www.isps.org
THE INTERNATIONAL SOCIETY FOR THE PSYCHOLOGICAL TREATMENTS OF THE SCHIZOPHRENIAS AND OTHER PSYCHOSES
Vol. no. 9 - Spring Issue 2005 ISPS - activity all time high!
people out there think that it is of no conference are well underway. value to offer "talking therapies" to Manuel and the other local organisers Dear members and people suffering from schizophrenia! have received more than 50 sugges- friends of the ISPS In Madrid next year we will have a tions for symposia, so we can already debate on that, and in the General at this stage promise you an exciting assembly of the ISPS in the same professional (and personal) experi- The activity in ISPS' local chapters is meeting, we will discuss the name of ence when you go to Madrid. flourishing, with national symposia the organisation. I think we should So, what else keeps the board occu- being held in many of our membership allow ourselves sufficient time to think pied? We try to support the develop- coun-tries, as you will see from this this through. The General assembly should make some recommendations ment of local groups, release new edition of the newsletter. The activity for the new 2006-board, and the final books in the ISPS book series, struggle on the web-based discussion lists is also decision be taken in 2009. with how to make a financial basis for on a "historical all time high", thanks our organisation, among other things. to Chris Burford's never ending energy Time flies, and soon it will be 2009.... As we are now getting close to the and enthusiasm. One hot topic this To organise a big international confe- Madrid meeting, people should start spring has been the future name of rence like the ISPS international sym- thinking about candidates for the next our organisation; a broad variety of posia needs a lot of work and prepara- board. Suggestions can be made to suggestions have come up, and the tion. Countries/ cities interested in the ISPS secretariat, and we really hope views differ on whether we should keep hosting ISPS 2009 now should make to see a lot of activity and engagement the concept of schizophrenia in. their bid to the board, so that every- around this process. thing can be ready for presentation in The concept of schizophrenia and its Madrid. As I am writing this, the first warm clinical and research validity and use- spring days are coming to my part of Another very important task for this, fulness is very much questioned, both the world. For those of you situated and the next board, will be to consider within ISPS-circles and in the broader on the northern hemisphere, I share mental health community. The major the ISPS promotion of a journal on the psychological therapies of psycho- your wishes for a long and warm question that needs to be addressed sis. Some journal experts have been summer. For you in the southern parts is: who will highlight the connection consulted about the first steps and the of the world, I hope winter will treat between schizophrenia and psychothe- board intend to have a proposal ready you well! rapy/psychological treatments if not for the Madrid conference. And, as Best wishes the ISPS? We should bear in mind you will see from elsewhere in this Jan Olav Johannessen when discussing this that a lot of issue, the preparations for the Madrid Chair
WELCOME TO MADRID SPAIN
13 – 16 JUNE 2006 newsletter
Editorial Objectives of ISPS O n nce again the ISPS newsletter shows the ISPS secretariat development of ISPS as a worldwide organisation The ISPS secretariat is a link between our with meetings and local groups in an increasing members and the executive committee; Promote the appropriate use number of countries. On the front page our maintaining the website, printing and of psychotherapy and psycho- chairman Jan Olav is telling about exciting plans distributing the ISPS newsletter, keeping a logical treatments for persons and challenges that the board is preparing for database of ISPS members and local groups, with schizophrenias and other discussions and decisions on the ISPS congress in and answering any queries for information psychoses Madrid in June 2006. and other services. The secretariat is partly hosted by the Centre The newsletter and the ISPS website www.isps.org Promote the integration of for Psychotherapy and Psychosocial are giving you information about these exciting psychological treatments in Rehabilitation of Psychoses (SEPREP), a non- developments, as well as about ideas, experiences, treatment plans and compre- commercial Norwegian foundation and meetings and books that may be useful to you in hensive treatment for all network of users, clinicians and researchers your involvement to promote psychological treat- persons with schizophrenias promoting psychological treatment of the ments of psychoses. But the newsletter and the and other psychoses psychoses. In addition, Antonia Svensson in website are also open for more local groups and Athens works part-time as ISPS Organiser and members to share their ideas and experiences with Promote the appropriate use does most of the work of the secretariat that others! of psychological understanding and psychotherapeutic can be done electronically. Antonia can be In this issue of the newsletter we are starting a series approaches in all phases of contacted on the [email protected] email address. of brief biographical sketches of honorary