Out of illness experience: metacognition-oriented therapy for promoting self-awareness in individuals with psychosis.

Abstract

Deficits in metacognitive abilities, which enable persons to make sense of their own mental states and those of others, often are observed among persons with schizophrenia. To address these deficits we have sought to develop a metacognition-oriented form of psychotherapy that may foster self-reflectivity leading to the ability to think critically about delusional beliefs and to engage in and sustain healthy social exchanges. To illustrate Metacognition Oriented Therapy, we analyzed its application in an early psychotherapy session with a young woman who had disorganized schizophrenia. In this paper we specifically explore how the therapist followed a sequence of steps aimed at: 1) reconstructing episodes in life-narratives, 2) helping the patient name distressing emotions that appear in the narrative episode, 3) validating and normalizing the patient's experiences, 4) promoting awareness of emotional triggers and the links between affects and social behavior, and 5) validating emerging subjective experiences. We stress how these procedures helped the patient eventually become more able to start questioning her own delusional beliefs. The generalization of these procedures to the psychotherapy of schizophrenia is discussed.

• Authors: Giampaolo Salvatore, Paul H Lysaker, Andrew Gumley, Raffaele Popolo, Jessica Mari, Giancarlo Dimaggio
• Journal: American journal of psychotherapy (Am J Psychother) Vol. 66 Issue 1 Pg. 85-106 ( 2012) ISSN: 0002-9564 [Print] United States
• PMID: 22523795 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Awareness
• Cognitive Behavioral Therapy (methods)
• Emotions
• Female
• Humans
• Physician-Patient Relations
• Schizophrenia (therapy)
• Schizophrenic Psychology
• Self Concept
• Theory of Mind