Psychosis and Cognition

Cognition is a mental process or set of thinking skills that allows us to learn and to carry out day to day tasks in life. Sometimes we need skills to process information, to read, to understand and to solve different problems

For someone who experiences psychosis, it can be harder for them to tackle some cognitive problems. It can be difficult to do tasks such as managing their homes, taking care of finances, buying groceries, driving etc

Not everyone with psychosis is affected by cognitive difficulties or in the same way. Each person’s experiences are unique. For example some may experience difficulties only in certain areas of cognition, for others the difficulties may come and go etc

This list is not complete as there can be alot of individual experiences and coping methods

The most likely types of cognition to be affected in people with psychosis include

1. Attention

2. Learning and memory

3. Critical thinking skills

4. Social cognition

Attention

Attention is something that allows us to stay focused on a task or work, despite any distractions. People with attention difficulties have trouble concentrating on a task for long and can easily become distracted. They may lose track of time, become easily confused and seem absent minded

Less demand on attention span: It may help to break any task into smaller chunks and to tackle each chunk one by one. Each chunk can be given less time. It may help to simplify the tasks

Focusing on one thing at a time: It can be very hard to multitask. It is easier to lose focus if our attention is divided among many different tasks at the same time. It can help to focus on only one task at a time

Take breaks: It can be important to take breaks to avoid any burnout

Use cues and reminders: Cues such as self talk, comfortable touch or look from someone or any visual reminder can help us focus back on our task when our attention goes off track

Learning and memory

People who experience psychosis can have memory problems in both verbal or visual information. When verbal memory is affected, there may be difficulty in remembering information or instructions. In visual, there may be difficulty in remembering things we have seen

Use repetition: It can help to have important information repeated to us. It is ok to ask someone to repeat themselves if we are unable to remember. Something I practice is to repeat what someone said to me but in my own words, which helps me in understanding and retaining what is being said. We can also develop habits that helps in retaining information. For example keeping our keys at the same place every time

Use memory aids: Writing down important information in a diary, phone notes, planners can help. Alarms can also act as reminders and sticky notes

Try multiple ways of remembering: For some people listening only might not be enough to retain information. It may be easier if other information is also presented visually. Different techniques can be used to find what works the best for us

Critical thinking

Some people may have difficulties in goal directed behavior. This includes planning tasks or simple decisions, coming up with plans, staying motivated. Some may also have difficulty in understanding other people's actions

Routine and planning: Having a routine can help with organization and planning. For example tasks like doing laundry can be scheduled for the same time each week. A to do list can be used to schedule. Sometimes it is hard for me to remember to use the to do list in the first place. So it may help to pair that with a daily routine or habit. For example looking at the to do list when having breakfast or using an alarm to remind us

Make lists and set priorities: The to do list can have tasks set according to priorities

Social Cognition

Some people might feel confused in social situations. It can be difficult to read social cues such as voice tones, facial expressions or difficulty in explaining things. It can be easy to misinterpret what other people say. This may lead to hurtful feelings and misunderstandings

Support from a trusted one: If we find ourselves in a confusing situation, we can ask a trusted friend or family to give us a second opinion on the situation

Asking for clarification: It is ok to ask someone for clarification when we feel confused in a certain situation

It is ok to take time and do what we feel is the best for us. Sometimes it can take time to figure out what works as we all are unique individuals and everyone’s feelings are valid. Be compassionate with yourselves in the process

If you prefer, it is ok to tell someone trusted about cognitive difficulties. Often cognitive difficulties can be misinterpreted and the person being considered lazy. Someone who experiences cognitive difficulties is not lazy. It is not the fault of the person who experiences cognitive difficulties

The following questions are optional

Do you experience some cognitive difficulties?

What are some of the ways that helps you?

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Resources heretohelp, earlypsychosis