Psychosis

Anthony Bateman; Peter Fonagy; Chloe Campbell; Patrick Luyten; Martin Debbané

doi:10.1017/9781108896054.011

Chapter 10 - Psychosis

from Part III - Application and Adaptations for Mental Health Presentations

Published online by Cambridge University Press: 18 May 2023

Patrick Luyten and

Anthony Bateman: Affiliation:
Anna Freud National Centre for Children and Families, London
Peter Fonagy: Affiliation:
University College London
Chloe Campbell: Affiliation:
University College London
Patrick Luyten: Affiliation:
University College London
Martin Debbané: Affiliation:
University College London

Book contents

Get access

Summary

Mentalization-based treatment (MBT) for psychosis focuses on the decoupling of bodily and mental experience as well as the stresses of mentalizing during social interaction. In a framework of mentalizing, psychotic phenomena can be represented as severe disturbances to the experience of oneself as a coherent unit. Clinical treatment that aims to increase integration and stability of self-experience is illustrated in this chapter using clinical examples. The first task is to identify treatment objectives and define any obstacles to treatment, working with co-constructed representations of the clinical problem. The second task is to integrate the viewpoints of the patient, the clinical team, and the social care network, and to agree an overall working formulation. This is followed by therapeutic intervention to stabilize self-mentalizing using interventions from the core MBT model.

Keywords

alien self embodied mentalizing neuroscience psychosis self-disturbance social interaction

Type: Chapter
Information: Cambridge Guide to Mentalization-Based Treatment (MBT) , pp. 253 - 276

DOI: https://doi.org/10.1017/9781108896054.011 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association, 2013.Google Scholar

Brent, B. Mentalization-based psychodynamic psychotherapy for psychosis. J Clin Psychol 2009; 65: 803–14.Google Scholar

Debbané, M, Benmiloud, J, Salaminios, G et al. Mentalization-based treatment in clinical high-risk for psychosis: a rationale and clinical illustration. J Contemp Psychother 2016; 46: 217–25.Google Scholar

Lana, F, Marcos, S, Mollà, L et al. Mentalization based group psychotherapy for psychosis: a pilot study to assess safety, acceptance and subjective efficacy. Int J Psychol Psychoanal 2015; 1: 1–6.Google Scholar

Weijers, J, Ten Kate, C, Eurelings-Bontekoe, E et al. Mentalization-based treatment for psychotic disorder: protocol of a randomized controlled trial. BMC Psychiatry 2016; 16: 191.CrossRef Google Scholar PubMed

Lana, F, Marti-Bonany, J, Sanz-Correcher, P et al. Brief day hospital mentalization based group psychotherapy for schizophrenia spectrum disorders: a feasibility study. Actas Esp Psiquiatr 2020; 48: 64–74.Google Scholar

Riddel, K, Clouse, M. Program development meets theory development: MBGT-I for schizophrenia spectrum and other psychotic disorders. Clin Schizophr Relat Psychoses 2020; 14: 39–44.Google Scholar

Brent, B, Fonagy, P. A mentalization-based treatment approach to disturbances of social understanding in schizophrenia. In: Lysaker, PH, Dimaggio, G, Brüne, M, eds. Social Cognition and Metacognition in Schizophrenia. San Diego, CA: Elsevier, 2014; 245–57.Google Scholar

Debbané, M, Salaminios, G, Luyten, P et al. Attachment, neurobiology, and mentalizing along the psychosis continuum. Front Hum Neurosci 2016; 10: 406.Google Scholar

Weijers, JG, ten Kate, C, Debbane, M et al. Mentalization and psychosis: a rationale for the use of mentalization theory to understand and treat non-affective psychotic disorder. J Contemp Psychother 2020; 50: 223–32.Google Scholar

Debbané, M, Bateman, A. Psychosis. In: Bateman, A, Fonagy, P, eds. Handbook of Mentalizing in Mental Health Practice, 2nd ed. Washington, DC: American Psychiatric Association Publishing, 2019; 443–58.Google Scholar

Armando, M, Hutsebaut, J, Debbane, M. A mentalization-informed staging approach to clinical high risk for psychosis. Front Psychiatry 2019; 10: 385.Google Scholar

Rapoport, JL, Addington, AM, Frangou, S, Psych, MR. The neurodevelopmental model of schizophrenia: update 2005. Mol Psychiatry 2005; 10: 434–49.Google Scholar

Lichtenstein, P, Yip, BH, Bjork, C et al. Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study. Lancet 2009; 373: 234–9.Google Scholar

Meehl, PE. Toward an integrated theory of schizotaxia, schizotypy, and schizophrenia. J Pers Disord 1990; 4: 1–99.Google Scholar

Debbané, M, Barrantes-Vidal, N. Schizotypy from a developmental perspective. Schizophr Bull 2015; 41 (Suppl. 2): S386–95.Google Scholar

Debbané, M. Schizotypy: a developmental perspective. In: Mason, O, Claridge, G, eds. Schizotypy: New Dimensions. Abingdon, UK: Routledge, 2015; 83–98.Google Scholar

Lenzenweger, MF. Schizotypy: an organizing framework for schizophrenia research. Curr Dir Psychol Sci 2016; 15: 162–6.Google Scholar

Guloksuz, S, Pries, LK, Ten Have, M et al. Association of preceding psychosis risk states and non-psychotic mental disorders with incidence of clinical psychosis in the general population: a prospective study in the NEMESIS-2 cohort. World Psychiatry 2020; 19: 199–205.Google Scholar

