Psychoanalytic Psychotherapy (June 2003)
Volume 17, No. 2, 163–174
DIFFERENT VIEWS OF A PSYCHOTIC BREAKDOWN
– COMPLEMENTARY PERSPECTIVES OF A
BEWILDERING EXPERIENCE
SONJA LEVANDER and ANDRZEJ WERBART
SUMMARY
As humans we cope with incomprehensible and threatening
experiences by creating our own theories about what is
happening. In this study two psychotic patients and their
therapists were asked to describe the patient’s problem, its
background and preferential treatment. To get a third
perspective, Rorschach was administered to the patients.
The interviews were repeated 6 and 18 months later. The
narratives were compared and related to the outcome
patterns. The most apparent difference was found in the
theories about the cure. The Rorschach assessment was
found to complement the interviews in a fruitful way.
INTRODUCTION
Experiences associated with a first-time psychotic breakdown can be
described in different ways: from within, that is from the subjective per-
spective of the patient, and from without, that is from that of the close
environment, including the family, work colleagues, neighbours, or from
the professional expert perspective. None of the perspectives can be said to
be more or less accurate or real than the others. Each has its own value,
depending on what it is used for. The patient tries to understand and handle
the anxiety-provoking experience by putting it in the context of previous
life experiences. The care-givers, on the other hand, make observations
related to the theories of their professional education. The medical staff
mainly focus on symptoms and anamnestic information of importance for
diagnosis and treatment-planning, whereas therapists, from their particular
frame of reference, try to understand the problems and treatment needs of
the patient from what is happening in the therapeutic relationship.
Psychoanalytic Psychotherapy ISSN 0266-8734 print/ISSN 1474-9734 online
© 2003 The Association for Psychoanalytic Psychotherapy in the NHS
http://www.tandf.co.uk/journals
DOI: 10.1080/1474973031000105311
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