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Psychotherapy for Psychosis is an original and carefully elaborated contribution to psychoanalytic psychotherapy for patients suffering from chronic delusional illness. Michael Garrett makes it clear that he includes a broad spectrum of patients, with various types of chronic schizophrenic, schizoaffective, and paranoid psychoses, with a particular focus on a subgroup of these patients with chronic psychotic illness for whom he proposes the treatment he has developed. He does not sharply circumscribe this select group of patients, but throughout the abundant clinical examples in this volume the preconditions that implicitly characterize the overall treatment situation and the common features of the clinical descriptions of these patients combine in a particular clinical perspective.
These are patients with chronic psychotic illness—hallucinations, delusions, alterations in linguistic expression, and severe disturbances in behavior and social relations—yet who maintain the capacity for specific affective interactions in their intimate and familial relationships. They generally evince no chronic antisocial behaviors, have at least normal intelligence, and, in spite of long-term adequate treatment with antipsychotic medications, have not been able to restore normal reality testing. It is a large group of patients, in whose cases the appropriate psychopharmacological treatment, combined with various degrees of supportive psychotherapeutic interventions and efforts at social rehabilitation, have been unable to reduce their symptomatology sufficiently to permit them to function at a nonpsychotic level, with restoration of adequate reality testing.
Interestingly, this is roughly the same group of patients that, years ago, Michael Stone (1993, 1999) described as presenting an indication for
psychoanalytic psychotherapy. He reviewed the many efforts of groups of psychoanalysts and psychoanalytic psychotherapists in various countries to treat these patients psychoanalyticall