Trust and Schizophrenia: Navigating the Challenges

For individuals living with schizophrenia, trust can be a significant challenge. Schizophrenia is a mental health condition that often involves symptoms such as paranoia, delusions, hallucinations, and cognitive difficulties, all of which can make it hard to distinguish between reality and distorted perceptions. These symptoms may cause a heightened sense of suspicion or mistrust, making it difficult to connect with others or form supportive relationships.

However, building trust is not impossible. With the right strategies, patience, and support, individuals with schizophrenia can gradually learn to trust themselves and others. Trust is essential for healthy relationships, emotional well-being, and recovery.

When someone, or an organization, has betrayed the trust of someone else, it is logical to expect that person’s belief in the concept of trust declining… or even further, progressing to the point of not trusting anyone or anything ever again. The more mistrust one experiences, the less likely they are to deeply trust again without some kind of redirection.

A point before we begin to learn the steps of building trust once again, I must remind you of a very important concept which will help you in becoming open to what is suggested. You are very much in control!

While learning, YOU can decide the principles that you would like to try. YOU have the ability to decide how quickly or how slowly you would like to progress through these steps. YOU can also determine the boundaries that need to be set, which will be discussed in this article.

Let’s begin with Self-Trust. We must establish the ability to trust yourself FIRST, to allow you to advance toward trusting others. To establish a borderline as we begin, on a scale of one to 10, 1 being the lowest amount, “How well do you trust yourself?” Remember your response as we will be using it later.

As one who has been living with the challenge of schizophrenia, you are aware of episodes that accompany the condition. So, let’s begin here. Is a person living with this condition able to apply the principle of TRUST while experiencing a moment of psychosis? It all depends upon their level of awareness.

Awareness of being in a moment of psychosis can vary greatly depending on the severity of the symptoms, the stage of the illness, and the individual’s overall insight into their condition. Psychosis in schizophrenia typically includes symptoms such as hallucinations (e.g., hearing voices or seeing things that aren’t there), delusions (e.g., believing in things that are not based in reality), disorganized thinking, and impaired insight. Here’s a more detailed look into the different levels of awareness during psychosis:

1. Lack of Insight (Anosognosia)

One of the hallmark challenges in schizophrenia is a lack of insight, known as anosognosia. This is a condition where the individual is not fully aware of or does not recognize that they are experiencing symptoms of psychosis. In this state, people may believe that their hallucinations or delusions are real and not question their reality. This can make treatment and self-management more difficult, as the person may not recognize the need for medical intervention or treatment.

In this case:

• The person may be fully convinced that their delusions or hallucinations are true, and they may not have any awareness that these experiences are a result of their illness.
• This lack of insight can lead to difficulty in following treatment plans or acknowledging when they need help.

2. Partial Awareness

Some individuals with schizophrenia may have partial insight into their condition. They may recognize that something is not quite right, but they might not fully understand the nature of their symptoms. For example, a person might realize that they are hearing voices, but they may not acknowledge that this is a symptom of psychosis. In this case, they may be unsure whether the voices are real or not but still experience distress or confusion.

In this case:

• The person may feel disturbed or anxious about their experiences but still have difficulty identifying them as part of a larger mental health issue.
• They might seek reassurance from others or have a sense that something is “off” but may struggle to explain it.

3. Full Awareness During Psychosis

In some instances, individuals with schizophrenia can be fully aware that they are experiencing psychosis. This is more likely in the early stages of the illness or in cases where the person has gained some insight over time through treatment or personal experience. They might recognize that their thoughts or perceptions are distorted and may be able to distinguish between reality and their symptoms. However, even if they are aware, they might still feel overwhelmed by the intensity of the psychotic experiences.

In this case:

• The person might acknowledge that their thoughts, voices, or beliefs are not grounded in reality, but they could still be unable to control or dismiss them.
• This awareness can lead to distress, as they may feel trapped by the psychosis despite knowing it is not real.

4. Awareness After Psychosis Ends

Sometimes, individuals with schizophrenia might only realize that they were in a psychotic episode after the symptoms subside. In this situation, they may look back and recognize that their perceptions or thoughts were not accurate but may not have been fully conscious of it while the episode was ongoing.

In this case:

• After the psychosis ends, the person may feel confused or even embarrassed about their behavior or experiences.
• They may seek treatment or assistance to better understand what happened and how to manage their symptoms moving forward.

In light of all of this information, and to create a path of sureness and truth, is it fair to say that there is a possibility that while experiencing a moment of psychosis, some things MIGHT not be true? Perhaps we can assume that even if 1% of the things that we experience are untrue, we can say that during moments of psychosis, have to be categorized as being uncertain if things are real, or perceived.

Remember, this article is centered upon trust, and developing trust. We are not here to say if what you experienced during a psychotic event was true or not. We have learned as it relates to trust, we should start by simply not trusting those moments of psychosis right now, so that we can advance by correctly answering, “Can I trust myself?”

