An "Incurable" Schizophrenic: The Case of Mr. X

Abstract

Mr. X, a schizophrenic, was evaluated by all his psychiatrists as “incurable” after several years of unsuccessful outpatient and two months of inpatient treatment, both with medications. Electro-convulsive therapy (ECT) was strongly but pessimistically recommended. He was not eating, not sleeping, and continuously hallucinating. He began outpatient psychoanalytic therapy. All medications were stopped. After three days he began eating. After four months he began working at an intellectually demanding job. After two years he could be assured that he would never be psychotic again under normal stresses. But that was not good enough for him. He kept raising new issues: problems in living, difficulties writing his first book, psychosomatic problems, problems in enjoying ordinary pleasures, marital problems, undoing problems he had caused his son. The total treatment took 14 years. More than 20 years after the completion of treatment the patient sent a note indicating his continued professional accomplishments and thanking the therapist for “giving me my life back.”

A Life-Saving Therapy: The Theory-Building Case of "Cora"

“…The first theme of persistence, along with a consistent, recurrent pattern of interaction would appear to confirm the findings arising from other case study analyses of psychotherapy with clients who exhibit a fragile capacity for interpersonal connection, for example, Atwood (2012), Karon (2008) and Terry (2003Terry ( , 2004Terry ( , 2005Terry ( , 2010. Related to this, a study by Imel and colleagues (2014) indicates that vocal synchrony in clinical dyads is related to process and outcome in psychotherapy.…”

“…Detailed accounts of therapy with difficult cases associated with psychotic features (Atwood, 2012;Karon, 2008;Terry, 2003Terry, , 2004Terry, , 2005Terry, , 2010 have emphasized the importance of therapist belief in a set of treatment principles, allied to willingness to be firm and patient in the repetitive application of these principles over a prolonged period of time.…”

Case studies within a mixed methods paradigm: Toward a resolution of the alienation between researcher and practitioner in psychotherapy research.

“…In PCSP , each case study is published in a module that includes two or more critical commentaries by experts in the field and a response by the author of the case itself. The resultant debates highlight methodological issues relevant to case interpretation and the implications of findings, as in those between Karon (2008) and Davidson (2008), and between Kramer (2009) and Hembree and Brinen (2009). PCSP has also already included modules dedicated to critical examination of methodological issues relevant to the use of cases as scientific data and evidence.…”

The healing nature of communion: Scottish psychoanalysis, R.D. Laing, and therapeutic communities.

“…As Karon and VandenBos (1994) write, Roger’s study, though not as positive as he had hoped, “demonstrates that the quality of the therapeutic relationship with a schizophrenic patient impacts directly on the outcome of treatment” (p. 375). The relevance and importance of this finding is demonstrated in the clinical work and case studies of psychoanalysts George Atwood (see Atwood, 2012) and Bert Karon (see Karon, 2008), where the therapeutic relationship creates the conditions for the understanding and meaning making of schizophrenic symptoms, with the ultimate recovery from schizophrenia.…”