life time the disorders including both Address to the ISPS secretariat members of ISPS. These persons have been major early in the onset and in longer contributors to the ISPS as a network and a society, lasting disorders ISPS c/o SEPREP, Jernbanetorget 4 A, as well as to the field of psychological treatments N-0154 Oslo, Norway of psychoses. It is important to be reminded and Promote research into Tel +47 23 10 37 77 / Fax +47 23 10 37 79 inspired by their work, and it is important for new individual, family, group E-mail: [email protected] Website: www.isps.org members of ISPS to get some knowledge about the psychological therapies, Bank account: 5005 06 56648 preventive measures and other roots and development of the ISPS. Den norske Bank, Oslo, Norway psycho-social programmes for The majority of the ISPS members are members those with psychotic disorders ISPS honorary life time members through their local ISPS groups or chapters, which • Yryö Alonen, Finland is in agreement with the decision of the board to Support treatments that put emphasis on the importance of local groups include individual, family, • Gaetano Benedetti, Switzerland with locally active members as the main basis for group and network approaches • Johan Cullberg, Sweden the organisation. and treatment methods that • Murray Jackson, UK The board now also wants to engage institutions are derived from • Jarl Jørstad, Norway and other organisations in promoting the same psychoanalysis, cognitive- objectives by signing up for institutional member- behavioural, systemic and • Julian Leff, UK ships. We encourage our members to make known psycho- educational • Christian Müller, Switzerland approaches to institutions and organisations that they in this • Barbro Sandin, Sweden way may support psychological treatments for psychoses, and at the same time open another Advance education, training • Harold Searles, USA and knowledge of mental channel for making their own work and events • Helm Stierlin, Germany health professionals in the known. Torleif Ruud psychological therapies • John Strauss, USA Editor • Lyman Wynne, USA The ISPS executive committee 2003 – 2006 ISPS board elections 2006 • Jan Olav Johannessen (Norway) It will be time for ISPS board elections once again in 2006. • Brian Martindale (UK) In accordance with our constitution, the board has chosen • Patrick McGorry (Australia) an election committee to oversee the elections. • Ann-Louise Silver (USA) This committee consists of: • Lyn Chua (Singapore) Ann-Louise Silver, Brian Martindale, Manuel González de Chávez Menéndez, Ivan Urlic and Jan Olav Johannessen. • Manuel Gonzalez de Chavez (Spain) The method of voting will be clarified in the next months. • Ivan Urlic (Croatia) ISPS members are now invited to nominate persons to • John Read (New Zealand) stand in the elections. Nominations must be proposed and seconded by sub-scribing ISPS members, may be accom- Co-opted board member: panied by a supporting statement, and should be emailed • Torleif Ruud (Norway). to Antonia Svensson, ISPS Organiser. Email: [email protected]
2 Vol. no. 9 - Spring Issue 2005 newsletter
“YOU PARTICIPATE” Dear friends, on behalf of the organizing committee of the ISPS Madrid 2006, I want to thank you for your participation in the next ISPS Congress which will undoubtedly be the largest world event ever dedicated to psychotherapies of the psychoses, up to the year 2009. We have received a large sum of pro- with presentations of any type accepted According to the estimation of our posals for all the main sessions of the by the scientific committee of our con- professional organizers, Viajes Iberia congress: more than 30 workshop gress, we offer grants that reduce regi- Congresos, our participation in Decem- abstracts and 50 abstracts for symposia stration by 50%, with an application ber of this year will exceed 500 abstracts and debates. These have come from form. This information is included on and about 1500 persons will attend all the continents, from all the pro- the website and those who believe they the Congress. We predict it will be a fessions involved in this mental health meet the conditions for this should great XV Congress of the ISPS. As with field and from practically all the aspects contact our Technical Secretary. all large Congresses, ISPS MADRID of the psychoses and psychothera- The information and application form 2006 must have few plenary sessions, peutic approaches, techniques and for the Feinsilver Award is also on the but it will have great variety of inter- modalities. website. This award was established by ventions and subjects parallel sessions, We have also received abstracts from David Feinsilver, founder of the ISPS with workshops, symposia, posters, family and user associations and some US, to facilitate participation in our presentations, conferences and debates outstanding members of these are di- symposia by those persons with meri- to communicate, learn and exchange rectly involved and committed, form- torious studies and low economic means. experiences and knowledge in those Lodging and travel costs will be paid ing a part of our organizing committee. that may interest us most in our field. for the person receiving the award. We want these family and user associ- As with all large Congresses, each per- ations to have an active presence at The new web page of ISPS