Now, removing these episodes in your life, I would like to ask you again, on a scale from 1 to 10, How well do you trust YOURSELF? Not others, or the world… Just yourself?

I would venture to guess that in comparing your two numbers, you have seen a bit of progress in defining the trust level that you have toward yourself.

I would ask that through this process, you remove the complexity of trusting yourself during episodes, and focus entirely upon learning and building trust when you are outside of these moments. If there is uncertainty if you are experiencing an episode, or not, have someone established as your go-to that can advise you if you are in a position that you can trust yourself or not. There outside influence can remove the anxiety of knowing when you can trust yourself or not.

I MUST share that even with your condition, YOU CAN TRUST! You are a very intelligent, knowledgeable person who has had a great deal of experiences in their life. You have gained wisdom through the years and you certainly know a great deal. You can successfully trust, by using the wisdom that you have gained. Begin by trusting the wisdom that you have received through your own individual experiences.

When you feel that you have a high level of certainty that you can trust yourself, then we can proceed with the following directives.

How can we learnt to trust other people or organizations? Does that though give you a bit of anxiety? Let’s dampen that anxiety with the reminder that you are always in control. Better? I hope so.

Consider the following steps:

1. Build Trust Gradually

Start Small:

Trust doesn’t happen overnight. It is important to start with small, low-risk situations where trust can be practiced in manageable steps. For example, you might begin by allowing someone to help with a simple task, like running an errand, or asking a trusted person to help with something that feels safe and non-threatening. The key is to set the bar low at first, so that the experience is not overwhelming.

Test Boundaries:

Allow yourself to experiment with trusting others in different situations, while also observing the outcomes. Trusting someone in a controlled, low-stakes environment can help you assess their reliability. If someone is supportive and dependable in small things, it can serve as evidence that they may be trusted in larger situations. Positive experiences can reinforce the ability to trust, while any negative experiences can be lessons for future interactions. It’s important to acknowledge and process both positive and negative outcomes.

2. Focus on Relationships with Safe People

Identify Trustworthy Individuals:

Building trust starts by identifying those in your life who are consistent, reliable, and safe to rely on. These individuals may include close family members, friends, or mental health professionals who have shown care, empathy, and support. They may also be healthcare providers who have demonstrated a long-standing commitment to your well-being.

Set Boundaries:

It’s essential to establish clear boundaries with others. Setting boundaries can be empowering, as it allows you to define what feels safe and comfortable in a relationship. For example, if someone makes you feel uncomfortable, it’s okay to limit your interaction with them. Boundaries may change over time as you grow in your comfort and trust level, but they provide a framework for building relationships on your terms.

3. Communicate Openly

Express Fears:

If you have feelings of doubt or mistrust, it can be helpful to express those feelings to someone you trust. Open communication about your fears can prevent misunderstandings, reduce anxiety, and encourage mutual understanding. Talking about your feelings can also provide reassurance and help you process any fears or doubts that may arise from the symptoms of schizophrenia.

Ask Questions:

If you’re uncertain about someone’s intentions, it is okay to ask questions to clarify their behavior. Engaging in honest, calm conversations can provide the clarity you need. For example, if you feel uncertain about someone’s words or actions, calmly inquire to understand their perspective. This dialogue can often provide reassurance, helping to foster trust.

4. Seek Professional Support

Therapy:

A therapist or counselor, especially one experienced in treating schizophrenia, can help address specific issues related to trust. Cognitive Behavioral Therapy (CBT) is one evidence-based approach that can help individuals challenge negative or paranoid thoughts. Therapists can also help with managing delusions or suspicions that may arise from the illness. They can work with you on reframing negative beliefs, providing tools for self-regulation, and improving coping skills.

Support Groups:

Support groups are another valuable resource, as they allow individuals to connect with others who are experiencing similar challenges. Being in a group setting where others share their experiences can foster a sense of belonging and understanding. These groups offer a safe environment to practice trust, share your experiences, and learn from others who have navigated similar issues.

Some groups can be found on-line and can be done while staying in your own home through several apps such as facetime.

5. Develop Coping Strategies

Challenge Negative Thoughts:

One way to work through feelings of mistrust is to actively challenge and reframe negative or paranoid thoughts. Cognitive restructuring techniques, such as asking yourself, “Do I have evidence for this feeling?” or “Is this thought based on facts or assumptions?” can be helpful in breaking the cycle of suspicion. By identifying patterns of thought and replacing them with more balanced perspectives, you can gradually develop a more trusting mindset.

Practice Mindfulness:

Mindfulness and grounding exercises are essential tools for managing anxiety and suspicion. Mindfulness helps you focus on the present moment without judgment, which can prevent you from being consumed by thoughts of distrust. Techniques such as deep breathing, progressive muscle relaxation, or using grounding techniques (like focusing on the five senses) can help reduce anxiety and bring you back to the present.

