"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
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.
About the Authors
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.