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In this groundbreaking volume, the authors bring us into the immediacy of the analyst's consulting room in direct confrontation with the thought disorder, delusions and hallucinations of their patients grappling with psychosis. From the early days of psychoanalysis when Freud explicated the famous Schreber case, analysts of all persuasions have brought a variety of theories to bear on the problem of schizophrenia and the other psychoses. Here, as William Butler Yeats notes, "the centre cannot hold" and any sense of self-esteem - positive feelings about oneself, a continuous sense of self in time and a functional coherence and cohesion of self - is shattered or stands in imminent danger. What makes psychoanalytic self psychology so compelling as a framework for understanding psychosis is how it links together the early recognition of narcissistic impairment in these disorders to the "experience-near" focus which is the hallmark of self psychology.
Psychosis and Near Psychosis offers a psychoanalytically-based approach to an integrated treatment of psychosis and near psychosis, achieved by organizing psychotherapy, medication, hospital and milieu interventions into a powerful therapeutic tool. The author navigates confidently between psychiatric and psychoanalytic approaches, between biological evidence and psychological assessments. According to Dr. Eric Marcus, since the past, so-called heroic psychoanalyses with psychotic patients have clearly been shown to fail, the time is now ripe again to discuss psychosis in terms of the broadened psychoanalytic theory, with the support of medication and a better understanding of the neuropsychological factors involved. This book, which maps out mental illness in concrete and innovative ways, will interest all researchers and clinicians eager to find the best means, both practical and theoretical, to initiate satisfying psychiatric therapies.
In Loss of Self in Psychosis: Psychological Theory and Practice Simon Jakes takes a critical look at contemorary approaches to the psychology of psychosis. In doing so, he explores how these vastly different approaches, as well as our numerous conceptualisations of schizophrenia, work to reduce the effectiveness of CBT as a treatment. Four different psychological approaches to psychosis are examined in the first part of this book, as well as the development of CBT for psychosis and the theory behind this. In the second part, he describes the therapy of some clients and suggests that incorporating ideas from some of the different theories of psychosis in the same treatment may be beneficial. Using extended examples from clinical practice over the past 20 years to illuminate his theories, Loss of Self in Psychosis: Psychological Theory and Practice will prove to be thought-provoking reading for clinical psychologists, psychiatrists and other mental health professionals working with this client group.
An invaluable sourcebook on the complex relationship between psychosis, trauma, and dissociation, thoroughly revised and updated This revised and updated second edition of Psychosis, Trauma and Dissociation offers an important resource that takes a wide-ranging and in-depth look at the multifaceted relationship between trauma, dissociation and psychosis. The editors – leaders in their field – have drawn together more than fifty noted experts from around the world, to canvas the relevant literature from historical, conceptual, empirical and clinical perspectives. The result documents the impressive gains made over the past ten years in understanding multiple aspects of the interface between trauma, dissociation and psychosis. The historical/conceptual section clarifies the meaning of the terms dissociation, trauma and psychosis, proposes dissociation as central to the historical concepts of schizophrenia and borderline personality disorder, and considers unique development perspectives on delusions and the onset of schizophrenia. The empirical section of the text compares and contrasts psychotic and dissociative disorders from a wide range of perspectives, including phenomenology, childhood trauma, and memory and cognitive disturbances, whilst the clinical section focuses on the assessment, differential diagnosis and treatment of these disorders, along with proposals for new and novel hybrid disorders. This important resource: • Offers extensive updated coverage of the field, from all relevant perspectives • Brings together in one text contributions from scholars and clinicians working in diverse geographical and theoretical areas • Helps define and bring cohesion to this new and important field • Features nine new chapters on: conceptions of trauma, dissociation and psychosis, PTSD with psychotic features, delusions and memory, trauma treatment of psychotic symptoms, and differences between the diagnostic groups on hypnotizability, memory disturbances, brain imaging, auditory verbal hallucinations and psychological testing Written for clinicians, researchers and academics in the areas of trauma, child abuse, dissociation and psychosis, but relevant for psychiatrists, psychologists and psychotherapists working in any area, the revised second edition of Psychosis, Trauma and Dissociation makes an invaluable contribution to this important evolving field.
