Psychodynamic contributions to early intervention in psychosis

Abstract

This article considers the contribution that psychodynamics can make to the work of teams providing early intervention in psychosis. Psychodynamic understanding enriches the stress and vulnerability psychosis model; can contribute to resolving the issues involved in relapse prevention; informs individualised formulations; and can make sense of patients' reactions to prescribing in psychosis. A rationale is given for longerterm individual, group and family dynamic psychotherapies within early intervention teams.Brian Martindale is consultant psychiatrist to the South of Tyne Early Intervention in Psychosis Service (Northumberland, Tyne and Wear NHS Trust,

Using psychodynamic small group work in nurse education: Closing the theory–practice gap?

“…The psychodynamic approach has informed psychiatric nursing practice and medical care (Jackson & Cawley 1992;Lustig 2009;Martindale 2007) in both community and inpatient settings internationally. It has been used in small group teaching in general nursing with student nurses (Fabricius 1991;1991b;1995;Franks et al 1994;Gilmartinpsychological forces that underlie human behavior, which emphasises the interplay between unconscious and conscious motivation (http://en.wikipedia.org/wiki/Psychodynamic).…”

“…However Allan et al 's findings (2007; under review) show that such systems may be in place but students, mentors and staff continue to experience the tensions borne out of the gap between education and practice following the move to higher education. The use of small group psychodynamic work has not been a popular approach in nursing education despite its use in medicine (Martindale 2007) and other fields of nursing (Clifford 1998;Irwin 2006). DISCUSSION I am a personal tutor to a group of undergraduate nursing students who have brought the feelings they struggle with to a monthly supervision group over the last year which I run.…”

Community-based psychodynamic group psychotherapy for treatment-resistant schizophrenia

“…He described how, listening to the patient in a therapeutic clinical setting, the clinician can identify neurotic and psychotic components in the patient's speech and facilitate a dialogue between the two. Recent interest in a psychoanalytic approach to psychosis suggests that it has a role in general psychiatry, helping clinicians to make sense of the chaotic presentation of chronic psychosis and offering the patient a space to reflect freely on their experience (Martindale 2007;Lucas 2008;Rosenbaum 2013). …”

An Early Intervention in Psychosis (Eip) Service for Adolescents: The Application of Psychotherapeutic Principles

“…According to a psychodynamic framework, we can understand psychotic experiences as occurring when the various functions of the unconscious mind become disengaged from each other. The senses, normally a source of information about the outside world, become a route by which unacceptable experiences and affects are expelled, giving rise to the characteristic perceptual disturbance, which can potentially occur in any modality (Martindale 2007). Moreover, unconscious anxieties are concretized and projected into the external world where they may take the form of unseen, but ever-present persecutors.…”

“…More extensive reviews of this fascinating area are available (Chadwick et al 1996, Martindale et al 2000, Kuipers et al 2002, Martindale 2007.…”