Treating People with Psychosis in Institutions

Author: Belinda S. Mackie
Publisher: Routledge
ISBN: 0429923341
Format: PDF, Mobi
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This book brings together the histories of a number of psychoanalytically-informed hospitals, and provides a synthesis of the theoretical underpinnings in the institutional practice of each. Of particular interest is how psychoanalysts and psychoanalytically-trained staff working in institutions apply their theoretical understanding, and in what ways the psychoanalytic technique has been modified or adapted to the treatment of individual patients with psychosis and to the workings of an institution in general. Here the institution is the subject of the case study. Institutions that are theoretically orientated to psychoanalysis were chosen and examined, taking into account their various approaches to the treatment. A number of institutional models that are informed by psychoanalysis offer a guide to the treatment and present a version of institutional practice that is different from the prevailing models in psychiatry. This has implications for health services in the current climate of mental health reform.Psychoanalysis has its greatest efficacy in long-term treatments and has shown its suitability for patients diagnosed with psychosis when the method is adapted to the uniqueness of each person and is conducted by an experienced clinician. The treatment of psychosis cannot usually be conceived without considering some form of institutional care, although this does depend on the level of the individual's psychopathology. This is because the majority of people with a psychotic illness, especially those with schizophrenia, will be exposed to inpatient, community or outpatient treatment, in one form or other, during the course of their lives.

Psychoanalysis in the Age of Totalitarianism

Author: Matt ffytche
Publisher: Routledge
ISBN: 1317643186
Format: PDF, ePub, Docs
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Psychoanalysis in the Age of Totalitarianism provides rich new insights into the history of political thought and clinical knowledge. In these chapters, internationally renowned historians and cultural theorists discuss landmark debates about the uses and abuses of ‘the talking cure’ and map the diverse psychologies and therapeutic practices that have featured in and against tyrannical, modern regimes. These essays show both how the Freudian movement responded to and was transformed by the rise of fascism and communism, the Second World War, and the Cold War, and how powerful new ideas about aggression, destructiveness, control, obedience and psychological freedom were taken up in the investigation of politics. They identify important intersections between clinical debate, political analysis, and theories of minds and groups, and trace influential ideas about totalitarianism that took root in modern culture after 1918, and still resonate in the twenty-first century. At the same time, they suggest how the emergent discourses of ‘totalitarian’ society were permeated by visions of the unconscious. Topics include: the psychoanalytic theorizations of anti-Semitism; the psychological origins and impact of Nazism; the post-war struggle to rebuild liberal democracy; state-funded experiments in mind control in Cold War America; coercive ‘re-education’ programmes in Eastern Europe, and the role of psychoanalysis in the politics of decolonization. A concluding trio of chapters argues, in various ways, for the continuing relevance of psychoanalysis, and of these mid-century debates over the psychology of power, submission and freedom in modern mass society. Psychoanalysis in the Age of Totalitarianism will prove compelling for both specialists and readers with a general interest in modern psychology, politics, culture and society, and in psychoanalysis. The material is relevant for academics and post-graduate students in the human, social and political sciences, the clinical professions, the historical profession and the humanities more widely.

Psychosis Psychoanalysis and Psychiatry in Postwar USA

Author: Orna Ophir
Publisher: Routledge
ISBN: 1317584899
Format: PDF, Mobi
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Covering the last four decades of the 20th century, this book explores the unwritten history of the struggles between psychoanalysis and psychiatry in postwar USA, inaugurated by the neosomatic revolution, which had profound consequences for the treatment of psychotic patients. Analyzing and synthesizing major developments in this critical and clinical field, Orna Ophir discusses how leading theories redefined what schizophrenia is and how to treat it, offering a fresh interpretation of the nature and challenges of the psychoanalytic profession. The book also considers the internal dynamics and conflicts within mental health organizations, their theoretical paradigms and therapeutic practices. Opening a timely debate, considering both the continuing relevance and the inherent limitations of the psychoanalytic approach, the book demonstrates how psychoanalysts reinterpreted their professional identity by formalizing and disseminating knowledge among their fellow practitioners, while negotiating with neighboring professions in the medical fields, such as psychiatry, pharmacology and the burgeoning neurosciences. Chapters explore the ways in which psychoanalysts constructed – and also transgressed upon – the boundaries of their professional identity and practice as they sought to understand schizophrenia and treat its patients. The book argues that among the many relationships psychoanalysis sustained with psychiatry, some weakened their own social role as service providers, while others made the theory and practice of psychoanalysis a viable contender in the jurisdictional struggles between professions. Psychosis, Psychoanalysis and Psychiatry in Postwar USA will appeal to researchers, academics, graduate students and advanced undergraduates who are interested in the history of psychoanalysis, psychiatry, the medical humanities and the history of science and ideas. It will also be of interest to clinicians, health care professionals and other practitioners.

