ABSTRACT
Psychiatry and related mental health fields, in particular psychotherapy, have a long history of close ties with the humanities. That bond has weakened, however, over the last few decades as medicalized views of mental health and treatment have emerged. In this paper, we explore the potential of the reintroduction of the humanities, specifically novels and related literary genre, into the supervision of student clinicians working with clients who have psychosis. We believe that incorporation of novels and related literary genre into supervision can lead to unique and deepened understanding of the experience of psychosis, and can create an opportunity for a working therapeutic alliance. The potential mechanisms that create these unique opportunities to understand psychopathology are explored, and considerations for the implications for treatment, training, and future research are presented.
Subject(s)
Medicine in Literature , Psychiatry , Psychopathology , Psychotherapy , Psychotic Disorders , Education, Medical/methods , Humans , Organization and Administration , Psychiatry/education , Psychiatry/methods , Psychopathology/education , Psychopathology/methods , Psychotherapy/education , Psychotherapy/methods , Psychotic Disorders/psychology , Psychotic Disorders/therapy , Teaching , Teaching MaterialsABSTRACT
When read as a fictional psychosis narrative, Jesus' Son, a collection of short stories by Denis Johnson, reveals important elements of the phenomenology of schizophrenia and recovery. It is possible that Jesus' Son, as a work of fiction, may be able to uniquely add depth and nuance to an understanding of the phenomenology of schizophrenia involving a state of psychological fragmentation, an ever-changing interpersonal field and a loss of personal agency. In addition, by following the protagonist in Jesus' Son as he begins to resolve some of his difficulties, the book also offers an individualised account of recovery. The authors detail how the book reveals these insights about schizophrenia and recovery and suggest that these elements are intertwined in such a manner that leads to a profound disruption of self-experience, characterised by a collapse of metacognitive processes. Jesus' Son may add depth to our understanding of the subjective experience of schizophrenia and recovery, and also may serve as one example in which the study of humanities offers an opportunity to explore the human elements in the most profound forms of suffering.
Subject(s)
Literature , Schizophrenia , Humans , Interpersonal Relations , Male , Personal Autonomy , Stress, PsychologicalABSTRACT
OBJECTIVE: Schizophrenia has been linked with deficits in the ability to form complex representations about oneself and others. Less clear is whether these deficits are stable over time, and whether they are related to symptoms. METHOD: We assessed metacognition capacity, affect recognition, executive function, and symptoms at baseline and 6 months later for 49 adults with schizophrenia. RESULTS: Paired t tests revealed assessments of metacognition and affect recognition were stable across measurements points. Metacognition was related to concurrent assessments of positive, negative and disorganized symptoms. Multiple regressions revealed metacognition was related to prospective assessments of negative symptoms after controlling for baseline negative symptoms and executive function. CONCLUSIONS: Metacognitive deficits are a stable feature of schizophrenia related with negative symptoms.
