Feeling better together: how companionship protects against paranoia
Friendship, Patty Legera
Based on research by Fett et al. (2022) in European Archives of Psychiatry and Clinical Neuroscience
We all feel lonely sometimes. But for people diagnosed with psychosis, being alone is often a daily reality. A recent study reveals something that might seem obvious: social connection can reduce paranoia and improve well-being.
The findings
Researchers tracked the daily experiences of three groups: people diagnosed with psychosis, their relatives, and people with no history of a mental health diagnosis. They discovered:
People with a psychosis diagnosis spent much more time alone (68.5% of their day) compared to others
When alone, people with a psychosis diagnosis felt MORE paranoid
When with others (especially friends and family), their paranoia DECREASED
Being with familiar people had a protective effect against paranoia for everyone
Connection to early life
These findings support other research linking isolating adverse childhood experiences such as physical and emotional neglect to increased risk of meeting criteria for psychosis (Filippo et al, 2012.) When children don't experience secure, reliable connections early in life, it may affect their ability to form trust and manage social interactions later on. The absence of positive social connections in childhood may create vulnerabilities that contribute to psychosis development and maintence.
Respect for autonomy
While social connection shows clear benefits, it's critical to respect individual autonomy. People meeting criteria for psychosis should never be forced into social situations against their will, especially with people who have been abusive or neglectful in the past without making amends that the person finds acceptable. Healing happens in safe-enough relationships, not in environments where boundaries are violated or past traumas are ignored.
References:
Fett, A.J., Hanssen, E., Eemers, M., Peters, E., & Shergill, S.S. (2022). Social isolation and psychosis: an investigation of social interactions and paranoia in daily life. European Archives of Psychiatry and Clinical Neuroscience, 272, 119-127.
Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., Read, J., van Os, J., & Bentall, R.P. (2012). Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies. Schizophrenia Bulletin, 38(4), 661–671.