MADRID son attending can design a timetable our congress and also in the demand 2006 already permits online registra- of his/her preference for each day. tion to the congress. It also allows you for greater quality and better health To be able to admit such a large num- to become a member of the ISPS care and social services and in the ber of participations, the ISPS Madrid before registering and thus you will therapeutic and rehabili-tating pro- 2006 will begin on the afternoon of benefit from, with the payment of the cesses and programs dedicated to those June 12, 2006 and end on July 16 in annual fee, a lower Congress registra- who suffer psychotic problems. the afternoon. People who have been tion fee, which is economically more All the proposals accepted and evalu- working with patients with psychotic favorable for ISPS members. ated favorably by the scientific committee problems in different parts of the world are included in the initial program that Of course, the period to present oral will have many opportunities to meet we will begin to print and distribute in communications and posters is still and make contact with each other. May and June 2005 and on our updated open until December 15, 2005. We website, www.ispsmadrid2006.com. On have already received, in April 2005, this website, you can also find infor- more than 130 abstracts, mostly sympo- mation about the Congress registration sia and workshops. Having already en- 50 years 2006 fees, with a reduced fee for members ded the period for submitting principal of the ISPS and for non-professionals sessions, proposals for oral interventi- ons and poster type presentations con- who are members of family and user We will celebrate the 50th Anniversary associations. tinue to arrive. The Scientific Committee will begin to examine them and will of the ISPS together, giving out a book For professionals with a low income chose the best evaluated oral presen on our history and our symposia, and and those from developing countries, tations as conferences of the Congress. a plenary session of homage to our founders and honorary members of the ISPS. We are already participating and will participate with them next year in the most important Inter- national congress dedicated to Psycho- therapies of the Psychoses ever.
Manuel Gonzalez de Chavez Chairman ISPS Madrid 2006 Auditorium and Meeting room ISPS venue Madrid 2006 Vol. no. 9 - Spring Issue 2005 3 newsletter Auckland
NORTH ISLAND Report from the 2nd Annual Making Sense of Psychosis Conference NEW ZEALAND Auckland University Conference Centre, New Zealand October 18th to 19th 2004 SOUTH ISLAND The conference was remarkable in at Ron made it clear that, if our services are to move least four important respects: towards a recovery paradigm, they need to respect clients’ rights to self-deter-mination and provide Firstly, the occasion marked the establishment them with genuine treatment choices and follow of the New Zealand branch of ISPS, the steering up options. Path-ways to exit services must be made group also being the conference organising clear. committee: John Read and Jim Geekie (clinical Ron’s workshop provided a fascinating in-sight into psychologists); Mike Ang and Patte Randall (psychi- the practice of voice dia-loguing. Although the atrists) and Dale Rook (occupational therapist). Ron Coleman preparing to give his voices may not always be eliminated, the client can keynote address on hearing voices, the cultural and professional diversity own their voices rather than be owned by their entitled Moving from maintenance Secondly, to recovery: Making the case of the speakers ensured a multi-layered perspective voices. Self-esteem and quality of life are, thereby, on the complex and multi-dimensional problem enhanced. of psychosis. Issues such as aetiology, treatment, Jim Burdett and Jim Geekie outlined their inno- service delivery, recovery, the role of the professio- vative philosophical approach to working with nal and the empowerment of the client were psychosis in groups. They demonstrated how the addressed in a richly textured fashion. The empha- Socratic exploration of the parallels between the sis was upon understanding symptoms and difficul- crisis of psychosis and crises in philosophy help ties within the con-text of the client’s subjectivity clients to appreciate the connection between their and lived experience. own experience and the human condition. Melissa Taitimu (left) whose talk was entitled Psychosis and spirituality: Cindy Mokomoko and Craven Te Au Maori understandings of extra-ordinary Thirdly, it was recognised that a holistic and described Whanaungatanga, a model of practice experiences and Vanessa Beavan who person-centred approach must be at the heart of presented her research on Angels at reflecting Maori cultural values, wherein alienation any genuine recovery process. Equally, it was recog- our Tables: New Zealanders experiences is addressed and motivation enhanced through of voice-hearing nised that a one-dimensional medical model that the bonds of social cohesion. elevates biological considerations to pre-eminence and devalues psychological conceptualisations and Jeffrey Masson delivered an insightful address on approaches, thereby, reducing the range of treat- how the minimisation of childhood trauma, in the ment choices available to the client, is not a work- early