Psychoanalysis Meets Psychosis proposes a major revision of the psychoanalytic theory of the most severe mental illnesses including schizophrenia. Freud believed that psychosis is the consequence of a biologically determined inability to attain and sustain a normal or neurotic mental organization. Michael Robbins proposes instead that psychosis is the outcome of a different developmental pathway. Conscious mind functions in two qualitatively different ways, primordial conscious mentation and reflective representational thought, and psychosis is the result of persistence of a primordial mental process, which is adaptive in infancy, in later situations in which it is neither appropriate nor adaptive. In Part I Robbins describes how the medical model of psychosis underlies the current approach of both psychiatry and psychoanalysis, despite the fact that neuroscience has failed to confirm the model’s basic organic assumption. In Part II Robbins examines two of Freud’s models of psychosis that are based on the assumption of a constitutional inability to develop a normal or neurotic mind. The theories of succeeding generations of analysts have for the most part reiterated the biases of Freud’s two models, so that psychoanalysis considers the psychoses beyond its scope. In Part III Robbins proposes that the psychoses are the result of disturbances in the attachment-separation phase of development, leading to maladaptive persistence of a primordial form of mental activity related to Freud’s primary process. Finally, in Part IV Robbins describes a psychoanalytic approach to treatment based on his model. The book is richly illustrated with material from Robbins’ clinical practice. Psychoanalysis Meets Psychosis has the potential to undo centuries of alienation between society and psychotic persons. The book offers an understanding of severe mental illness that will be novel and inspiring not only to psychoanalysts but to all mental health professionals.
Ego Development and Psychopathology presents an original theoretical underpinning for classification and interpretation of the major mental disorders, one based largely on the author's clinical experience. Ausubel's central thesis is that the most significant and crucial factors predisposing persons to mental disorders are critical developmental defects that arise at vital transitional phases of ego development. He sees both normal and pathological personality functioning as most cogently explained in terms of an individual's ego structure at a given point in the life cycle. Ausubel relates his developmental theory to the phenomenology and related clinical problems of psychiatric diagnosis. He classifies mental disorders in terms of their developmental history. Such factors, in his opinion, offer the most precise delineation of etiological, functional, and phenomenological similarities and differences among the various psychiatric syndromes. He provides an overview of ego development, as well as major variants of the norm. He also discusses development of conscience and moral values, as well as psychopathological considerations that follow from deficiencies, defects, failure, and distortions in ego development. He examines at length classification of mental disorders, such as anxiety states, psychotic depression and mania, schizophrenia, autism, antisocial and narcissistic personality disorders, and defense mechanisms. Ausubel is careful to point out that ego development is not the only significant determinant of normal and aberrant personality. Genetic predispositions, situational stress, and sociocultural factors must always be taken into consideration since mental disorder is always a product of multiple causality. However, he believes ego development is by far the most critical factor, and hence offers the most for classification of mental illness. This intriguing study will be of interest to professionals as well as educated and concerned practitioners in the fields of psychology, psychiatry, psychoanalysis, child psychotherapy, and social work.
Psychoanalysis of the Psychoses brings together a distinguished international set of contributors, offering a range of views and approaches, to explore the latest thinking in the psychoanalytic treatment of psychosis and related disorders. Drawing on findings from neuroscience, theory and clinical material from many schools of psychoanalytic thought, this book offers a comprehensive guide to understanding how psychosis is conceptualised from a psychoanalytic perspective. It looks at how to work with psychotic patients, typical problems in treating psychosis and the role of pharmacology. It demonstrates the relational dimension, capable of strengthening the patient’s observing Ego and facilitating the integration of the different areas of the personality. This process can identify and work through the main psychological stress factors involved in psychotic disturbances, transforming chaotic thoughts into springboards for important insights, and offering patients the precious chance to construct for the first time a creative relationship with their own existence. Psychoanalysis of the Psychoses will be of great interest to psychoanalysts and psychoanalytic psychotherapists as well as psychiatrists wishing to draw upon psychoanalytic ideas in their work.
