Now that the limits of medication treatment for seriously ill patients are becoming known, talking treatments are being rediscovered. Although no longer in the forefront of inpatient treatment, psychoanalysts have much to contribute to the debate over appropriate treatment models and systems. We solicited articles from various analysts with expertise in understanding and working with patients with psychosis.
Andrew Lotterman leads off our section with an evaluation of the core studies cited by those who oppose treating psychotic patients with psychotherapy, finishing with a discussion of the status of the current debate over effective treatment. Brian Koehler presents thumbnail discussions of the considerable work that has been done in recent years on the relationship amongst genetics, neurobiology, cognition, emotion, and interpersonal relationships in severe mental disorders.
In the next issue of TAP, Michael Stone, Michael Garrett, and Marlene Kocan will present clinical material in their discussions of their different approaches to treating people with psychosis. Stone works with a unique spectrum of serious character pathology, often co-morbid with severe mood disturbances or cognitive problems. Michael Garrett argues that challenging cognitive distortions with CBT techniques can be an important prelude to psychodynamic work, while Marlene Kocan will discuss working with psychotic patients in psychoanalysis proper. Lauren Scott will extend the reach of psychodynamic psychotherapy into the community mental health center.
We will conclude with discussions of creative process and psychosis. Danielle Knapfo will consider the similarities—as the therapist and patient learn of themselves together—while Eric Marcus will consider the differences.
We would like to thank our authors for this discussion of the current status of psychoanalytic ideas and treatment of patients with psychosis.
Editor's Note: The work of many researchers and clinicians (predominantly psychoanalysts) is cited throughout this series. If you would like the list of references, please contact Michael Slevin at michael. slevin1800@gmail.com.
Michael Slevin, M.A., M.S.W., a former TAP editor, graduated as academic associate from the Baltimore Washington Institute for Psychoanalysis, where he completed as a clinician the Adult Psychotherapy Training Program. He works at Sheppard Pratt and has a private practice.
Eric R. Marcus, M.D., is director of the Columbia University Center for Psychoanalytic Training and Research and has a long-standing interest in psychosis. His book on the topic is Psychosis and Near Psychosis: Ego Function, Symbol Structure, Treatment.