development of psychoanalysis, contributed able recovery paradigm. to objectification of clients by abstracting them from their lived experience and reifying the notion Finally, the courage and openness with which of a disordered mind to explain their problems. Occupational therapist Dale Rook (left) some of the participants discussed their own per- John Read paid a moving tribute to the inspirational and psychologist Jim Geekie, members sonal experience of psychosis and recovery, focused life and work of Loren Mosher. In so doing he of the ISPS NZ steering group who organised the conference the conference on the necessity of a person-centred spoke of his collaboration with Loren and Richard paradigm. All of the presentations reflected in Bentall in planning and editing the new ISPS book, some way the above themes: Models of Madness. This work provides a scholarly Ron Coleman, a leader in the Voice Hearing Net- and highly readable analysis of the theoretical and work in the UK, gave the first keynote address on research foundations for psychological conceptuali- the concept of recovery and closed proceedings sations and interventions for schizophrenia. Sadly, with a workshop on dealing with the voice hearing it was to be one of Loren’s final projects before his death last July. experience. Debra Lampshire (left) and Miriam Loretto, on their way to presenting Ron made the point that many of the existing ser- Patte Randall, captured the mood of the conference when she spoke of the hope that can be generated their Hearing Voices group, which is vices in the first world are based upon maintenance informed by their own experiences by framing psychosis as a spiritual emergency. So of voice-hearing. rather than upon recovery models. Maintenance often there are spiritual themes in psychosis and models reflect the belief that clients do not recover, so often their relevance to the identity of the person that the best that can be hoped for is symptom ma- is over-looked in the clinician’s determination to nagement and ongoing treatment for an unspeci- assign a diagnosis or apply a particular theoretical fied period, possibly for life. Within such models, model. Human spirituality is enduring. It is a recovery rates are around 33%. By contrast, in resource that is too often unexplored and under parts of the third world, where spiritual leaders utilized by professionals. and professionals believe the client will recover and, where medication is not employed, the Negotiating the labyrinth between psychosis and recovery can take a long time. For some, there are Cindy Mokomoko (left) & Craven Te Ua recovery rates can be as high as 86%. after their lecture on a Maori model Cont. next page, bottom of service delivery
4 Vol. no. 9 - Spring Issue 2005 newsletter
John Read, Loren Mosher and Richard Bentall, in Models of Madness, have thrown down the gauntlet. I and the rest of my psychiatric colleagues can no BOOK longer arrogantly dismiss as naïve their well- reasoned arguments for the experiential origins of mental disorder. Instead, we must work to review reconcile our philosophical positions and, more importantly, our clinical practices, with this book’s powerful implications. training presented as “Truth”. In my opin- Models of Madness ion they succeed in seriously undermining suddenly Edited by: John Read, Loren Mosher, the concept of schizophrenia and in obvious. I find and Richard Bentall demolishing the contention that ECT is myself embarrassed by my benign. I’m less moved by the anti- anti- historical resistance to this idea. Publisher: Brunner-Routledge, psychotic arguments, while acknowledging Hove and New York. 2004 I suggest that sensitive clinicians begin at that I frequently prescribe these medica- Chapter 11 and save the passionate criti- tions. After absorbing the authors’ criti- cisms of the first ten chapters for the end. When I first arrived in New Zealand in cisms, however, it’s difficult to regard medi- Once exposed to the arguments supporting 1999, I quickly became angry with and dis- cations as more than partially successful, the “bad things happening” model of missive of John Read’s opinions as relayed costly adjuncts to psycho-social inter- causation and the implications arising from to me by my disgruntled colleagues. He ventions. it, I expect that the critique of the biological was characterised as profoundly “anti- After vilifying the biological model of the model will be more palatable. psychiatry” and I initially felt defensive and causation and treatment of psychosis, the hostile. As I have become more familiar The Mental Health Commission has book proceeds in the middle-third to argue recently begun an initiative to explore the with John and his ideas, my scepticism has that psychosis is caused in large measure subsided. approaches taken in New Zealand to the by bad things happening in both childhood assessment and treatment of trauma. I Still, I understand some of the resis-tance and adult life. Without any hint of blaming would like to suggest that the challenges of my colleagues. John doesn’t make it families, various authors very convincingly posed in Models of Madness serve as a star- easy. As the editors admit in Chapter 1, explore the impact on the developing child ting point for a national discussion of the “We have not attempted an even-handed, of childhood trauma, poverty, gender, and