Dr Charlie Heriot-Maitland - Social-rank threat and compassion in psychosis

People with psychosis live in a constant world of internal and external threat; whether it’s a voice in their head making explicit threats, a feeling they're being watched, a conspiracy, or whether it’s the threat implicit in having their life influenced by outside forces. What this means, at the biological level, is that the entire brain-body system that's evolved to process and respond to threats is being constantly stimulated. And the more this system gets activated, the more sensitised it becomes. As if this weren’t problematic enough, psychotic conditions like schizophrenia carry severe social stigma, and many of those diagnosed will internalise this stigma to experience shame. What this brings is an additional layer of threat, linked to one's social position or social-rank.

This talk will firstly consider the role of social-rank threats in maintaining people’s vulnerability to psychotic states, via continued activation of the threat system. It will then consider the role of social processes in regulating this system, and outline a rationale for compassion-focused therapy (CFT) for psychosis, which aims to target these mechanisms at the individual psychological level. An overview of the key aims, processes and interventions in CFT for psychosis will be provided, followed by a look at some of the projects underway with thanks to funding awarded to Dr Heriot-Maitland (by the MRC for period 2014-2017).