- Hardcover: 240 pages
- Publisher: Karnac Books; 1 edition (February 5, 2009)
- Language: English
- ISBN-10: 1855756099
- ISBN-13: 978-1855756090
- Product Dimensions: 6 x 0.8 x 8.9 inches
- Shipping Weight: 1 pounds (View shipping rates and policies)
- Average Customer Review: 7 customer reviews
- Amazon Best Sellers Rank: #2,043,249 in Books (See Top 100 in Books)
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Treating the "Untreatable": Healing in the Realms of Madness 1st Edition
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"Treating the 'Untreatable' is a beautiful forward development of Frieda Fromm-Reichman's seminal work. It's a creative confirmation of the virtues of psychodynamic psychotherapy in the hands of a virtuoso for the most disturbed patients many of us are reluctant to engage. For our residents who have little psychotherapy training and for seasoned clinicians, the book is an awakening!" (Herbert S. Sacks, M.D., Past-President, American Psychiatric Association and Clinical Professor)
“In bell clear, eloquent language, Ira Steinman shows his deep knowledge and compassion for the mentally ill and their problems. He never falls into the trap of thinking that mentally ill people are only that, and so he pleads for the understanding that will allow therapists to elicit the strength and health in their sickest patients. The word 'cure' is seldom attached to schizophrenia. Dr Steinman dares to use it and sometimes to prove it.” (Joanne Greenberg, author of I Never Promised you a Rose Garden (under the pseudonym of Hannah Green))
“Treating The "Untreatable" demonstrates in a lucid and impressive way the possibilities for the intensive psychotherapy of severely ill psychiatric patients in a way that can lead to lasting benefit and restoration of full life functioning, much beyond the kind of systematic management that can come with the use of psychoactive drugs (though of course such medications are indeed part of Dr Steinman's treatments in selected cases). This kind of treatment was once quite in vogue in psychiatric and psychoanalytic circles back in the mid-2Oth century associated then with the names of Frieda Fromm-Reichman, Margaret Sechehaye, Gertrud Schwing, Harry Stack Sullivan, and John Rosen, the best known of that generation, but has since been largely eclipsed by the rise of the use of psychoactive drugs, and this I feel has been a major curtailment of the restorative possibilities of these patients.
Ira Steinman's manuscript is an effort, and a substantial one, to redress this imbalance and to bring the intensive psychotherapy possibilities with these very ill patients back into the foreground. As such it can serve a very useful purpose for both the practitioner world and the world of current and potential patients.” (Robert S. Wallerstein, M.D., Past President)
”Alongside psychopharmacological intervention and the benefits it brings, the treatment of seriously disordered individuals requires that their delusional beliefs be addressed psychotherapeutically; otherwise, there is no significant and sustained symptom relief. Ira Steinman's Treating The "Untreatable" provides the most thoughtful, well articulated account available of how such treatment should be conducted, complete with captivating and instructive case examples.
I wish we could have used his book in our residency program when I was Director of Training at the Department of Psychiatry, Mount Zion Hospital, San Francisco. I can assure you that clinicians from various backgrounds and with all levels of experience will want to read Treating the "Untreatable" and will find it enormously useful when they do.” (Owen Renik, M.D., Past Editor-in-Chief of The Psychoanalytic Quarterly and Past Program Chair)
”I am very pleased to enthusiastically recommend Treating the 'Untreatable' by Ira Steinman. This is a most important book. I have no doubt that it will be controversial, but there are a good number of persons, of which I include myself, who are very familiar with the content of the kind of work that Ira Steinman is describing; although we might not all have the degree of success that he has, we do have similar successes and indeed there is a long history of such work from this approach. I think it very exciting to contemplate this kind of book, which will appeal to a wide audience and that focuses on immediate narratives of one person's clinical experiences in a psychodynamic psychotherapy as a treatment for schizophrenia.” (Brian Martindale, M.D. Past President)
“A brilliant story teller of journeys through Madness to Sanity, Ira Steinman, has skillfully and sensitively crafted Treating The "Untreatable" a must read for anyone interested in the work of true psychological healing. These compelling clinical tales combine the artistry of Robert Lindner's The Fifty Minute Hour and the clinical brilliance and wisdom of the writings of Harold Searles and Harry Stack Sullivan.” (Stanley Prusiner, M.D. Nobel Laureate in Medicine and David Leof, M.D. Distinguished Life Fellow of the American Psychiatric Association and Senior Jungian Training Analyst)
About the Author
Ira Steinman has focused on schizophrenia for 45 years; his early training ranged from studying with R.D. Laing to working at the National Academy of Sciences’ Drug Efficacy Study, which evaluated all the antipsychotic medications available at that time. For more than 35 years, he has pursued an out-patient psychiatric practice where he has been able to demonstrate that an intensive psychoanalytic psychotherapy, in conjunction with the judicious use of antipsychotic medication, can help even the most lost and disturbed schizophrenic and delusional patients recover, heal and, at times, achieve a cure. With such an approach, some allegedly “untreatable” schizophrenics have been able to work their way off of antipsychotic medication. He has spoken on this subject at length on a local, statewide, national and international level for more than twenty five years. He is a member of the ISPS (International Society for the Psychological Treatments of the Schizophrenias and other Psychoses); the American Psychiatric Association; and the Northern California Psychiatric Association.
