Psychotherapy of Schizophrenia: The Treatment of Choice [Hardcover]

Bertram P. Karon (Author), Gary R. VandenBos (Author)

Book Description

Publication Date: 1981 | ISBN-10: 0876684444 | ISBN-13: 978-0876684443

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.

Editorial Reviews

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.

Product Details

• Hardcover: 504 pages
• Publisher: Jason Aronson, Inc. (1981)
• Language: English
• ISBN-10: 0876684444
• ISBN-13: 978-0876684443
• Product Dimensions: 8.3 x 5.5 x 1.7 inches
• Shipping Weight: 1.8 pounds (View shipping rates and policies)
• Average Customer Review: 4.3 out of 5 stars  See all reviews (6 customer reviews)
• Amazon Best Sellers Rank: #277,612 in Books (See Top 100 in Books)
  • #71 in Books > Health, Fitness & Dieting > Mental Health > Schizophrenia

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Customer Reviews

Most Helpful Customer Reviews

12 of 12 people found the following review helpful:

5.0 out of 5 stars Excellent Source for Practitioner and Student, June 22, 1999

By A Customer

This review is from: Psychotherapy of Schizophrenia: The Treatment of Choice (Paperback)

I enjoyed the frank and honest language of the book. It cut through much that is misunderstood and unknown about people who have schizophrenia. I consider it one of the hallmarks of my personal psychology library. I highly recommend this book to practitioners, students and those who wish to broaden their knowledge of schizophrenia.

10 of 11 people found the following review helpful:

5.0 out of 5 stars A must read for treating people suffering from schizophrenia, June 21, 1998

By A Customer

This review is from: Psychotherapy of Schizophrenia: The Treatment of Choice (Paperback)

Drs. Karon and Vandenbos have written a book that allows anyone with a serious interest in helping individuals who suffer from schizophrenia to better understand the psychology that is all too often overlooked . The simple truths conveyed in this book will illuminate the desparate lives of individuals who are unfortunate enough to have fallen into psychosis and have yet to find a way out on their own. It is an excellent stimulus that can trigger one's own creativty which is essential in effective treatment with those caught in psychosis. I continue to rely on the lessons learned in this book after having read it 14 years ago!

6 of 6 people found the following review helpful:

4.0 out of 5 stars A classic, August 23, 2007

By 

Chris Michael "Ph.D." (CA, USA) - See all my reviews

This review is from: Psychotherapy of Schizophrenia: The Treatment of Choice (Paperback)

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.