Cognitive dissonance in the treatment of paranoid schizophrenia

Paranoid thinking is often well organized, systemized and detailed so that treating a paranoid patient is a difficult challenge. It is suggested that cognitive dissonance, once created, may cause a person to change his cognitions in order to lower or eliminate it. The treatment of a paranoid schizophrenic is presented wherein by introducing strong group pressure the patient accepted an axiom, which created dissonance with his paranoid content. This axiom was 'A wise man sees more than two alternatives in any given situation.' Therefore, by stepwise pacing, alternative evaluations of affect 'free' situations were made by the patient using the accepted basic axiom. This technique was gradually used with the patient's paranoid content, and later on with basic characteristics underlying the paranoid system. The patient exhibited curiosity and a willingness to investigate his paranoid inner state according to the new accepted axiom, and a significant symptomatic relief was seen within a few days, in contrast to past hospitalizations where only partial response to antipsychotic medication was noted. Research is needed in order to examine the effectiveness of this mode of treatment.