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Long-term psychotherapeutic relationships in schizophrenia

Regional Department of Psychotherapy, Claremont House, off Framlington Place, Newcastle upon Tyne NE2 4AA

EDITED BY MATTHEW HOTOPF

I would like to add what I believe is an important factor not mentioned by Thornicroft & Susser (2001) in their editorial on evidence-based psychotherapies in the community care of schizophrenia. It is a factor that I think is missing from a great deal of psychiatric literature on what helps patients get better and what makes us human. People with schizophrenia have withdrawn from being able to relate to others. They need somebody who is able to provide a long-term therapeutic relationship and is not frightened off by those who say ‘beware of dependency’ or seduced by the culture of brief interventions; a person who can stand up to the ‘package culture’ and stay with the patient and family over a long period of time. This sort of work does not make headlines. I think it is the role of psychodynamic psychotherapists to champion dependency in order that the patient can find something of his or her own from the shattered fragments of self; a mature dependence, within the constraints of illness. This work is not easy, requires support, supervision, time and resources. Perhaps the paucity of evidence is because this apparently simplistic viewpoint meets great resistance and is culturally dystonic.

REFERENCES

Thornicroft, G. & Susser, E. (2001) Evidence-based psychotherapeutic interventions in the community care of schizophrenia. British Journal of Psychiatry, 178, 2-4.[Free Full Text]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Brogan, C. Search for Related Content PubMed PubMed Citation Articles by Brogan, C.