Schultze-Lutter, F, Michel, C, Schmidt, SJ et al. EPA guidance on the early detection of clinical high risk states of psychoses. Eur Psychiatry 2015; 30: 405–16.Google Scholar

Schultze-Lutter, F, Ruhrmann, S, Berning, J et al. Basic symptoms and ultrahigh risk criteria: symptom development in the initial prodromal state. Schizophr Bull 2010; 36: 182–91.Google Scholar

Alvarez-Jimenez, M, Gleeson, JF, Henry, LP et al. Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years. Psychol Med 2012; 42: 595–606.Google Scholar

AlAqeel, B, Margolese, HC. Remission in schizophrenia: critical and systematic review. Harv Rev Psychiatry 2012; 20: 281–97.Google Scholar

Bevington, D, Fuggle, P, Cracknell, L, Fonagy, P. Adaptive Mentalization-Based Integrative Treatment: A Guide for Teams to Develop Systems of Care. Oxford, UK: Oxford University Press, 2017.Google Scholar

Boyette, LL, Korver-Nieberg, N, Meijer, C et al. Quality of life in patients with psychotic disorders: impact of symptoms, personality, and attachment. J Nerv Ment Dis 2014; 202: 64–9.Google Scholar

Nevarez-Flores, AG, Sanderson, K, Breslin, M et al. Systematic review of global functioning and quality of life in people with psychotic disorders. Epidemiol Psychiatr Sci 2019; 28: 31–44.Google Scholar

Jones, K. Addressing the needs of carers during early psychosis. Early Interv Psychiatry 2009; 3 (Suppl. 1): S22–6.Google Scholar

Harley, EW, Boardman, J, Craig, T. Friendship in people with schizophrenia: a survey. Soc Psychiatry Psychiatr Epidemiol 2012; 47: 1291–9.CrossRef Google Scholar PubMed

Castelein, S, Bruggeman, R, van Busschbach, JT et al. The effectiveness of peer support groups in psychosis: a randomized controlled trial. Acta Psychiatr Scand 2008; 118: 64–72.Google Scholar

Weijers, J. Mentalization and Psychosis: Trying to Understand the Un-Understandable. Maastricht: Ridderprint, 2020.Google Scholar

Bleuler, E. Dementia Praecox or the Group of Schizophrenias. New York: International Universities Press, 1911/1950.Google Scholar

Freud, S. Three essays on the theory of sexuality. In: Strachey, J, ed. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 7. London, UK: Hogarth Press, 1905/1953; 123–230.Google Scholar

Freud, S. On narcissism. In: Strachey, J, ed. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 14. London, UK: Hogarth Press, 1914/1957; 67–102.Google Scholar

Freud, S. The unconscious. In: Strachey, J, ed. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. 14. London, UK: Hogarth Press, 1915/1957; 159–216.Google Scholar

Sass, LA, Parnas, J. Schizophrenia, consciousness, and the self. Schizophr Bull 2003; 29: 427–44.CrossRef Google Scholar PubMed

Auerbach, JS, Blatt, SJ. Self-representation in severe psychopathology: the role of reflexive self-awareness. Psychoanal Psychol 1996; 13: 297–341.Google Scholar

Lysaker, PH, Buck, KD, Pattison, ML et al. Supervision in the psychotherapy of schizophrenia: awareness of and mutual reflection upon fragmentation. Am J Psychoanal 2019; 79: 284–303.Google Scholar

Adams, RA, Stephan, KE, Brown, HR et al. The computational anatomy of psychosis. Front Psychiatry 2013; 4: 47.Google Scholar

Friston, K. Active inference and free energy. Behav Brain Sci 2013; 36: 212–13.Google Scholar

Derome, M, Fonseca-Pedrero, E, Badoud, D et al. Resting-state networks of adolescents experiencing depersonalization-like illusions: cross-sectional and longitudinal findings. Schizophr Bull 2018; 44 (Suppl. 2): S501–11.Google Scholar

Frith, CD. The Cognitive Neuropsychology of Schizophrenia. Hove, UK: Psychology Press, 1992.Google Scholar

Salaminios, G, Debbané, M. A mentalization-based treatment framework to support the recovery of the self in emerging psychosis during adolescence. In: Hasson-Ohayion, I, Lysaker, PH, eds. The Recovery of the Self in Psychosis. Abingdon, UK: Routledge, 2021; 12–35.Google Scholar

Byrne, G, Sleed, M, Midgley, N et al. Lighthouse Parenting Programme: description and pilot evaluation of mentalization-based treatment to address child maltreatment. Clin Child Psychol Psychiatry 2019; 24: 680–93.CrossRef Google Scholar PubMed

Lysaker, PH, Klion, RE. Recovery, Meaning-Making, and Severe Mental Illness: A Comprehensive Guide to Metacognitive Reflection and Insight Therapy. New York, NY: Routledge, 2017.Google Scholar

Reininghaus, U, Kempton, MJ, Valmaggia, L et al. Stress sensitivity, aberrant salience, and threat anticipation in early psychosis: an experience sampling study. Schizophr Bull 2016; 42: 712–22.Google Scholar

Book contents

Chapter 10 - Psychosis

Summary

Keywords

Access options

References

Save book to Kindle

Save book to Dropbox

Save book to Google Drive