Hope Without Borders: Psychosis, polypharmacy and the future of care?
DOI:
https://doi.org/10.65828/yjh67q32Keywords:
Psychosis, polypharmacy, existential psychoanalysis, McDonaldizationAbstract
This paper explores the concept of treatment and healing in the twenty-first century, emphasising the importance of open-heartedness and more humanistic and compassionate approaches in psychotherapy. Drawing from the work of R.D. Laing, it critiques the continued over-reliance on pathologising, theorising and commodification in mental healthcare. Instead, it advocates for authentic care characterised by openness, spontaneity, accessibility and directness, aligning with an existential psychoanalytic sensibility.
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References
Beckett, S. (2010). The Unnamable. London: Faber & Faber. DOI: https://doi.org/10.1017/cbo9780511659430.013
Bentall, R. (2004). Madness Explained: Psychosis and human nature. London: Penguin.
Bracken P. & Thomas, P. (2005). Post-psychiatry: Mental health in a postmodern world. Oxford: Oxford University Press.
Clark, C.F. (2004). R.D. Laing: What was therapeutic about that? Journal of Transpersonal Psychology. 36 (2): 150-178.
Correll et al. (2018). What is the risk-benefit ratio of long-term antipsychotic treatment in people with schizophrenia? World Psychiatry. 17 (2): 149-160. DOI: https://doi.org/10.1002/wps.20516
Deegan, P.E. (1996). Recovery and the Conspiracy of Hope. http://akmhcweb.org/recovery/deegan-recovery-hope.pdf [Accessed on 9 January 2024] DOI: https://doi.org/10.2307/jj.18011448.14
Dustin, D. (2007). The McDonaldization of Social Work. London: Routledge. DOI: https://doi.org/10.4324/9781315555676
Oxford: Oxford University Press.
Frazer-Carroll, M. (2023). Mad World: The politics of mental health. London: Pluto Press. DOI: https://doi.org/10.2307/jj.4418234
Freud, S. (1897). Omitted fragments from letter 70 to Fliess. In Torok, M. (1986). Unpublished by Freud to Fliess: Restoring an oscillation. Critical Inquiry. 12 (2): 391-398. DOI: https://doi.org/10.1086/448337
Fricker, M. (2009). Epistemic Injustice: Power and the ethics of knowing. Oxford: Oxford University Press. DOI: https://doi.org/10.1093/acprof:oso/9780198237907.001.0001
Gadamer, H-G. (2004). Truth and Method. London: Bloomsbury Academic.
Garety, P.A., Kuipers, E., Fowler, D., Freeman, D. & Bebbington, P.E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine. 31 (2): 189-195. DOI: https://doi.org/10.1017/s0033291701003312
Garrett, M. (2019). Psychotherapy for Psychosis: Integrating cognitive-behavioral and psychodynamic treatment. Oxford: Oxford University Press.
Garson, J. (2022). Madness: A philosophical exploration. Oxford: Oxford University Press.
Gnaulati, E. (2018). Saving Talk Therapy. Boston, MA: Beacon Press.
Gordon, C., Gidugu, V., Rogers, E.S., DeRonck, J. & Ziedonis, D. (2016). Adapting open dialogue for early-onset psychosis into the US health care environment: A feasibility study. Psychiatric Services. 67 (11): 1166-1168. DOI: https://doi.org/10.1176/appi.ps.201600271
Harrow, M. & Jobe, T.H. (2018). Long-term antipsychotic treatment of schizophrenia: Does it help or hurt over a 20-year period? World Psychiatry. 17 (2): 162-163. DOI: https://doi.org/10.1002/wps.20518
Heaney, S. (2010). A herbal. In Poem 16 in Human Chain. London: Faber & Faber.
Heidegger, M. (1962). Being and Time. Trans. Macquarrie, J. & Robinson, E. London: Blackwell Publishing.
Ho, B-C, Andreasen, N.C., Ziebell, S., Pierson, R. & Magnotta, V. (2011). Long-term antipsychotic treatment and brain volumes: A longitudinal study of first-episode schizophrenia. Archives of General Psychiatry. 68 (2): 128-137. DOI: https://doi.org/10.1001/archgenpsychiatry.2010.199
Karon B.P. (2003). The tragedy of schizophrenia without psychotherapy. The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry. 31 (1), 89-118. DOI: https://doi.org/10.1521/jaap.31.1.89.21931
Karon B.P. & VandenBos, G.R. (2004). Psychotherapy of Schizophrenia. Oxford: Rowman & Littlefield
Laing, A. (2006). R.D. Laing a Life. London: Sutton Publishing.
