Understanding Psychosis

Book excerpt: Do psychotic disorders make sense? Are psychotic symptoms amenable to interpretation? Understanding Psychosis: A Psychoanalytic Approach takes the various pathways to psychotic illness outlined by psychoanalytic clinicians and scholars and integrates them into a model that allows a systematic assessment of relevant psychodynamic dimensions in the diagnosis of psychotic disorders, and which serves as a guide to psychotherapy with psychotically ill patients. Joachim Küchenhoff reviews and integrates various psychoanalytic concepts and theories about psychosis into a multi-dimensional psychodynamic model that allows an assessment and understanding of the patient’s subjective experience, objective psychological capabilities, and interpersonal resources. Küchenhoff helps the therapist to establish a basic attitude in working psychodynamically with patients and to understand the dynamics of the therapeutic relationship. Understanding Psychosis also addresses specific issues that can arise in work with clients experiencing psychosis, including understanding imminent crises or precursor states, elucidating semiotic qualities in seemingly negative symptoms, differentiating the psychotic and a non-psychotic part of the personality and providing a dynamic approach to the psychopharmacological treatment. Clinical vignettes and three detailed case reports are included in the book. Understanding Psychosis will be an essential guide for psychiatrists, psychotherapists and psychoanalysts working with patients experiencing psychosis. It will also be of use to psychologists, and academics and students of psychotherapy, psychiatry and psychoanalysis for psychosis.