To work with the severely disturbed is to be frightened, angry, depressed, bored, discouraged, or confused because the patients are frightened, angry, depressed, bored, discouraged, or confused, although patients also deal with their confusion by clinging to premature closure. False beliefs usually solve an immediate problem but in the long run make a satisfying life impossible.
Rarely are student therapists told that being confused is essential to successful work with severely disturbed patients. Moreover, good therapy with severely disturbed patients almost always involves improvisation. If what we try works, we continue it. If it does not work, we stop and try something else.
Also discussed will be conscious resistance (the most important
difference between working with psychotics and working with neurotics), its sources and handling, phrasing of interpretations, and frequency of sessions.
Bertram Karon, Ph.D Professor, Psychology, Michigan State University. Former President, Division of Psychoanalysis (39) of APA and of the Michigan Psychoanalytic Council. Approximately 160 publications including the book (with G.R. VandenBos) Psychotherapy of Schizophrenia: The Treatment of Choice, and the 2001 Fromm-Reichmann Memorial Lecture at the Washington School of Psychiatry, “The Tragedy of Schizophrenia Without Psychotherapy.” He has received awards for clinical insights and technique, research, and teaching from Division 39, APA Graduate Students, the American Psychological Foundation, the United States chapter of the International Society for the Psychological Treatment of Schizophrenia and other psychoses, the International Center for the Study of Psychiatry and Psychology, the International Federation for Psychoanalytic Education, the Appalachian Psychoanalytic Society, and the New York Society for Psychoanalytic Training. Dr. Karon is in
private practice in East Lansing.