1st Edition

Beyond Medication Therapeutic Engagement and the Recovery from Psychosis

Edited By David Garfield, Daniel Mackler Copyright 2009
    216 Pages
    by Routledge

    216 Pages
    by Routledge

    Beyond Medication focuses on the creation and evolution of the therapeutic relationship as the agent of change in the recovery from psychosis.

    Organized from the clinician’s point of view, this practical guidebook moves directly into the heart of the therapeutic process with a sequence of chapters that outline the progressive steps of engagement necessary to recovery. Both the editors and contributors challenge the established medical model by placing the therapeutic relationship at the centre of the treatment process, thus supplanting medication as the single most important element in recovery.

    Divided into three parts, topics of focus include:

    • Strengthening the patient
    • The mechanism of therapeutic change
    • Sustaining the therapeutic approach.

    This book will be essential reading for all mental health professionals working with psychosis including psychoanalysts, psychiatrists, psychologists and social workers.

    Karon, Silver, Foreword. Part I: Engaging the Patient. Garfield, Dorman, Strengthening the Patient. Faulconer, Silver, The Initial Engagement in the Psychotherapy of Psychosis, With and Without an Asylum. Prouty, Making Contact with the Chronically Regressed Patient. Schwartz, Summers, The Role of the Therapeutic Alliance in the Treatment of Seriously Disturbed Individuals. Part II: The Elements of Change. Summers, Sustaining Relationships: Cure, Care, and Recovery. Kipp, Sustaining Relationships in Milieu Treatment: A Corollary to Summers. Koehler, The Process of Therapeutic Change: Trauma, Dissociation, and Therapeutic Symbiosis. Gibbs, Technical Challenges in the Psychoanalytic Treatment of Psychotic Depression. Mackler, Practicing the "Impossible Profession" in Impossible Places. Part III:  Listening to the Patient: Stories of What Really Works. Penney, Leaving Schizophrenia: The Returning Home of the Awakened Mind. Greenberg, Life in the Mines: A Retrospective on my Therapy. Foltz, The Experience of Being Medicated in Schizophrenia: A Subjective Inquiry and Implications for Psychotherapy. Part IV: Concluding Chapter. Steinman, Sustaining the Therapeutic Approach: Therapists May Need Help Too!


    David Garfield is Professor, Associate Chair and Director of Residency Training in the Department of Psychiatry and Behavioral Sciences at Rosalind Franklin University of Medicine and Science, Chicago Medical School. He is also faculty at the Institute for Psychoanalysis, Chicago.

    Daniel Mackler is a psychotherapist in private practice and a filmmaker, New York City.

    "This superbly executed work is as courageous as it is timely. At last psychoanalytically informed psychotherapy is being recommended and justified for the treatment of psychotic patients - over and above - and often instead of - psychopharmacology! This work is recommended for all mental health workers but particularly for psychiatric residents and psychologists in training." - James Grotstein M.D. Clinical Professor of Psychiatry at the David Geffen School of Medicine, UCLA and Training and Supervising Analyst at the Psychoanalytic Center of California and The New Center for Psychoanalysis, Los Angeles, USA

    "This book will surely be an interesting read for experienced clinicians to better understand the therapeutic effect of psychodynamic psychotherapy in some disturbed patients." – Dr Sherry Kit Wa Chan, Psychological Medicine, 40, 2010