Free PDF Psychotherapy of Schizophrenia: The Treatment of Choice, by Bertram P. Karon, Gary R. VandenBos
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Psychotherapy of Schizophrenia: The Treatment of Choice, by Bertram P. Karon, Gary R. VandenBos
Free PDF Psychotherapy of Schizophrenia: The Treatment of Choice, by Bertram P. Karon, Gary R. VandenBos
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Inevitably, every psychotherapist has some experience with severely disturbed patients. Consequently, they will turn with excitement to this important new book which is a stunning attempt by two knowledgeable, persevering psychotherapists to present their understanding and sound therapeutic approach to these difficult and challenging patients. The authors argue that the treatment of choice is clearly psychotherapy and that such treatment can be successful and as long lasting for schizophrenic patients as it is for neurotic patients, but the journey may be longer and it may take more time to traverse.The task of therapy is to untangle the past from the present to make the future conceivable.
The volume provides a thorough historical overview of the theoretical and clinical approaches to the problem of schizophrenia, including the views of leading contemporary clinicians on the topic. In general, the major clinical controversies have been regarded as issues of whether to focus on past, present or future; reality or fantasy; affects; exploration or relationship; whether the therapist should be active or passive; and how to handle regression. The authors argue that these are the wrong issues. They say that the task of therapy is to untangle the past from the present to make the future conceivable. Reality and fantasy are intertwined and must both be dealt with. Affects are central to all therapy, and emphasis on anger, despair, loneliness, terror, and shame are all necessary, as is the clarification of affect, and the acceptance of positive affect. Activity versus passivity is again in the wrong question; the right one is what action is helpful, when it is helpful, and when is not doing anything helpful? Regression is inevitable; should one accept it fully or try to limit it? This has no general answer other than do what is necessary (i.e., unavoidable) or most helpful to a particular patient at a particular time.
- Sales Rank: #680298 in eBooks
- Published on: 1977-07-07
- Released on: 2013-03-22
- Format: Kindle eBook
Review
Given the temper of the times, the title of this book is brave and somewhat provocative. In the current world of general psychiatry, and even in psychoanalytic circles, few would agree with the authors that psychotherapy is the treatment of choice for schizophrenic people. The conventional wisdom is that schizophrenia is an illness with a biological, probably inherited, cause and that psychological approaches have not proved effective in its treatment...But Karon and Vandenbos have a different view. It istheir belief that in the hands of a skillful, experienced, and motivated therapist, psychotherapy can be dramatically helpful to schizophrenic people, more helpful and even less expensive than alternative treatments stressing medication management. Thisbelief is supported by their vast clinical experience and by the findings of the Michigan State project, in which they compared the efficacy of psychotherapy and medication. Neither that project nor this book settles the question once and for all, but they have written an extremely useful volume which should convince anybody open to their argument that there is a great deal to say in favor of their position... This book will stir strong feeling. In spite of its shortcomings, it is well worth reading. (James P. Frosch, M.D. Review Of Psychoanalytic Books)
Given the temper of the times, the title of this book is brave and somewhat provocative. In the current world of general psychiatry, and even in psychoanalytic circles, few would agree with the authors that psychotherapy is the treatment of choice for schizophrenic people. The conventional wisdom is that schizophrenia is an illness with a biological, probably inherited, cause and that psychological approaches have not proved effective in its treatment...But Karon and Vandenbos have a different view. It is their belief that in the hands of a skillful, experienced, and motivated therapist, psychotherapy can be dramatically helpful to schizophrenic people, more helpful and even less expensive than alternative treatments stressing medication management. This belief is supported by their vast clinical experience and by the findings of the Michigan State project, in which they compared the efficacy of psychotherapy and medication. Neither that project nor this book settles the question once and for all, but they have written an extremely useful volume which should convince anybody open to their argument that there is a great deal to say in favor of their position... This book will stir strong feeling. In spite of its shortcomings, it is well worth reading. Whether or not the authors are correct in their belief that schizophrenia is a purely psychological phenomenon best treated by psychotherapy, they have demonstrated that psychoanalysis has much to contribute the understanding of schizophrenic individuals." (James P. Frosch, M.D. Review Of Psychoanalytic Books)
About the Author
Bertram P. Karon, Ph.D., is a Professor of Clinical Psychology at Michigan State University, where he has taught since 1962. He is a past President of the Division of Psychoanalysis of the American Psychological Association, and President of the Michigan Psychoanalytic Council. He was selected by the New York Society for Psychoanalytic Training for their 1988 Distinguished Psychoanalyst Award, and their 1982 Outstanding Publication Relevant to Psycho-analysis Award for Psychotherapy of Schizophrenia: The Treatment of Choice. He was also selected for the 1990 Fowler Award for Distin-guished Graduate Teaching by the American Psychological Association Graduate Students and for the 1990 Master Lecturer Award by the Michigan Psychological Assoc-iation. He has over 100 publications in American and European journals of Psychoanalysis, Psychology, and Psychiatry.
