ABSTRACT

Although advances have been made in the understanding and treatment of positive symptoms of psychosis such as paranoid thinking and voice-hearing, negative symptoms such as loss of motivation and reduced social functioning often present a major barrier to recovery. The psychosocial treatment options for negative symptoms should benefit from systematic examination and refinement, both in terms of the models used to understand symptom development and maintenance as well as the specific treatment techniques. We examine the possibility that negative symptom burden is particularly related to insecure-avoidant attachment style and that this manifests in difficulties with understanding one’s own mental states and the minds of others. Drawing on key studies that have examined mentalisation and related processes alongside negative symptom profile data, we provide a model of negative symptom formation and maintenance along with a case example that portrays the use of these principles in case formulation and treatment.