Suffering Insanity

Author: R. D. Hinshelwood
Publisher: Psychology Press
ISBN: 1583918949
Format: PDF, Mobi
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When madness is intolerable for sufferers, how do professional carers remain sane? Psychiatric institutions have always been places of fear and awe. Madness impacts on family, friends and relatives, but also those who provide a caring environment, whether in large institutions of the past, or community care in the present. This book explores the effects of the psychotic patient's suffering on carers and the culture of psychiatric services. Suffering Insanity is arranged as three essays. The first concerns staff stress in psychiatric services, exploring how the impact of madness demands a personal resilience as well as careful professional support, which may not be forthcoming. The second essay attempts a systematic review of the nature of psychosis and the intolerable psychotic experience, which the patient attempts to evade, and which the carer must confront in the course of daily work. The third essay returns to the impact of psychosis on the psychiatric services, which frequently configure in ways which can have serious and harmful effects on the provision of care. In particular, service may succumb to an unfortunate schismatic process resulting in sterile conflict, and to an assertively scientific culture, which leads to an unwitting depersonalisation of patients. Suffering Insanity makes a powerful argument for considering care in the psychiatric services as a whole system that includes staff as well as patients; all need attention and understanding in order to deliver care in as humane a way as possible. All those working in the psychiatric services, both in large and small agencies and institutions, will appreciate that closer examination of the actual psychology and interrelations of staff, as well as patients, is essential and urgent.

Psychoanalysis and Holocaust Testimony

Author: Dori Laub
Publisher: Routledge
ISBN: 1317510038
Format: PDF, Mobi
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Psychoanalytic work with socially traumatised patients is an increasingly popular vocation, but remains extremely demanding and little covered in the literature. In Psychoanalysis and Holocaust Testimony, a range of contributors draw upon their own clinical work, and on research findings from work with seriously disturbed Holocaust survivors, to illuminate how best to conduct clinical work with such patients in order to maximise the chances of a positive outcome, and to reflect transferred trauma for the clinician. Psychoanalysis and Holocaust Testimony closely examines the phenomenology of destruction inherent in the discourse of extreme traumatization, focusing on a particular case study: the recording of video testimonies from a group of extremely traumatized, chronically hospitalized Holocaust survivors in psychiatric institutions in Israel. This case study demonstrates how society reacts to unwanted memories, in media, history, and psychoanalysis – but it also shows how psychotherapists and researchers try to approach the buried memories of the survivors, through being receptive to shattered life narratives. Questions of bearing witness, testimony, the role of denial, and the impact of traumatic narrative on society and subsequent generations are explored. A central thread of this book is the unconscious countertransference resistance to the trauma discourse, which manifests itself in arenas that are widely apart, such as genocide denial, the "disappearance" of the hospitalized Holocaust survivors and of their life stories, mishearing their testimonies and ultimately refusing them the diagnosis of "traumatic psychosis". Psychoanalysis and Holocaust Testimony provides an essential, multidisciplinary guide to working psychoanalytically with severely traumatised patients. It will appeal to psychoanalysts, psychoanalytic psychotherapists and trauma studies therapists.

The Shadow of the Second Mother

Author: Prophecy Coles
Publisher: Routledge
ISBN: 1317578368
Format: PDF, ePub, Mobi
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The Shadow of the "Second Mother" explores why has there been such little interest, in psychology, social history and biography, in the important contribution that ‘second mothers’, such as wet nurses and nannies, have had upon the emotional life of the children they have nursed. For the last three thousand years and throughout most civilisations they have nurtured the children of the privileged, and kept alive the abandoned and unwanted child, and yet there has been a profound silence surrounding the influence they may have had. The author explores the lives of several well-known people who have been wet nursed, such as Michelangelo, Rousseau, Jack London, Nabokov and Klein. She speculates that they all were affected emotionally by their ‘second mother’, and concludes that a universal feature of such delegated mothering seems to be that the bond between mother and child is broken, and the child may be left with a life-long distrust of close relationships. In The Shadow of the "Second Mother", Coles combines an exploration of attachment theory with neurology, making it possible to give an explanation as to why these important figures have lain unnamed and ignored in our social and psychological consciousness. This intriguing new approach to an ancient practice will be fascinating reading for psychotherapists, psychoanalysts, sociologist and students of social history.