Top customer reviews
He chronicles his intensive treatment of a dozen patients. His delusional and schizophrenic patients gradually become aware "that they are the creators of their psychotic productions" and that their "projected and feared impulses that took the form of hallucinations and delusions become understandable and detoxified." The basis of his approach to treatment seems so logical and sensible, although he is one of very few mental health professionals who has continued to treat this population as though they are indeed treatable. He asks, "What happens if we genuinely try to understand the origin of such psychotic beliefs, even with the most disturbed, and attempt to put together an emotional and historical thread that describes how delusional beliefs or schizophrenic thought began?"
The therapist, according to Dr. Steinman, "must be able to see and gradually work therapeutically with delusions, hallucinations, unconscious meanings, resistances to insights, his own reactions and the patient's transference reactions from the past and to the current changing situation." Judiciously using medications for his patients as he helps them work through their traumas, Dr. Steinman has found the delicate balance between what symptoms are tolerable to his patients, and where they need a pharmaceutical shield.
Courageously gearing his book to the general public as well as to his colleagues, Ira Steinman illustrates the inner life of severely mentally ill patients, "articulates a rationale for the use of an intensive psychodynamic psychotherapy" for these patients, and "proves false the current belief that such an in-depth exploratory psychotherapy is of no benefit in such severely disorganized patients." He demonstrates, through case examples, that childhood trauma is "instrumental in the development of a certain percentage of people who are diagnosed as schizophrenic." Nearly all of the patients he described in his book have been off antipsychotic medications for up to thirty years, even after previous long courses of supportive psychotherapy, extensive antipsychotic medication, and repeated hospitalizations that left the patients in the throes of schizophrenic disorganization. Dr. Steinman's intensive psychotherapeutic work, as described in Treating the `Untreatable' led to healing and cure.
Dr. Steinman offers a compelling argument for the use of psychoanalytic psychotherapy in treating the severely disturbed. Over the long run, such treatment is likely to cost less than repeated hospitalizations and lifelong supportive psychotherapy. He concludes that as a field we "have lost our way in treating severely disturbed and delusional patients." Undoubtedly he is correct. And most importantly he demonstrates the efficacy of uncovering exploratory dynamic psychotherapy to treat the `untreatable'. Dr. Ira Steinman is an inspiration to graduate students as well as to established psychotherapists. Similarly, Treating the `Untreatable' offers hope--the possibility of having a fulfilling life--for those who suffer terribly from serious mental illness.
--Mary C. Lamia, Ph.D.
I have a nephew who has been diagnosed with 'schizoaffective disorder'. He has been in and out of hospitals and jail and on and off anti-psychotic meds. He has a mother who would drive anyone, including me, insane. Every time I spend time with my nephew, within a couple of days, he starts to integrate, he feels better and better, and it seems obvious that he is not 'incurably schizophrenic' as his mother insists - because, of course, if he is not crazy, then she is the problem.
This book made me feel sane for insisting, against the opinions of dozens of psychologists, psychotherapists, social workers and counselors, that my nephew is reachable. I cried at the stories of abuse that Stein chronicles and the healing that is possible. His proscription for healing is exquisitely simple although not easy. His explanations are accessible for the layperson but aimed squarely at the field of psychotherapy, as well. He merely insists that the client confront and integrate the idea that the client is the inventor of their delusions, voices, other personalities, their break with external reality. Stein demonstrates that the delusions of his clients are understandable, that they are created out of the need to escape dire emotional pain. Merely giving clients supportive therapy does not work. Compassionate listening is critical for about three months, he finds, just the time it takes to compile an in-depth history of the client and, as much as he can, the history of the different delusions and voices. Stein invites the reader into the therapy room as he goes to work, gently but insistently, bringing the client into reality. Sometimes he talks directly to the delusions and different voices, making sense of who and what they represent to the client. He helps his clients learn to deal with their pain in other ways while reminding them over and over that they are the source of the delusions invented - and brilliantly so - for protection from a desperately painful reality. During this time, maybe a couple of years, it gets dicey for the clients as they let go of their defenses and confront sometimes horrible abuse. Stein writes of chasing clients as they flee his office, running for the Golden Gate Bridge to commit suicide. But he seems unfazed. Stein uses antipsychotic medications and short term hospitalizations for such episodes, but his clients progress. He has stories of clients in their fifties, with thirty years of derangement, hospitalizations, and heavy medications, who let go of their delusions, get off of medications and heal themselves.
I felt as if I were sitting in the room with Stein and his clients, as if I were a first-year student in psychotherapy, listening to a master. Stein has written a tribute to the power and brilliance of the human mind.
This book should start a revolution in the art of psychotherapy.
Now, Dr. Stein, please write a book about how to deal with the parents who interfere with the recovery of their adult children at every turn.
possibilities for the intensive psychotherapy of severely ill
psychiatric patients in a way that can lead to lasting benefit and
restoration of full life functioning much beyond the kind of systematic
management that can come with the use of psychoactive drugs (though of
course such medications are indeed part of Dr Steinman's treatments in
selected cases). This kind of treatment was once quite in vogue in
psychiatric and psychoanalytic circles back in the mid-2Oth century,
associated then with the names of Frieda Fromm-Reichman, Margaret
Sechehaye, Gertrud Schwing, Harry Stack Sullivan, and John Rosen, the
best known of that generation, but has since been largely eclipsed by
the rise of the use of psychoactive drugs, and this I feel has been a
major curtailment of the restorative possibilities of these patients.
Ira's manuscript is an effort - and a substantial one - to redress this
imbalance and to bring the intensive psychotherapy possibilities with
these very ill patients back into the foreground. As such it can serve a
very useful purpose for both the practitioner world and the world of
current and potential patients out there.'
- Robert S. Wallerstein, M.D., Past President of the International