A look at the the film The Soloist and how current theory and research on Loss and Trauma can help us understand Nathaniel's situation better.

1. Loss and Trauma
The Soloist
By Rob Lawrence

2. • Summary of film
• Time line
• Schizophrenia
• The trauma of Psychosis
• Loss and Grief of Psychosis
• Nathaniel's recovery
• References
Contents

3. In 2005, the only thing hurting Los Angeles Times columnist Steve Lopez more than his face from a recent bike accident was his
pressing need for story ideas. That is when he discovers Nathaniel Ayers, a mentally ill, homeless street musician who possesses
extraordinary talent, even through his half-broken instruments. Inspired by his story, Lopez writes an acclaimed series of
articles about Ayers and attempts to do more to help both him and the rest of the underclass of LA have a better life. However,
Lopez's good intentions run headlong in the hard realities of the strength of Ayers' personal demons and the larger social
injustices facing the homeless. Regardless, Lopez and Ayers must find a way to conquer their deepest anxieties and frustrations
to hope for a brighter future for both of them.
Summary of the film

4. Nathaniel's Symptoms
• Auditory Hallucinations
• Disorganized speech
• thought
• ObsessiveDisorganized thoughts
• Paranoid delusions
Schizophrenia

5. The Trauma of Psychosis
PTSD
Rund (2014) – Untreated initial
psychotic break is toxic on the brain.
• Damage to neural connectivity
• Cognitive problems
• Decline in academic ability
• Decline in social functioning
• Isolation
Untreated
psychosis
Thought disorder
DSM-5 criteria
• The person
Experienced a threat to the physical
integrity of self.
• The person’s response
involved intense fear,
helplessness, or horror.
Holzman (1987)
• Derailment of thought
• Poverty of speech
• Illogicality
• Thought blocking
• Tangentially

6. Internal Loss
• Incongruence of
thought and
reality
• Faulty Memories
• Loss of control
External Loss
• Not belonging
• Loss of satisfying
social contact
• Loss of social
network
• Loss of
relationships
Expressions of
Grief
• Grief of
psychotic
symptoms
• Voices
• Delusions
• Obstacles of
daily life
Loss of personal
identity
• Self Esteem
• Self awareness
• Internalized
Stigma
• Internalized
blame
The cycle of
grief & morning
• Denial
• Anger
• Bargaining
• Depression
• Acceptance
1 2 3 4 5
Loss and grief of schizophrenia
Wittmann, Daniela & Keshavan, Matcheri. (2007)

7. Cahn et al (2014)
Impaired theory of mind and
insecure attachment styles
• Insecure attachment
• Avoidant
attachment
(discomfort
with close
relationships
• Anxious
attachment
Parental separation has
a more serious impact
on adult psychosis in
black African/Caribbean
population
Craig et al (2007)
Positive factor of Grief
• Moving on (Moved
to LA)
Harvey (2002)
The quality of the sibling
relationship has a
significant impact on the
lives of adult
schizophrenics
Smith & Greenburg
(2008)
Parental death
• Prolonged grief
• Problem with
sustained
employment
• Homelessness
• Lowliness/Isolation
Giza et al (2003)
Psychosis and family

8. 01 Socialization Martin et al (2015)
• Social skills
• Abnormal behavior
02Functioning Chaterkarn (2015)
• Personal care
• Daily life activities
03 Homelessness Burich (2009)
• Sustained Employment
• Relapse
04Flattening of emotion Kring (2009)
• Difficulties to express emotion in the
moment
• Difficulties in anticipating future
enjoyable activities
05 Isolation Baek (2014)
• Stress of socialization
• Stigma and discrimination
06Violence Hodkins (2008)
• Both the victim and participant of
violent behavior
• Antisocial behavior
Schizophrenia and
life in LA

9. WALSH (2016)
• Stability
• Consistency of understanding
and compassion
• Patience
• Trust
• Enhancement of well-being
Friendship with Steve Lopez
Raglio & Vico (2017)
• Social Functioning
• Release of Anxiety
• Emotional expression and focus
• Focus
Music
Road to recovery

10. REFERENCES
Baek, S.-B. (2014). Psychopathology of social isolation. Journal of Exercise Rehabilitation, 10(3), 143–147
Frederick J. Frese, Edward L. Knight, Elyn Saks; Recovery From Schizophrenia: With Views of Psychiatrists, Psychologists, and Others Diagnosed
With This Disorder, Schizophrenia Bulletin, Volume 35, Issue 2, 1 March 2009, Pages 370–380
Harvey, J. (2003) Perspectives on loss and trauma: Assaults on the self. Thousand Oaks
Hodgins, S. (2008). Violent behaviour among people with schizophrenia: a framework for investigations of causes, and effective treatment, and
prevention. Philosophical Transactions of the Royal Society B: Biological Sciences, 363(1503), 2505–2518.
Jones, D., Harvey, J., Giza, D., Rodican, C., Barreira, P. J., & Macias, C. (2003). PARENTAL DEATH IN THE LIVES OF PEOPLE WITH SERIOUS MENTAL
ILLNESS. Journal of Loss & Trauma, 8(4), 307–322
Joseph Walsh. (2016) Can Relational Therapy be Appropriate for Clients with Schizophrenia?. Practice 28:4, pages 267-280.
Kring, A. M., & Caponigro, J. M. (2010). Emotion in Schizophrenia: Where Feeling Meets Thinking. Current Directions in Psychological Science,
19(4), 255–259
Martin, E. (2003) Social skills and behavioural problems in schizophrenia: The role of mental state attribution, neurocognition and clinical
symptomatology. Psychiatry Research , Volume 190 , Issue 1 , 9 – 17
.

11. REFERENCES
Morgan, Craig & Kirkbride, James & Leff, Julian & Craig, Thomas & Hutchinson, Gerard & Mckenzie, Kwame & Morgan, Kevin & Dazzan, Paola
& Doody, Gillian & Jones, Peter & Murray, Robin & Fearon, Paul. (2007). Parental separation, loss and psychosis in different ethnic groups: A
case-control study. Psychological medicine. 37. 495
Neil, B., Hodder, D. & Tesson, M. (2009) Schizophrenia among homeless people in inner-Sydney: Current prevalence and historical
trends, Journal of Mental Health, 12:1, 51-57
Raglio, A., & Vico, F. (2017). Music and Technology: The Curative Algorithm. Frontiers in Psychology, 8
Shenton, M., Solovay, R. & Holzman, P. Comparative Studies of Thought DisordersII. Schizoaffective Disorder. Arch Gen
Psychiatry. 1987;44(1):21–30
Suttajit, S., Arunpongpaisal, S., Srisurapanont, M., Thavichachart, N., Kongsakon, R., Chantakarn, S., … Nerapusee, O. (2015). Psychosocial
functioning in schizophrenia: are some symptoms or demographic characteristics predictors across the functioning domains? Neuropsychiatric
Disease and Treatment, 11, 2471–2477
Wittmann, Daniela & Keshavan, Matcheri. (2007). Grief and Mourning in Schizophrenia. Psychiatry. 70. 154-66. 10.1521
Yudofsky, Stuart C.; Hales, Robert E. (2002). The American Psychiatric Publishing Textbook of Clinical Psychiatry. Washington, DC: American
Psychiatric Association