Data showing a link between trauma, social exclusion, and psychosis highlights the importance of building and reinforcing social links for vulnerable individuals. Perhaps less well understood, however, are the ways in which bullying and peer victimization have been linked to severe psychopathology, most particularly to psychotic spectrum disorders. Data from developmental studies and attachment research shows not only the importance of early relationships in building resilience in young people, but also that early deficits can be moderated with sufficient attention to the quality of later relationships. At a time when we are seeing some of the dire consequences of peer victimization in our schools, information about the consequences of bullying and social exclusion is crucial to educators, who are in a unique position to help vulnerable young people to find resources if they are sufficiently aware of risk factors and potential resources. In this chapter, Dr. Marilyn Charles tries to highlight those vulnerabilities and resources in ways that might be of use to educators.
In the stories of many individuals who struggle with psychosis, there is a history of severe bullying and/or social exclusion in childhood. This anecdotal evidence does not tell us much about cause and effect. We cannot say, in retrospect, to what extent the child became alienated or excluded because of bullying or to what extent the exclusion was in relation to psychotic symptoms or liabilities already in evidence. We do know, however, that psychotic symptoms mark strain that is not being sufficiently attended to. Such strain is often apparent in the classroom, where academic and social pressures may exacerbate other vulnerability factors. In this way, the attentive teacher may be an important resource for the vulnerable child, particularly as teachers’ attitudes and behavior are important factors in determining the extent to which bullying will manifest in the classroom.
Although psychosis is often seen as evidence of a degenerative disease process already in place, epidemiological studies provide evidence that psychosis is best viewed as a continuum such that initial psychotic symptoms can be seen as a risk factor for later disorder rather than as a sign of disease per se. This evidence encourages a view of symptoms as warning signals and highlights the importance of early recognition and intervention at the first sign of psychotic symptoms. Early intervention may be crucially important in children during the critical years of emotional and social development, particularly given studies showing that psychotic symptoms may affect interpersonal relationships in negative ways, thereby increasing the likelihood of peer rejection and hostility.
Early intervention approaches have shown that swift and intensive attention to the first break of psychosis can result in a marked decrease in the incidence of chronic illness. Notably, early intervention that focuses on strengthening the social bonds and helping the individual and his or her support system to better understand and work with difficulties that are arising have been extremely effective in reducing chronicity. These facts suggest that educators may play a crucial role in recognizing disturbance when it first appears and helping the vulnerable child to maintain his or her place in the social structure of the classroom while other resources are brought to bear.
Research shows the importance of such social bonds and also affirms the strong link between bullying and social exclusion in childhood and severe psychological distress in later life. Although educators have been aware of this link, it has been difficult to ameliorate the problem. In this chapter, Charles first discusses ways in which early childhood experiences affects resilience. Charles then discusses the evidence that links bullying and social exclusion to later psychopathology, with a particular emphasis on the link to psychosis. Charles then describes possible mechanisms implicated that may help educators better understand this link. Finally, Charles notes intervention methods that have been created to try to address the problem of bullying within the school setting.
In: M. O’Loughlin (Ed.), The Uses of Psychoanalysis in Working with Children's Emotional Lives, Jason Aronson, pp. 207-226.