6. Strengthen Self-Trust

Honor Your Instincts:

Self-trust is essential when learning to trust others. Recognizing when someone feels truly safe or supportive can be empowering. Listen to your inner voice and acknowledge when you feel comfortable or uneasy. Building self-trust enables you to set healthy boundaries and make decisions that are best for your well-being.

Focus on Self-Care:

When you take care of your physical and mental health, you are better equipped to engage with others in a healthy way. Proper self-care—whether through sleep, nutrition, physical activity, or relaxation—strengthens your resilience and improves your ability to form positive, trusting relationships.

7. Build Positive Experiences

Engage in Activities:

Participating in activities that involve social interaction can provide opportunities to practice trust in safe, low-pressure settings. Joining a hobby group, taking a class, or volunteering can be positive ways to interact with others while maintaining a sense of control. These activities allow you to observe and interact with others in a structured environment, which can make it easier to build trust.

Celebrate Progress:

Trust is a gradual process. It’s important to celebrate small successes along the way. Whether it’s sharing a thought with a trusted person or accepting help from someone, these small victories are steps toward building a stronger sense of trust. Acknowledge your progress, and be kind to yourself when things don’t go as planned.

8. Be Patient with Yourself

Understand that it’s a Process:

Learning to trust is a journey, not a destination. It’s normal to feel frustrated or overwhelmed at times, especially when trust is a challenge due to the symptoms of schizophrenia. Be patient with yourself, and remember that healing and growth take time.

Seek Encouragement:

Surround yourself with people who encourage and validate your efforts to trust. Having a support network that understands your struggles can boost your confidence and remind you that progress is possible.

Building trust as someone with schizophrenia is a process that involves gradual steps, and openness. With the right strategies, you can create meaningful, trusting relationships that contribute to your mental and emotional well-being.

I will conclude by addressing the topic of dealing with people, or organizations that have betrayed your trust. Should you trust them? Ever?

A logical response to those questions is, that if someone has betrayed your trust once, it is fair to wonder if additional things that they have shared with you can be trusted as well. But the in-depth answer depends upon YOU!

If a car salesman, blatantly lies to you about a car and after your purchase you find it to be a complete lemon. How would you proceed? Would you go back and buy another car from that person? Probably not. That person can not be trusted, and it is best that you simply move on and eliminate that person from your life.

If someone in your family has hurt you deeply because of a trust issue, then what? Remember, you are in control of that response. If the person is apologetic, and sincerely is sorry for what they have done, and has an extreme desire to regain your trust, it is likely that you would do just that. Let that person regain the trust that they once had with you. As you see them making progress in their honesty with you, you slowly begin to move your level of trust with that person a bit higher setting.

If that person has no interest in expressing sorrow, or a desire to earn your trust back, you are safe to leave them in the “non-Trust” category. This trust status may be revisited if that person shows some desire to work toward regaining your trust.

What about an organization who has betrayed your trust? I think that is important to note that this betrayal, has likely come from a handful of people, rather than the entire organization. And, if betrayal of trust included many others, they were likely just trying to follow the leadership of that organization. So, where does this leave us regarding trusting an organization?

We should divide this group up to answer that question. We can certainly trust members of that organization that have not betrayed our trust in the past. And the others, the leaders, we should dial back our trust towards them and only trust in the things that they say which can be proven or validated. Should they continue with their deceit, it is less likely that the trust level of those leaders would be anything other than a low score.

It’s been written that the best lie is mixed in with the majority of truth. Chances are, this organization teaches truths as well as their lies. You might want to consider all of the teachings of the organization which have led to happiness, or fulfilment. Those teaching are likely true, since you have seen positive or supporting responses through their application. Those teachings that have been proven to not be true, should be placed in the non-trust column, as they have rightfully earned their place there.

So, to simplify all that has been said, Trust can be given there towards a person. Trust can also be removed from a relationship. There can also be varying levels of trust given to someone. YOU have the ability to determine where the trust meter lies… But it is through the actions of others that determine where you will place that pointer on the meter of trust.

I send my love to all who are reading this post. I also share a sense of friendship, and an understanding of the difficulty that you face. For I too share the ice cream, yet a different flavor. As we continue to understand ourselves, some of the barriers can be removed. We can see ourselves beyond a diagnosis, for we are so much more than that.

We are resilient, strong, creative, innovative, and possess a deep level of empathy and sensitivity. We have a strong sense of determination, mixed in with a bit of stubbornness. We are a spiritual group, always seeking a sense of purpose. We have the characteristic of self-realization and insight, coupled with patience and tolerance. We are loyal and understand the importance of commitment. We are intelligent, and possess analytical thinking. So rather than just a diagnosis, what are the characteristics that truly describe you?

You can read more of River’s writings on his blog www.riverwilde.blog