Gestion de la colère dans la schizophrénie

The usual CBT techniques can be modified to take into account any individual memory, attentional and/or executive function problems. The aim is to set clear, accessible goals, repeat the exercises, use simple language, and, from time to time, abandon written materials (such as Beck's columns) in favor of short, frequent oral discussions. The patient can often manifest difficulty focusing attention on these materials. Such tools can sometimes encourage patients to write up long texts that cannot be used in therapy. Two principles must be respected in therapy. First, it is important to avoid exposure to anger-provoking situations. This technique is contraindicated in the case of schizophrenic spectrum disorders. Second, as with the general population, we must advise against catharsis. Indeed, repetition of violent behavior, associated with intense activation of the sympathetic nervous system, reinforces angry responses and increases assimilation of this behavior. Therefore, both in the patient's personal life and in health care settings, we would advise against tools such as punch bags and balls, which allow patients to reproduce their angry behavior. If the patient needs to vent their frustration, they should choose a sport that does not reproduce angry behavior and violent acts. For example, running, cycling or swimming could be recommended. Anger management based on cognitive behavioral therapy seems a promising therapy. It deserves to be practiced more widely and to be scientifically assessed in the psychotic population.