Dr. Gary R. VandenBos received his doctorate in clinical psychology from the University of Detroit. He has held positions as the director of the Howell-Area Community Mental Health Center in Michigan and professor of Clinical Psychology at the University of Bergen in Norway. He is a diplomate of the American Board of Forensic Psychology, and he is a licensed practicing clinical psychologist in the District of Columbia. He has been associate editor of the American Psychologist since 1984 and a contributing editor to Hospital and Community Psychiatry since 1982. He received the Early Career Award for Contribution to Psychotherapy from Division 29 (Division of Psychother-apy) of the American Psychological Association in 1983.
Most helpful customer reviews
11 of 11 people found the following review helpful.
A classic
By Chris Michael
This is an excellent book for those who want to do longer term work with psychothic individuals, which is a deplorably under-regarded endeavor.
People have an idea that only medications will enact a "cure," and at that, really only a suppression. Yet, there is evidence, swept under the rug lately but beginning to emerge again, that long term psychotherapy can help with the overall personality structure problems, and that short-term cognitive and behavioral therapy, as well as longer term therapy, can help for the actual symptoms. Some of this evidence is found in this book, as well as a book by another psychoanalyst, "Dante's Cure."
Although in today's climate, shorter term interventions are often needed (until changes are made or unless the professional works in a hospital with high resources), the real deal for severe problems is long-term work, for more than one session per week if possible. Psychoanalytic, interpersonal, cognitive, client-centered, whatever, but a long-term relationship must be established for the purposes of healing. From the analytic perspective, this book covers that fairly well.
This text is very heavy on the psychodynamic, which is fine for me as I am a theory-integrationist with analytic and behavioral leanings. The cases used are few. For example, the authors will use the same case examples to illustrate different aspects of symptoms or therapy, and one begins to wonder, "why so few actual individuals in the text?"
All in all, it's one of the best available on the topic, in addition to the CBT folks coming mostly out of England. However, I would like to have seen more on technique. There are great general tips on what to do and not do in general, but if the authors are going to strongly espouse an analytic perspective I would like to see a whole chapter on typical stages in the therapy, what interpretations are typically made in response to typical patient reactions, etc. The patient is an individual, but there are commonalities among all humans, and often among those with severe disorder. More micro- and less macro, I guess.
I am a reader who is able to separate therapists and authors from controversy surrounding them, if it appears that there could be more than one side to the story within the controversy. However, if you are not, you might want to be advised that the author studied with Rosen, the author of "Direct Anslysis." I found the old book by Rosen really good, but am very aware it would need tweaking for today's world. However, if you are one of those staunch opponents of Rosen's therapy or person, you may not want to read a book by one of his students.
All in all, a classic and very useful text.
16 of 19 people found the following review helpful.
Refreshing, enlightening, and useful
By Dathan A. Paterno
Thank God for Dr. Karon. Literally. While in the process of reading his book, I began experimenting with a few of his suggestions and precepts. I was elated when not only did they work, but the fact that my psychotic patients could tell that I was actually trying to understand them allowed these patients to feel safe with me. Karon's ideas have become like a clinical gospel to me and many of my colleagues, and his intellectual prowess speaks mightily for his clinical methods.
4 of 4 people found the following review helpful.
Karon is on-target
By Amazon Customer
I was a student of Karon's in the early 80's. I still have this book and I remain completely influenced by his ideas.
Bertram Karon is a man who has made a significant contribution to the understanding of psychotic and schizophrenic experience. I highly recommend this book for his insights into psychosis as I believe they are profound and true.
Harry Stack Sullivan was the genius before him and Karon advances and simplifies an understanding of these conditions.
As I remember, psychosis relates to a chronic terror state. Not at all hard to help a person in this state if you can have an opportunity to provide stability, security, and be trustable. You have to be comfortable with people being psychotic. For some reason, psychosis makes people uncomfortable. But it shouldn't be so because it really is kind of a natural defense last resort built-in mind mechanism to handle extremely difficult circumstances.
Extremely difficult life circumstances are related not only to family situations. Not at all really. Our society is complex and problematic enough. Many circumstances are difficult to navigate. In my opinion, schizophrenia and psychosis can develop from a variety of circumstances. Pre-adolescence is a very important time as our children really begin to venture out. And not all parents can always be in a position to safely protect their young.
The only idea related to this that I remember to be important and noteworthy, is the idea of when the needs of two people conflict, whose needs prevail? Has the schizophrenic person been in a lot of situations where his or her wants and needs have been brushed off?
So it's simple. How do you reduce fear and terror? Understanding, acceptance, time, reassurance, non-judgemental, empathy, patience, appreciation, etc..
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