Living on the Border

Author: David Bell
Publisher: Karnac Books
ISBN: 1855756013
Format: PDF
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This book centers on the problem of psychosis, understood from a psychoanalytic perspective, as it manifests itself in different contexts and different levels of organization: from the individual psychoanalytic session, through work with couples, groups and institutions and wider levels of social organization. Beginning with a discussion of the psychoanalytic approach to psychosis centering on the work of Freud, Klein and the Post-Kleinians, it goes on to cover individual, couple and group therapy with psychotic patients. It draws on clinical material and theoretical discussion to explore the links between psychotic processes on different levels. This work is aimed at different professionals working within the psychodynamic frame of reference: individual psychotherapists, couple and family and group psychotherapists; organizational consultants and trainees in different therapies. As well as this it will be a useful resource to nurses, doctors and social workers who work with very disturbed patients and wish to learn about psychotic processes.

Making Room for Madness in Mental Health

Author: Marcus Evans
Publisher: Karnac Books
ISBN: 178220329X
Format: PDF
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In this book, Marcus Evans argues that in addition to providing a helpful treatment for patients who suffer from serious psychological difficulties, psychoanalytic thinking can also help mental health staff develop a better understanding of their patients and complement other ways of thinking about mental disturbance. Mental health professionals need to be receptive to their patients’ projections and communications, but these powerful projections can become overwhelming, especially for clinicians who are in direct contact with their patients for long periods of time. A psychoanalytic model which puts the understanding of the relationship between the clinician and patient at the centre of its preoccupations can also give mental health professionals a language for describing their experiences of, and interactions with, their patients. This model is developmental and provides a dynamic picture of the ways in which different parts of the patient’s self wrestle for control of the patient’s mind over time. Evans argues that this framework for understanding can help in the day-to-day management of these changes and fluctuations. Evans believes that the diagnosis and active interventions employed by psychiatry need to be accompanied by a receptive approach to treatment and care. Mental health professionals need to be interested in the meaning of their patient’s symptoms and verbal and physical communications. These may convey important information about the patient’s internal world and underlying conflicts. This receptive approach requires mental health professionals to make a switch from the active state of mind demanded by active interventions, to the receptive state of mind required by the need to take in the patient’s emotional state and underlying personality structure. Making Room for Madness in Mental Health draws on the author’s extensive experience of working psychoanalytically with people with severe and enduring mental illness, as well as providing psychoanalytic supervision and consultation in a range of mental health settings to show how psychoanalytic ways of thinking may complement other approaches to mental disturbance by highlighting the communication and meaning of such disturbance. This is illuminated by lively clinical vignettes, supported by accessible accounts of key psychoanalytic theory. Working with people with mental illness can be rewarding and enlightening. It can also be disturbing, frightening, boring, frustrating, anxiety provoking and stupefying. Evans argues that we need to provide room and space for mental health professionals to reflect upon and think about their experiences on a day-to-day basis, and to train clinicians to senior levels in order that they can offer clinical supervision to front-line staff, which can help them develop ideas about the meaning of their patients’ symptoms and behaviours. Psychoanalysis offers a model for thinking about and providing meaning for, the anxieties that drive us ‘out of our minds’, and this can reduce the risk of thoughtless action. To some extent this involves putting the madness back into mental health.

Late Onset Schizophrenia

Author: Robert Howard
Publisher: Routledge
ISBN: 9781871816396
Format: PDF, ePub
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Schizophrenia, which starts in middle age or late life, has been described as 'the darkest area of psychiatry.' It is certainly controversial, with much disagreement about cut-off ages, diagnostic criteria and nomenclature. The contributors to this unique and very important book represent views from Europe and North America as well as Australia, Japan, and Nepal; they come from backgrounds of clinical practice and research. The contributors and editors were motivated by common aims: to review current international knowledge about late onset schizophrenia, to debate issues of heterogenity, gender, brain maturation and aging, putative structural and functional cerebral substrates for psychosis, to reach consensus on diagnosis and terminology, and to future research directions. The resulting book is an unqualified success which as well as being invaluable in old age psychiatry, sheds light on all aspects of schizophrenia treatment and research.

Psychosis and Near Psychosis

Author: Eric Marcus
Publisher: Taylor & Francis
ISBN: 1317383427
Format: PDF, Mobi
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The goal of psychotherapy as formulated in this revision of a classic text is to improve ego function of severely disturbed patients who are often hospitalized. This book shows why and how. It describes the psychotherapeutic techniques that aid patients to understand the meaning of the psychotic symbols so that they can experience reality and their emotions as separate entities. Medication effects and the neurobiology of psychotic and near psychotic patients are explained and evaluated in terms of specific ego dysfunction so that psychopharmacology may be targeted. With the first edition originally a recipient of the prestigious Heinz Hartmann Award, this valuable resource is a go-to guide for clinicians who treat patients suffering from crippling mental disorders.