future directions of mental health services. ‘objective’ approach…. what is required is familial emotional and communication a balancing stance rather than a balanced styles. Thomas Rudegeair, M.D., Ph.D. one.” Clinical Director Te Whetu Tawera - Finally, the last-third of the book explo-res Psychiatric Inpatient Unit Auckland Hospital, Models of Madness is a bitter pill for psychia- a range of interventions consistent with 10th January, 2005 trists to swallow. The first-third of the book the assumption that bad things cause exposes psychiatry’s historical failings and psychosis. The most powerful appeal comes (My opinions are my own and do not necessarily then attacks its sacred cows – schizophrenia, from Judi Chamberlain, an American pio- reflect those of the Auckland District Health Board) ECT, and anti-psychotics. The authors are neer in the develop-ment of “user-run N.b. This book review has also appeared in the February not polite, but their arguments and explo- services”. The idea that people who have edition of Mental Notes - a bi-monthly publication by ration of the supporting evidence are grappled with serious emotional and cog- the NZ government body the Mental Health powerful. They have challenged me to nitive problems are in a powerful position Commission. reconsider much of what my psychiatric to support their struggling peers seems
Cont. from last page Auckland too many locked doors barring the way and it takes too long. The Making Sense of Psychosis Conference inspired us to search high and low for the keys to those doors, not by ourselves in our labs, nor alone at our desks but, with our clients, for it is they who have been on the journey and who know where the keys are hidden. Dr. Nicholas Marlowe, Clinical Director The Macquarie Street Psychology Centre Sydney, Australia [email protected] The 3rd annual Making Sense of Psychosis Conference will be held in Auckland on the 18th and 19th of October 2005, with U.S. psychiatrist Dr Colin Ross as the keynote speaker. For further information email [email protected] and keep an eye on the ISPS website www.isps.org Vol. no. 9 - Spring Issue 2005 5 newsletter ISPS honorary lifetime members Biographical sketches
Yrjö O. Alanen NORWAY
Yrjö O. Alanen is one of the professionals who has helped SWEDEN FINLAND RUSSIA shape the history of schizophrenia, its understanding and its Kurikka global, flexible approach adapted to the needs of patients. Turku Helsinki
MANUEL GONZÁLEZ DE CHÁVEZ mics of schizophrenic patients, leading to schizophre-nic patients in Finnish mental rofessor of Psychiatry (Emeritus) Yrjö P the monographs The Mothers of Schizo- hospitals had diminished about 60 per cent Olavi Alanen was born Jan. 31, 1927 in phrenic Patients, 1958; and (together with over 10 years. In the 1980s and ‘90s Alanen Kurikka, Finland. He got his M.D. degree also led, together with Endre Ugelstad and in the University of Helsinki in 1952 and co-workers) Family in the Pathogenesis of did his specialist training in psychiatry and Schizophrenic and Neurotic Disorders, other Scandinavian colleagues, the NIPS neurology in the Psychiatric University 1966. These studies already included (Nordic Investigation on Psycho-therapy Hospital in Helsinki from 1954 to 1957. features of integrated views, typical to of Schizophrenia) project, aiming to pro- He was appointed to senior level clinical Alanen’s later theoretical and clinical ways mote psychodynamically oriented study positions in this hospital from 1958 to 1968, of thought. In 1959-60 he was Research and treatment of new schizophrenic pati- after which he was appointed Professor of Associate in Yale University Dept. of ents within the community psychiatric Psychiatry and Chairman of the Depart- Psychiatry in New Haven, Conn., U.S.A., context (cf. the book Alanen et al.: Early ment of Psychiatry at the University of working in Theodor Lidz’s team. In 1979 Treatment for Schizophrenic Patients; Turku, Finland. This position also included he received the seventeenth annual Stanley Scandinavian psychotherapeutic approac- the chairmanship of the Department of R. Dean Research Award, given by The hes; Oslo: Scandinavian University Press, Psychiatry and clinical work as Medical American College of Psychiatrists and The 1994). He is also one of the editors of the Director of the university hospital The Fund for the Behavioral Sciences in recog- book Psychotherapie der Psychosen; Inte- Clinic of Psychiatry of Turku. He retired nition of basic research accomplishment grative Behandlungsansätze aus Skandi- in 1990, however, since then he has con- in the behavioural sciences contributing navien (V. Aderhold et al., eds, Giessen: tinued his professional work as a psycho- to our understanding of schizophrenia. Psychososozial-Verlag, 2003). therapist and teacher, dedicating more time than previously to writing and editing In 1971, Yrjö Alanen organized the IVth In 1982-84 Alanen acted as the chair-man books in his field. ISPS symposium, held in Turku, Finland. of the Committee of Mental Health in Fin- After that, he was a member of the inter- land, aiming at the innovation of the activi- lanen had already begun his personal A national executive comm-ittee of the ISPS ties to a more open care-oriented direction psychoanalysis in 1955 and was one of the until 1997. He is a lifetime honorary and to end the separation of