The History of Sanity in Contemplative Psychotherapy

A patient in therapy has two kinds of psychological history: a history of sanity as well as a history of illness. In order for healthy development to begin within the therapeutic relationship, it is necessary that both patient and therapist shift their allegiance towards the history of sanity. Landmark events in that history can be found in both developmental moments and in the current experience of neurosis or psychosis. Six types of landmarks derived from clinical experience reveal the history of sanity. The patient has periods of repulsion when feeling estranged from life and nauseated about his or her way of living. If the repulsion is not recognized as an intelligent response to the patient\u27s condition, it can degenerate into a suicidal self-loathing. The patient longs to transcend his or her stifling and constant self-centeredness. Ordinary everyday experience can provide a glimpse beyond the walled-off ten-itory of isolation. The patient has an urge for discipline, to gain some control over mind and body. Each seemingly mundane attempt at discipline carries with it the urge to work with one\u27s state of mind, by syncluonizing physical and mental activity. The patient has a longing for compassionate action. The patient\u27s regret and frustration at losing this basically human capacity is a powerful sign of his or her intelligence, although if fixating upon this the patient comes to feel less than human. There have been times in the patient\u27s life when he or she was capable of a precise sense of clarity. The patient longs for this capacity for non distraction. By being helped to track and be mindful of the wandering mind itself, the patient can again sharpen his or her sense of clarity. The patient has demonstrated courage in daily confrontation with fear and punishment within the thoughtworld of psychosis. If others do not support this courage, the patient may lose confidence and abandon himself or herself to illness. It is essential for client and therapist to learn to recognize and protect these six landmarks of sanity. The author discusses particular applications of the history of sanity to the therapeutic relationship, and shows that the therapist\u27s path of training parallels the patient\u27s path to recovery

Minimal-medication approaches to treating schizophrenia

UK guidelines for treating people diagnosed with schizo phrenia currently emphasise the primacy of antipsychotic medication, with or without psycho-socially based interventions as circumstances dictate. We now see increasing calls, most notably from mental health service users, for the provision of ‘whole-person-based’, minimal-medication approaches to treating people with this diagnosis. This article is intended to locate the development of such approaches within the history of modern and pre-modern psychiatry and, in doing so, summarise the available evidence base that underpins their efficacy