Laing, R.D. (1965). The Divided Self. London Penguin. DOI: https://doi.org/10.5040/9781911501787.00000003
Laing, R.D. (1967). The Politics of Experience. London Penguin.
Laing, R.D. (1985). The use of existential phenomenology in psychotherapy. In Zeig, J. (ed.) The Evolution of Psychotherapy. 203-211. London: Routledge. DOI: https://doi.org/10.4324/9781315791821
Lumet, S. (dir.) (1976). Network [Film]. Metro-Goldwyn-Mayer.
Luyten, P. & Fonagy, P. (2022). Integrating and differentiating personality and psychopathology: A psychodynamic perspective. Journal of Personality. 90 (1): 75-88. DOI: https://doi.org/10.1111/jopy.12656
Miller, R. & Palvo, A. (2022). From deinstitutionalization to deprescribing and beyond. In Stacy, S. (ed.) Recovering the US Mental Healthcare System .183-205. Cambridge: Cambridge University Press. DOI: https://doi.org/10.1017/9781108951760.011
Montgomery, M.R. (2016). The McDonaldization of Psychotherapy? Existential Analysis: Journal of the Society for Existential Analysis. 27.2: 244-256. DOI: https://doi.org/10.65828/p699gp70
Montgomery, M.R. (2018). An exploration of the psychotherapist's fear, anxieties and changing capacity for risk tolerance, when working with expressed suicidal ideation by a client: A grounded theory study. Journal of Psychotherapy and Counselling Psychology Reflections. 3 (2): 29-36.
Montgomery, M.R., Luca, M. & Gordon-Finlayson, A. (2023). The shifting sound of silence: A constructivist grounded theory. Counselling and Psychotherapy Research. 1-11. DOI: https://doi.org/10.1002/capr.12654
National Institute for Health and Care Excellence (NICE). (2014, updated 2020). Psychosis and Schizophrenia in Adults: Prevention and management. [Clinical guideline CG178]. https://www.nice.org.uk/guidance/cg178 [Accessed on 9 January 2024.]
Nuttall, M.D. (2019). Co-presence and the transpersonal field according to R.D. Laing: Pointing towards holism. Journal of Transpersonal Psychology. 51 (2): 225-241.
Ridenour, J.M. & Garrett, M. (2023). Intent to understand the meaning of psychotic symptoms during patient-psychiatrist interactions. American Journal of Psychotherapy. 76 (2): 57-61. DOI: https://doi.org/10.1176/appi.psychotherapy.20220034
Ritzer, G. (2013). The McDonaldization of Society: 20th Anniversary Edition. London: Sage.
Robinson, P. (dir.) (1974). Approaches. Part 1, Dr R.D. Laing Talks with Jane. Peter Robinson Associates.
Semple, D., Smyth, R., Burns, J., Darjee, R. & McIntosh, A. (2005). Oxford Handbook of Psychiatry. Oxford: Oxford University Press. DOI: https://doi.org/10.1093/med/9780199239467.001.0001
Sullivan, H.S. (1968). The Interpersonal Theory of Psychiatry. London: W.W. Norton. DOI: https://doi.org/10.4324/9781315014029
Thompson, M.G. (2016). On Sympathy: The Role of Love in the Therapeutic Encounter. https://michaelguythompson.com/Library/Downloads/2016_Esalen-Sympathy-and-Therapy.pdf [Accessed on 9 January 2024.]
Thompson, M.G. (2023). Essays in existential psychoanalysis: The primacy of authenticity. London: Routledge. DOI: https://doi.org/10.4324/9781003429104
U2. (1987). Running to stand still [Song]. On The Joshua Tree. Island Records.
Weismann, A. (1965). The Existential Core of Psychoanalysis: Reality, sense and responsibility. Boston: Little, Brown & Co.
Winnicott, D.W. (1965). The Maturational Processes and the Facilitating Environment: Studies in the theory of emotional development. London: Karnac. DOI: https://doi.org/10.4324/9780429482410
Yeates, W.B. (2022 [1899]). Aedh wishes for the cloths of Heaven. In The Poetry of W.B. Yeates. London: Arcturus Publishing.


