13. Psychodynamic Interpretation of Psychotic Symptoms
Includes bibliographical references and index
Cover; Half Title Page; Title Page; Copyright; Dedication; About the Author; Acknowledgments; Contents; Introduction; How This Book Is Different; An Argument for Psychotherapy for Psychosis; Discrediting Myths about Psychotherapy for Psychosis; Part I. Theory; 1. Essential Problems in Psychosis and Basic Definitions; Some Basic Definitions of Reality; Jamel's Experience of Reality; Literal Falsity and Figurative Truth; Approaching Jamel in CBTp Mode; 2. Biological and Psychological Models of Psychosis; The Pathogenesis of Psychosis; Current Biological Theories of Psychosis
Attachment Styles and Early RelationshipsA Phenomenological Psychodynamic Model of Psychosis; The Self as a Primal Perceiver; Effects of Biologically Weakened Boundaries on Psychodynamic Processes; 3. Psychosis: An Autobiographical Play Staged in the Real World; Psychoanalytic Object Relations Theory: The Script; Persecutory Psychological Objects; Psychological Objects in Ordinary Development; The Play of Ordinary Children, Fairy Tales, and Delusions; Trauma Lifts the Curtain on Opening Night; 4. Disturbances of Figurative Language, Concrete Metaphors, and Delusional Identities
Defining the Working FormulationThe CBTp Component; The Psychodynamic Component; Paired Psychodynamic and CBTp Working Formulations; Edison's Working Formulation; Upala's Working Formulation; Starting to Examine the Core Delusion; 11. Working with Voices and other CBTp Techniques; Voices as Messengers from Within; Discussing Explanations for Voices with Patients; CBTp Toolbox of Techniques; 12. Challenging Delusions; Alternative Explanations; CBTp and Psychodynamic Technique; Bearing Witness to Altered States of Consciousness; Blending CBTp, Empathy, and Psychodynamic Technique
Encouraging Doubt about Delusional IdeasIdentifying What Most Distresses the Patient; Daily Life and Affirming the Ordinary; Defining Problems and Setting Goals; 8. Discussing Reality with a Psychotic Person; Finessing the Reality Question; Psychotic Symptoms as Tertiary Psychic Reality; Understanding Psychotic Patients' Sense of Reality; Conversation with Melody; 9. Assessing Coping Strategies and Introducing Three CBTp Models; Coping Mechanisms and Maintaining Hope; Coping with Delusions; Coping with Voices; Introducing the CBTp Phase; 10. Working CBTp and Psychodynamic Formulations
Loose AssociationsMaking Sense of Language in Psychosis; A Continuum of Metaphor; Metaphor and Affect; Psychotic Symptoms as Apt Metaphors; Part II. Psychotherapy Technique; 5. Treatment Overview and Patient Selection; Patient Selection; Negative Symptoms; Thought Disorder; 6. Engaging the Patient; Establishing Rapport; Practical Particulars of the Initial Meeting; Retreat from Reality and Informed Consent; Naming the Diagnosis; Confidentiality; Clarity of Communication; Reassurance; 7. Eliciting the Patient's Story; Constructing a Timeline; Understanding the Evidentiary Chain