The invisible wound: Understanding childhood emotional neglect in those diagnosed with schizophrenia
Lucas with Teta Nabila, Sherif Salama.
Often connections with even one person like a grandparent or teacher can help people to get in touch with their inherent loveablility and worth.
Content warning: This post discusses childhood emotional neglect and uses the term "schizophrenia." This term appears because it was used in the research being discussed, but I recognize that many people, including myself, find this label outdated and harmful. The diagnosis applies a label that groups a variety of issues to an individual that may not fully apply to them. The stigma associated with schizophrenia, as well as common misconceptions that it is an unhealable, biological, progressive disease requiring medication, make the label harmful and outdated. I use it here only to accurately reflect the research while acknowledging the limitations and potential harm of this terminology.
The hidden impact of what didn't happen
When we talk about childhood trauma, we often focus on what happened—abuse, violence, or specific harmful events. But sometimes, the deepest wounds come from what didn't happen—the emotional connection, validation, and nurturing that was absent. This is childhood emotional neglect (CEN), and recent research suggests it may play a significant role in the development and experience of schizophrenia.
Childhood emotional neglect occurs when parents or caregivers fail to respond adequately to a child's emotional needs. It's not necessarily about bad parenting—many well-intentioned parents who provide physical necessities may still struggle to connect emotionally with their children due to their own upbringing, substance use, mental health difficulties, or life circumstances.
The connection to schizophrenia
Recent research has revealed that emotional neglect is actually the most frequent form of childhood trauma reported by individuals with schizophrenia (Popovic et al., 2019). Unlike more obvious forms of trauma, emotional neglect can be subtle and often goes unrecognized, yet its impact can be profound.
People who experience emotional neglect in childhood and later develop schizophrenia often show specific patterns of neural connectivity and cognitive functioning that differ from those who didn't experience such neglect. Research has found decreased connectivity between brain regions involved in emotional processing and self-awareness in those with histories of neglect, which may contribute to difficulties in social cognition and emotional regulation (Popovic et al., 2019). Research like this can be scary to read, but neuroplasticity research suggests there are ways to increase connectivity between brain regions impacted by trauma and neglect.
How emotional neglect shapes the experience of schizophrenia
When childhood emotional neglect intersects with schizophrenia, several patterns often emerge:
Heightened disconnection: Many people diagnosed with schizophrenia who experienced emotional neglect report feeling fundamentally disconnected from others, even before psychotic symptoms emerged. This sense of being "different" or "outside" can be traced back to early experiences of not being emotionally seen or validated.
Difficulty identifying emotions: In her book "Running on Empty," Dr. Jonice Webb describes how emotionally neglected children often grow up unable to identify or express their own emotions—what she calls "emotional blindness" (Webb, 2012). For someone experiencing psychosis, this additional layer of confusion about internal states can make experiences of altered states even more disorienting.
Increased negative symptoms: Research suggests that childhood emotional neglect correlates with more pronounced negative symptoms in schizophrenia—the withdrawal, flat affect, and reduced motivation that can be so challenging to address (Popovic et al., 2019).
Struggles with self-worth: The pervasive message of emotional neglect is "your feelings don't matter," which leads to deep-seated beliefs about one's lack of importance or value. These beliefs can make it incredibly hard to seek support.
Pathways to healing
The good news is that the wounds of emotional neglect can be healed, even for those also navigating a diagnosis of schizophrenia, schizoaffective disorder, or psychosis. Here are some approaches that can help:
1. Emotional awareness and literacy
Dr. Webb emphasizes the importance of developing emotional awareness as a first step. For someone diagnosed with schizophrenia who experienced emotional neglect, learning to identify, name, and understand emotions can be transformative. Simple practices like:
Keeping an emotion journal
Using emotion wheels to expand emotional vocabulary
Mindfully noticing physical sensations connected to emotions
These can help build the emotional literacy that may have been missed in childhood.
2. Validating the experience
Many people with histories of emotional neglect question their own perceptions—"Am I making too big a deal of this?" "Should I just get over it?" This self-doubt can be particularly challenging for someone diagnosed with schizophrenia, who may already face questions about their perception of reality.
Validation—from therapists, support groups, or understanding friends—can be healing. Acknowledging that emotional neglect was real and impactful is an essential step toward recovery.
3. Self-compassion practices
Learning to treat oneself with kindness rather than judgment is crucial for healing from emotional neglect. Self-compassion practices can help counter the internal critical voice that often develops in emotionally neglected children.
4. Building a support network
Creating new experiences of emotional connection can rewire the brain patterns established in childhood. Supportive therapy, peer support groups, and nurturing relationships all provide opportunities to experience being emotionally seen and validated, perhaps for the first time.
5. Integrative approaches
For those navigating both schizophrenia and the effects of emotional neglect, integrative approaches that address both the neurobiological aspects of schizophrenia and the emotional wounds of neglect tend to be most effective. These might include:
Trauma-informed cognitive approaches such as cognitive behavioral therapy for psychosis (cbt-p) or Acceptance and Commitment Therapy (ACT) to help work with difficult thoughts and feelings
Body-based therapies that address the somatic aspects of emotional neglect
Dance/movement therapy has shown promising results in addressing the withdrawal, flat affect, and reduced motivation that many people diagnosed with schizophrenia experience.
Hearing Voices Network approaches that help find meaning in experiences
The path forward
Healing from childhood emotional neglect while managing schizophrenia isn't a linear journey. It's a process of gradually building emotional awareness, self-compassion, and connection. Small steps matter—each moment of recognizing and honoring your own emotions helps repair what was missed in childhood.
A growing body of reserach like that by Popovic et al, challenges the idea that schizophrenia is a biological disease that can only be treated medically and suggests that their are gentler and more relational approaches to helping people through experiences often labeled as schizophrenia.
If you recognize yourself in this description, please know that support is available. You deserve to be emotionally seen, understood, and connected—and it's never too late to begin that journey.
References
Popovic, D., Schmitt, A., Kaurani, L., Senner, F., Papiol, S., Malchow, B., et al. (2019). Childhood trauma in schizophrenia: Current findings and research perspectives. Frontiers in Neuroscience, 13, 274.
Webb, J. (2012). Running on empty: Overcome your childhood emotional neglect. Morgan James Publishing.