Guidance and treatment

You can't just make a low-contextual person high-contextual.
The guidance therefore does not focus on “changing who someone is”, but on strengthening resilience and reducing suffering.

Core principles

• Learning vulnerability' – the ability to openly acknowledge what one is struggling with. This is often difficult for low-contextual people, but essential to receive support.
  See: TED talk by Brené Brown: The Power of Vulnerability and the book The power of vulnerability.* Low-contextual is not negative – the thinking style also has strengths (goal-oriented, detail-oriented work).
  Guidance must acknowledge this instead of focusing exclusively on deficits.
• The empathy paradox – the problem is not that the person with context blindness has no empathy, but that the environment often shows too little empathy for the efforts and vulnerability of the person himself.
• Doing activities – by literally doing things, persistent or first-degree thinking can be interrupted. Activity acts as a "reset" for the overstimulated brain. This is also sometimes called "focus change".

Casus

A student was very anxious during the school year and was constantly stuck in worrying thoughts and compulsive checking (OCD).

According to the mother, however, these complaints disappeared completely during the exam period.

The reason: during the exams, the student was forced to act actively and concentrate on concrete tasks. The constant "mental rumination" was interrupted by the external structure and pressure of the exam.

This example shows how "active doing" can work as a reset for persistent thinking and fear.

Casus

A general practitioner refers low-contextual patients/clients with psychotic complaints to the fitness (Basic-Fit).

The physical activity and clear structure interrupt the persistent thinking.

The patients/clients experience the fitness as positive and helpful. Thanks to this approach, the dosage of antipsychotics could be reduced.

This illustrates that "active doing" can not only break through fear, but also has a therapeutic effect on psychotic thinking.

Drug support

In some situations, medication can be useful, especially to treat secondary complaints:

• overstimulation or psychotic thinking → antipsychotics, SSRIs, TCAs, lithium
• sleep problems (essential to start recovery) → melatonin, trazodone
• concentration problems and focus between stimuli (ADHD-like) → methylphenidate

Conclusion

Guidance focuses on:

• recognizing the thinking style as variation rather than deficiency
• strengthening vulnerability and self-insight
• support with structure and clear context
• if necessary, medication to relieve secondary symptoms

The core message: not trying to turn a low-contextual person into a high-contextual one, but looking together for ways to better deal with the tensions between individual and environment.