Social exclusion prevents us understanding the role of sleep in psychosis and “schizophrenia”
| Published date | 13 November 2017 |
| Pages | 252-258 |
| DOI | https://doi.org/10.1108/MHSI-09-2017-0036 |
| Date | 13 November 2017 |
| Author | Sue Holttum |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Social exclusion prevents us
understanding the role of sleep in
psychosis and “schizophrenia”
Sue Holttum
Abstract
Purpose –The purpose of this paper is to discuss recent papers on trauma, sleep and psychotic
experiences to highlight the lack of attention given to sleep.
Design/methodology/approach –A search was carried out to find recent papers on psychosis or
schizophrenia, trauma and sleep.
Findings –Papers tended to focus on trauma and psychosis, or on sleep and psychosis, but not on trauma,
sleep and psychosis. The two papers discussed in most detail here focussed on sleep difficulties from either
a service user or professional perspective. Both concluded that sleep difficulties need more attention.
The author also discussed evidence suggesting that stress and trauma cause sleep difficulties and that these,
in turn, are an important cause of psychotic experiences. Severe or prolonged stress may also directly cause
some psychotic experiences.
Originality/value –The two main papers highlight for the first time in detail service users’own experiences
of sleep difficulties, a nd how mental health professiona ls view them, suggesting more help i s needed. Other
papers suggest that slee p is overlooked in resear ch into the causes of psycho sis. There is growing
evidence that people have sleep problems before psychotic experiences, and that many have experienced
severe or prolonged stre ss due to life events and circumstance s, often in childhood. Given that stres s can
interfere with sleep, it is time to investigate further the role of stress and sleep in the development and
maintenance of psychos is.
Keywords Social exclusion, Schizophrenia, Psychosis, Sleep, Trauma
Paper type Viewpoint
Much research is now suggesting that people who get a diagnosis of schizophrenia are
distressed as a result of seriously stressful life events and circumstances, and especially things
that happened in their childhood, such as physical or emotional abuse and neglect. Longden and
Read (2016) explain some of this research, and also point to the tendency for mental health
services to treat “schizophrenia”as if it is a brain disease with a strong genetic cause without
good evidence to support these assumptions. Longden and Read (2016) point to flaws in the
genetic research, and remind us that there is no identifiable degenerative disease. They also
mention harmful effects of medication, which may cause damage to the brain if taken at high
doses over a long period of time.
If trauma and difficult life events and circumstances are behind psychotic experiences, then, as
Longden and Read (2016) point out, there are existing approaches available in the form of talking
therapies. However, when people receive their diagnosis, not much attention is usually paid to
their accounts of either childhood or current stressful circumstances to inform decisions about
what will help. Stressful experiences would be more central in most talking therapies, to help
understand where people’s distress has come from. This can help people understand how they
have built up coping strategies during their younger years, such as being hyperalert for danger.
Some people have the kind of childhood where such hyperalertness may have helped them
survive, but it can cause problems in adult life because of the way it affects their day-to-day
functioning. One effect on daily functioning is problems in sleeping.
Sue Holttum is a Senior
Lecturer at the Salomons
Centre for Applied Psychology,
Canterbury Christ Church
University, Canterbury, UK.
PAGE252
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MENTALHEALTH AND SOCIAL INCLUSION
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VOL. 21 NO. 5 2017, pp. 252-258, © Emerald Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-09-2017-0036
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