Tag: therapy for psychosis
A skilled approach to working with beliefs involves both toleration of differences in perspective and an awareness of a variety of possible things that can be tried when a belief is causing problems that do not seem to be tolerable, either to the person or to others with whom they must interact.
When voices are engaged with creativity and compassion, the result can be a positive change in the relationship with voices, leading to much greater peace of mind. But how can people learn how to facilitate this? A new video series by Charlie Heriot-Maitland, Rufus May and Elisabeth Svanholmer offers some practical ideas.
When John Herold went to see a Process Work counselor, they talked about how his experience of extreme states had been disruptive in his life, but how these states also had value. The counselor compared John's experience with drinking an entire bottle of Tabasco sauce all at once. Why not instead, the counselor suggested, "try being just a little psychotic all the time?"
In my graduate education, we were taught how to deal with a wide variety of human troubles — but one big exception was psychosis! For that, we were told to send our clients to the psychiatrist.
We need to learn to listen and respond in a caring way to the disturbed and disturbing voices within the population—to really engage with them, while also not believing any lies or distortions or letting destructive forces take over.
A new study out of Kings College London found that twelve sessions of a group mindfulness-based therapy relieved distress associated with hearing voices while reducing depression over the long-term. The person-based cognitive therapy (PBCT) intervention had significant effects on depression, voice distress, voice controllability and overall recovery.
In the past five years, there has been a dramatic explosion of interest in the Open Dialogue Therapy practiced in Tornio, Finland. It is a humanistic “treatment” that has produced five-year outcomes for psychotic patients that are, by far, the best in the developed world, and there are now groups in the United States, Europe and beyond that are seeking to “import” this care. However, the challenges for doing so are many and, last month, Open Dialogue UK - on the occasion of the first-ever fully recognized Open Dialogue training outside of Tornio - organized a conference in London to hold an open dialogue about Open Dialogue.
It’s now widely known that a good relationship between helper and person to be helped is one of the very most important factors determining the outcome from many different types of mental health treatment. But when people are in an extreme state such as the kind we call “psychosis,” forming a good relationship is not an easy thing to do. And unfortunately, the typical interaction between professionals and clients seen as psychotic in our current mental health system has characteristics which make a positive human relationship almost impossible.
Cognitive behavioral therapy or CBT has been pretty heavily criticized by a number of Mad in America (MIA) bloggers and commenters in the past few years. In a way that isn’t surprising, because most MIA bloggers are looking for radical change, and CBT often appears to be part of the establishment, especially within the therapy world. But while I’m all for criticizing what’s wrong with CBT, especially with bad CBT, I think there’s also a danger in getting so caught up in pointing out real or imagined flaws that we fail to notice where CBT can be part of the solution, helping us move toward more humanistic and effective methods of helping.
As we struggle to invent a humane approach to the extreme states that get called “psychosis” or “madness” or “schizophrenia,” it may be helpful to investigate some of the better approaches developed in the past. While these approaches are not without their flaws, they are often surprisingly insightful. (It can also of course be depressing to notice how truths once more widely known were so easily “forgotten” as compassionate approaches got ditched in favor of the latest coercive innovations.)
The kinds of experiences we call psychotic are often incredibly scary: people feel they are being persecuted by strange forces, or that their brains have been invaded by demons or riddled with implants from the CIA . . . the list of possible fears is endless, and often horrifying. While standard mental health approaches counter many of these fears, they often create new fears of a different variety. Wouldn’t it be helpful if professionals were trained in an approach that could help people shift away from both dangerous psychotic ways of thinking and also away from the sometimes equally terrifying explanations which emphasize pathology?
When Doug Turkington, a UK psychiatrist, first announced to his colleagues that he wanted to help people with psychotic experiences by talking to them, he was told by some that this would just make them worse, and by others that this would be a risk to his own mental health, and would probably cause him to become psychotic! Fortunately, he didn’t believe either group, and in the following decades he went on to be a leading researcher and educator about talking to people within the method called CBT for psychosis.