Constructing the sense of self in psychosis using the amniotic therapy: a single case study

Some people diagnosed with “schizophrenia” showed a fundamental alteration of the sense of self. From a psychodynamic perspective, it has been hypothesized that patients diagnosed as schizophrenic have disorders of the embodied self and its boundaries. Phenomenologically, it has been observed a self-disorder, at an implicit and pre-reflective level of bodily awareness. Neuroscientific evidence seems to confirm the aforementioned aspects. The mean levels of Interoceptive Accuracy (IA), which is an objective empirical measure of interoception, namely a measure of basic awareness distinct from subjective measures, are significantly lower in patients with a diagnosis of schizophrenia than among healthy controls. Affiliative touch is crucial for constructing a basic sense of self and its boundaries, and it affects interoception. In order to reduce the disturbance of the sense of self, Angelo participated for three years in an experimental intervention plan including Amniotic Therapy (AT) and individual psychodynamic psychotherapy. AT is a group-therapy based on sensory-motor interactions, especially affiliative touch, similar to those involved in “holding”. Results showed an increase in the Angelo’s IA and global functioning, as well as a significant decrease in positive symptoms. In Angelo, AT seems to strengthen a basic sense of self, reducing self-disorder

Sense of self and psychosis, part 2: A single case study on amniotic therapy

Some people diagnosed with schizophrenia show an alteration of the sense of self. From a psychodynamic perspective, it has been hypothesized they have disorders of the integration of self/other identification/differentiation processes. From a neuroscientific view some with this diagnosis present dysfunctions in neural correlates of representation of self from other (the implicit sensorimotor-based bodily self), and self united with other. In “Sense of self and psychosis, part 1” we discussed scientific literature offering empirical evidence for the psychodynamic clinical observations that patients with diagnoses of psychoses didn't receive adequate early infancy parental care and sufficient affective-sensorial/tactile interactions. Introducing parental care/cutaneous interactions seemed relevant in the analytic treatment of psychoses, as the pioneers of the psychoanalytic approach to psychosis suggested. From this theoretical basis we developed amniotic therapy, which reproduces the affective-tactile interactions of early infancy, insufficient in cases of psychosis, and aims at integrating the processes of differentiation and identification. We present a single case study of an experimental intervention plan including amniotic therapy. Results showed increases in interoception and global functioning, with significant decreases in positive symptoms suggesting that amniotic therapy contributes to increasing the protective strength of self-boundaries and integration of identification/differentiation processes

Sense of self and psychosis, part 1: Identification, differentiation and the body; A theoretical basis for amniotic therapy

We will describe in two articles ("Sense of self and psychosis", 1 and 2) the theoretical basis and the methodology of a new therapeutic group approach called amniotic therapy, which aims to improve the sense of self of psychotic patients. In this first article we explore the role of the surface of the body and its early sensorimotor interactions in the processes of self/other identification and differentiation. We propose that these processes have common origins, the body surface and its interactions, but different destinies, depending on where the body's surface is projected. When it is projected intrapsychically we have differentiation, and when it is projected externally onto the body's surface of the other, we have identification. Identification is a reciprocal process, in which the self's and the other's surfaces mutually contain each other and co-create a shared field. The neural correlates of identification and differentiation are discussed. The second article, which follows, describes amniotic therapy and explores a single case study