Fostering Group-Analytic Culture in Therapy with Psychotic Patients (Meet the Author Session)

In this paper we aim to encourage practitioners to increasingly use psychodynamic therapy groups in the treatment of ‘psychotic’ patients.  Having worked in mental health since the late 1970s, we have learned that... [ view full abstract ]

In this paper we aim to encourage practitioners to increasingly use psychodynamic therapy groups in the treatment of ‘psychotic’ patients.

 Having worked in mental health since the late 1970s, we have learned that ‘schizophrenia’ and other‘psychoses’ are constructs and diagnoses which, unfortunately, have often been used to exclude people or to treat them differently. In fact, ‘psychotic’ patients frequently have a background of traumatic experiences and damaging disruptions of their early attachments, which may hinder their capacity to trust other people and to form satisfactory relationships. These patients’ capacity for communication, intimacy and participation in groups might be impaired. However, in our work, we have seen many people using their own resources to recover from and work through their ‘psychotic’ experiences. This healing process is enhanced when a proper therapeutic alliance is established, in which the patient is an active collaborator – as it happens in sensitive, user-friendly psychotherapy groups.

 As mental health professionals we are responsible for trying our best to mitigate human suffering, and to provide the conditions within which our patients can best develop their resources to cope and relate meaningfully to other people. That is the driving force behind this paper, in which we shall describe the flexible application of group-analytic principles in a long-term group psychotherapy programme for ‘psychotic’ patients, within the wider containing structure of a weekly day project, in a modified therapeutic community setting. Through clinical vignettes we shall illustrate the steady development of a benign group therapeutic culture, supported by the continuity and stability of our multi-layered service, which helped our patients achieve deeper levels of communication and understanding, resulting in better functioning and in a greater capacity to cope with everyday life. The task was challenging and daunting at times – but the overall experience fulfilling and rewarding.