psychiatric first candidates for psychoanalytic training member of the ISPS. organizations from the organizations in- after IPA training became possible in Fin- cluding other medical specialties. The land in 1965. He became a member of the In Turku, Alanen, along with his co- proposals of the Committee led to a new Finnish Psychoanalytic Association in 1969. Mental Health Act, enacted in 1991, after His main interests has been the psycho- workers, established the Turku Schizo- phrenia Project, which led to the de- the establishment of an Act joining the dynamic study of schizophrenic psychoses organizations for special health care to- velopment of the now well-known and individual and family psychotherapy gether. From 1982 to 1985 Alanen also of schizophrenic psychoses. He instigated need-adapted approach, an integrated held the position of Research Professor, the first regular family therapy training in and individualized psychotherapeutically Academy in Finland, coinciding with his Finland in 1979 and acted as a member of oriented treatment of schizophrenic pati- work as the leader of the National the first trainer group in family therapy. ents, leading to several later projects and Schizophrenia Project. This training soon became very popular practice in Finland and in the other Scandi- and more extensive in different parts of navian coun-tries. This approach and its Yrjö Alanen is an honorary member of 9 Finland because, among other things, of results are presented in Alanen’s major scientific and/or professional societies, its multi-professional quality. Family thera- work, the book Schizophrenia – Its Origins including – besides the ISPS – the Finnish, py training was also later established at an and Need-Adapted Treatment (London: Kar- Swedish and Polish Psychiatric Associations advanced special level. In the 1990s Alanen nac, 1997), which has also been published and the Euro-pean Family Therapy Associ- joined his closest working pupils and co- in Finnish (1993), German (2001), Polish ation. His special interests have included workers Viljo Räkköläinen and Jukka (2001), and Spanish (2003). During the cross-country skiing and still include, Aaltonen in the establish-ment of the ad- 1980s, he was the leader of The Finnish especially, literature (he has published two vanced special level training program in essay books in Finnish, one of them dealing psychodynamic individual therapy of National Schizophrenia Project, which with Dostoyevsky’s The Idiot and The De- seriously disordered patients. aimed for a more psycho-therapeutic and humanistic treatment of psychotic patients. vils). He is married to Johanna, née Aalto, According to the follow-up in 1992, both has four children and six grandchildren. Among other things, Alanen’s early studies the amount of “new” and “old” long-term dealt with family environments and dyna- Cont. next page, bottom
6 Vol. no. 9 - Spring Issue 2005 newsletter ISPS honorary lifetime members Biographical sketches
John S. Strauss ANN-LOUISE S. SILVER John S. Strauss is a warm and that they, too, had had such experiences. As the discussion evolved, John felt that gentle man and a scholar, a he and the “other” patients were allied prolific psychiatrist researching against the defensive professionals, and persons suffering from severe that there never was resolution. mental disorders. His over 200 John was born in Cleveland, Ohio in 1932. He earned his B.A. degree with high hon- scientific papers address issues of ors at Swarthmore College, majoring in diagnosis, course of disorder, and psychology (Swarthmore’s t-shirts read “A ‘B’ here would be an ‘A’ anywhere the processes of improvement. else.”) He earned his M.D. at Yale and then was a special student with Jean Piaget in on effective research into schizophrenia. He emphasizes the role of the person with Geneva, Switzerland. He then studied He stresses that occupational rehabilitation mental disorder as a person in the struggle community psychiatry at the Washington is not an ancillary part of treatment but is to recover, and understanding in depth School of Psychiatry. He was a resident in a central part of the recovery process. Pati- the subjective experiences of people with medicine and then in psychiatry at the ents often tell him, “When I work, I don’t severe disorder. These experiences provide McLean Hospital and Beth Israel Hospital hear voices.” As people recover from psych- crucial data for understanding and treating in Boston, then worked at the National osis, they talk about reintegration and the the basic processes involved in disorder Institute of Mental Health from 1964 to sense of finding out who they are; they talk and recovery. 