Social Withdrawal
How do we define it? It is the apparent reluctance to participate in "normal" interpersonal contacts of day to day life and retreat into one's own comfort zone.

Context for Social Withdrawal
We all have different capacities for social interaction and interest both within and outside the family. It is quite common for adolescents to withdraw from family interaction and activities as they try to separate from family and develop individual identities. It is also quite "normal" for people to withdraw from social interaction when they are very stressed and not able to cope with the pressures induced by being with others and having to "play the game". Some people have always been seen as shy and preferring their own company, not enjoying parties and avoiding activities where they may be required to interact with others. So, sometimes social withdrawal is seen as normal. Social withdrawal exists within a context.

When the context has been an episode of mental illness, there may be a period of social withdrawal that is not related to pre-existing personality and outside normal adolescent "coolness". People who have experienced a psychosis may at times struggle to cope with the stress of social interaction.
They may appear to withdraw into their private world and carers and friends may find that they are not as accessible as prior to the onset of their illness. There may be a number of reasons for this:

• People often may describe a genuine feeling of loss of energy / motivation to engage in social activities.
• People may have suffered a loss of confidence and self esteem after a psychotic episode.
• They may still be coming to terms with what has happened and not ready or able to discuss the situation with people outside the family.

Carers should not interpret this as a sign of personal rejection, rather that the relative cannot handle the level of stimulation involved with interaction at particular times.

Concerns
It is, however, important to try to prevent social withdrawal becoming a habitual way of life. This can happen if avoidance becomes a primary coping strategy over an extended period of time, people's social confidence will be further eroded and the recovery period may be extended. From basic social interaction such as that which is required to engage in daily activities of living (shopping, catching public transport etc.) to returning to study or work and to extending our interest in the world, developing and maintaining relationships is essential.

What are reasonable expectations?
There are no hard and fast rules in terms of when it is appropriate to expect changes in the way your relative behaves or how to achieve this.
But it is clear that a continued level of low stimulation can be just as detrimental as over-stimulation. Like all things in life, setting realistic and achievable goals is the way to go. To gently encourage the person to participate in family life as much as possible, to maintain contact with friends and neighbours and to pursue and social or hobby interests that they might have is an aim in the recovery period.

It is important to remember that people need their own space where they can go to whenever necessary - preferably their own bedroom. If people ask for space through actions or verbal requests it may be advisable to support their need to be alone during these times. In this way they may feel less pressure to perform socially when they do not feel able. It is important to show respect for their desire for distance and autonomy when they wish to do their own thing.

Attempting to force people into activities may meet with resistance. People will be more responsive to gentle encouragement, support and positive reinforcement for attempts.

Social withdrawal can equally apply to family members.
It is also important to note that members of the family may sometimes withdraw from their routine social engagements while they make sense of their person's situation. They may endure some self-imposed social isolation during critical times for their family member. While this may result from a range of factors, it is equally important for all members of the family to maintain and develop social and recreational contacts.

As far as possible, maintain set routine and activities within the household with clear guidelines about behaviour. E.g. If it is expected that the family dines together at the same time, communicate this to all members.

Encourage family and friends to maintain contact. (Ideally in small numbers)

Acknowledge the stressful nature of large social gatherings and do not force attendance.

Provide the opportunity for the person to be alone with friends in the safe space of his / her comfort zone.

Encourage the discussion of realistic goal setting vis-a-vis returning to study / work.

Be aware and acknowledge small improvements.

Provide relevant information about organizations that may assist in the area's of :

• Employment / study (Volunteer Centre, Workright, Commonwealth Rehabilitation Services, Mission Australia Community Support Program, TAFE)
• Recreational opportunities (Recreation Network, Ministry of Sport and Recreation) Youth services in your area (Local Council)