country as a promising way to help people with schizophrenia interact with others. Creators David Penn and David Roberts at University of North Carolina at Chapel Hill and Dennis Combs at the University of Texas at Tyler hope that SCIT will help participants understand intentions and dispositions.
The disease can cause obvious symptoms such as paranoia, or hallucinations. But many people with schizophrenia also suffer from ailments such as memory loss, or inability to pay attention -- which make it incredibly difficult to lead normal lives.
Researchers believe paranoia, difficulty communicating and poor social functioning are some of the most debilitating aspects of the disease. Without the basic social skills most of us take for granted, it's nearly impossible to hold down a job, make friends, or, for some, simply co-exist. There is often a sense of loneliness, and fear.
Standard therapies for schizophrenic patients focus on coping with emotions or specific behaviors, according to Joanna Fiszdon, a clinical research psychologist at Yale. But SCIT is broader -- not only does it address the way patients interpret emotions, it also asks patients to look at different social situations and come up with alternative ways of coping with them.
"Whether you like people or not you have to interact with people," said Fiszdon. "If we can make those interactions with other people less stressful and less difficult that would be a great thing."
Although research is still in the early stages, Psychiatric Services, an American Psychiatric Association journal, identified SCIT as a "potential best practice" earlier this year. Pilot testing with 18 inpatients demonstrated SCIT therapy improved emotion perception, ability to understanding people's intentions, and reduced the tendency to attribute hostile intent to others. Patients were also less likely to act out in an aggressive way.
The NIMH approved a larger, randomized control study that started during the summer to find out if the results from their pilot studies will hold up.