Citation

Watts J. Br. J. Psychother. 2017; 33(2): 239-252.

Copyright

(Copyright © 2017, John Wiley and Sons)

DOI

10.1111/bjp.12289

PMID

unavailable

Abstract

Psychoanalytic work can help people meaningfully engage with aspects of psychotic experience which feel overwhelming. However, such contact is only possible if we offer a practice that is acceptable to both potential patients, and the family, team and social groups they exist within. As a psychoanalytic community we are failing to do this, partly because of the political terrain, but also due to our perceived unapproachability. I argue that the type of tentative, humble positions advocated by approaches such as ?open dialogue? allows psychoanalytic techniques to be more palatable to those experiencing psychosis. This is especially important given how language functions in psychosis, and the histories of intrusion and oppression that language interacts with. Clinical material from work with a female patient suffering from paralysing visual hallucinations is discussed, with a particular emphasis on how contact was only possible once certain discourse knots were deconstructed. Such work requires giving up some traditional ideas around technique in the interest of serving one of the most disenfranchised client groups.

Keywords

Engagement; Open Dialogue; Psychoanalytic Therapy; Psychosis; Teams