1972. After a stint at the University of about resolving conflicts about goals. Rela- Rochester, he settled in at Yale, where he tionships are central to the recovery pro- John Strauss represents the best in pheno- has worked since 1977. Since 1985, he has cess, not just relationships with professio- menological research into severe mental served as Director of the Center for Studies nals, but with their fellow humans in gene- disorders. He does not turn his research of Prolonged Psychiatric Disorder, Connec- ral. He chides the profession, reminding subjects into the objects of study, but tries ticut Mental Health Center, New Haven, CT. us that recovering patients routinely say unstintingly to feel his way into their way how rare it is to find a doctor who took of being, to imagine his own struggle to He was a Collaborating Investigator in the them seriously. He still is working over a regain sanity, to imagine the moment-to- World Health Organization’s historic com- patient’s challenge to him: “Why don't you moment pain caused by these alienating parative research in schizophrenia, and ever ask me what I do to help myself?" He afflictions. Thus he sets an example not has served on many scientific councils in- says, "This is a very heterogeneous disease only as a prolific researcher but as a strong cluding the Veterans Administration on with a very heterogeneous outcome. therapist. Listening to his talks (he was the Rehabilitation Research in Mental Health, There's been a tendency to dehumanize keynoter for the ISPS-US annual meeting the Scientific Council of the National Alli- and depersonalize schizophrenics, but in Philadelphia in 2004), we felt we had ance for Research on Schizophrenia and that's bad science, and bad for everyone known him for a long time, a valued friend Depression (NARSAD) and the Society for involved. I've interviewed many patients, for years. He let us into his thinking and Life History Research in Psychopathology. and I can tell you that we're talking here feeling. He described the time when at a He has received many grants from NIMH about people with goals who are struggling large conference he had role-played a pati- and other granting agencies, mostly on to make sense of life. I don't know any ent and found himself utterly deflated and schizophrenia, including the processes of basket cases." sullen, unable to continue talking with the improvement. He has never lost sight of interviewer. The interviewer had asked the person struggling with the disorder. For over a decade, John has hosted writing him about work, and John started telling groups in various countries, supporting about his new job at McDonalds. The inter- John Strauss is worldly, living part of each people writing about their work with pati- viewer wasn’t interested in the details but year in France, traveling often to Scandi- ents. His one strict rule is that negative moved on to the next question. It took a navia, his works translated into French, remarks are forbidden; he finds that the while for John to realize that he became German, Norwegian and Japanese. He says problems in the writing drop out by them- silent because he felt hurt and angry. The he has combined French phenomeno selves. This would be a great rule by which few patients in the audience all responded logy with American pragmatism in his views all therapists of psychosis should abide.
Cont. from last page of all the professionals, of the creation of Finland exemplary for the organization of rjö Alanen has had a complete life of Y early psychotherapeutic and familial inter- public services worldwide. From the city lucidity, dedication and devotion. He inves- vention teams, of the development of inte- of Turku to the rest of Finland, from Fin- tigated the familial dynamics of psychotic grated therapeutic programs and of the land to the other Scandinavian countries patients while establishing the most effec- investigation of the results of these pro- and to many other parts of the world, the tive familial and individual psychothera- grams on improvement or overcoming of figure and the work of Yrjö Alanen has peutic strategies and interventions and the psychotic disorders. had a decisive influence and has been a global health care devices that these pati- great example for many professionals in ents require for their recovery. He took As the leader of Finland's National plan our field. charge of the psychotherapeutic training for Schizophrenia, Alanen has made Vol. no. 9 - Spring Issue 2005 7 newsletter ISPS honorary lifetime members Biographical sketches Johan Cullberg It is difficult to find a perspective that will catch the scope of what has constituted Johan Cullberg´s professional life – thus far. Every aspect seems to touch upon the other. By Sonja Levander
PHOTO: ULLA MONTAN PHOTO: shocks and insulin treatments. Even if his brother The following book, ”Psychoses”, is as exciting in many respects faded away slowly as a person, as a novel, and has surely tempted many students he is still active and recognized for his artistic to start working in psychiatry. He gives psycho- painting. Having lived with this pain for the main dynamic explanations of the background to the part of his life, Johan has fought for a more de psychotic condition, and demonstrates how the cent treatment of psychotic patients. He has compulsory measures can be replaced by respect claimed the need for lower doses of antipsychotic and kindness. But it also leaves space for much medicine and a reduction in the use of compul- that is still to be understood about these condi- sory treatment. On the whole he has wanted the tions, especially the vague concept of schizophre- psychiatric care to take a more humane direction. nia, which probably covers a lot of different states of mind. Of course it has kindled a hope in many patients and their families, when a person from the psyc- Later he widened his perspective to the literary hiatric establishment took sides with the patients: field and has written two so called psychobio- He started his career at the