Michael Garrett, MD is a psychiatrist and psychoanalyst with 35 years experience in public psychiatry. In this workshop he will review the psychological model of psychosis and the integration of cognitive-behavioral and psychodynamic treatment described in his recent book, Psychotherapy for Psychosis: Integrating Cognitive Behavioral and Psychodynamic Treatments. (2019) Guilford Press/New York. The workshop will address the following topics:
• The role of genes and adverse life experience (trauma) in the genesis of psychosis
• Three dimensions of psychosis: altered perceptual experiences of the material world; altered subjective experiences of the self; delusional narratives expressive of life experiences
• Clinical example: the man who believed a dog had xray vision that allowed the dog to see through his clothing
• Primary and secondary process thinking (Sigmund Freud)
• Paranoid/schizoid and depressive postions (Melanie Klein)
• The relationship of fairy tales and the mental life of ordinary children to delusions
• Disturbances of symbol formation and figurative language in psychosis
• Clinical example: the man who intermittently believed his mother was Satan
• An overview of cognitive-behavioral therapy for psychosis
Three basic paradyms underlying CBTp
Stress/vulnerability model of psychosis
Continuum between psychosis and ordinary mental life (‘normalizing’ psychotic symptoms)
A-B-C cognitive frame: activating event leads to belief leads to emotional/behavioral consequences
• Essential CBTp techniques
• Integrating CBTp and psychodynamic treatment
Clinical example: the woman who heard voices warning her that someone was about to die