The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence.Accordingly, recent research has suggested that deficits in metacognition, or the ability to form integrated ideas about oneself, others and the world, are involved in the development and maintenance of negative symptoms. One implication of this work is that treatments which address metacognition may effectively lead to reduction in negative symptoms. This paper explores the application of one such treatment, designed to address deficits in metacognition, Metacognitive Reflection and Insight Therapy (MERIT), to addressing persistent negative symptoms. First the basic principles of MERIT are presented and then its potential to address negative symptoms is illustrated by a comprehensive case report.
Keywords: ; self-reflectivity; psychosis; negative symptoms; experiential symptoms; expressive deficit; metacognition; schizophrenia