department of gyn- But the disappointment has been equally strong, graphies. In his eagerness to try to understand aecology at the Karolinska Hospital: The psycho- when it turned out that he had kept his belief more about the psychotic process, he grappled logical effect of contraceptive pills. Somewhat in neuroleptic treatment in adequate doses and with three Swedish authors: Stig Dagerman, who later he interviewed 60 women who had lost their in the existence of biological factors as the main committed suicide, and August Strindberg and child during delivery, a study which he used for determinants of schizophrenia – even if he is a Gustaf Fröding both of whom became psychotic. his dissertation. These narratives from women psychoanalyst. For him the psychodynamic under- From a psychodynamic perspective he reads their in crisis helped him to fully understand that it standing is indispensable, but it is not really an texts, supplementing them with outside informa- is not only a painful period that has to be lived alternative when it comes to the treatment of tion about their lives and excerpts from their through. It is also, in fortunate cases, a starting psychotic patients. What we read about in the psychiatric files. In describing their existential point for a process of maturation that opens up literature are single case reports that he believes situations he digests it into portraits of human for insights not available previously. This experi- are exceptional. beings of flesh and blood, who in their literary ence is described in his book: “Crisis and matura- works have tried to understand their problems. tion”, which was published in 1975, a book which He has discussed his opinion that it is necessary has contributed to the general understanding to integrate the biological with the psychodyna- The last ten years of research have been domi- of the crisis experience. He points to the impor- mic approach in open debates and in the scien- nated by his work with the ”Parachute Project” tance of coming to a stand still to be able to look tific press. But the ambivalence to his integrative – an expression of his wish to understand what at the catastrophe in a personal life context. endeavours has appeared when at times his con- factors are of importance for the psychotic break Many unfortunate individuals will eventually tributions have been passed over in silence or down and for the outcome. First of all, however, come out as stronger and more mature persons. have been considered unrealistic. This was parti- he wanted to demonstrate that it is possible to cularly clear when they were nominating a candi- make to make psychiatric care more humane by At that time Johan Cullberg also became the date for a professorship, which according to considering the patients’ individual needs. head of one of the outpatient clinics in the Nacka many people was intended for Johan Cullberg, Important research questions have been: What project, one of the first areas in Sweden to focus and he was disregarded. Many were very upset. distinguishes those of the 175 patients who had on psychiatric care outside the hospital. He took When asked about it Johan himself thinks that a good outcome from those who never were able special interest in the interplay between the indi- the academic debate in Sweden is polarized and to return to their prepsychotic life? And what vidual patients and their close environment. simplified. (Some ten years ago, however, he was did it mean to them that instead of noisy and Medicine and hospital care came second, and warded an honorary professorship). messy hospital wards they stayed in quiet, small, normalization was at the centre of his interests. homelike units – mostly outside the hospital? Later he became the head of the research unit During the eighties and the beginning of the Especially he wanted to find out the consequen- of the project where he more systematically stu- nineties he worked clinically at the same time ces of offering lowest effective doses compared died the environmental effects on mental health. as he continued formulating his experiences in to minimizing symptoms by using high doses of He wrote about the anomic milieu; its alienating writing. It was for him a matter of course to con- antipsychotics, often with heavy side effects. The effects and how it tends to deprive people from vey to others what he had seen and thought project is going to be presented at the ISPS getting enough confirmation of their human about psychiatric conditions, their background conference in Madrid 2006. dignity to allow them to go on. Most people who and treatment. First of all medical students have live in a suburban environment find ways to over- been his target group, as he sees them as central Johan Cullberg has said that he more and more come this, but it is harmful for those who are when it comes to a change of Swedish psychiatry. has adopted a view of the human being as one vulnerable. Johan Cullberg wanted to understand He wanted to write study literature from the who has to take responsibility for her life, irre- what conditions in society have to be changed subjective and objective perspective as well as spective of her psychological problems. After all, to make the interaction more positive. the biological, the psychological and social, each one has to believe that no one can change being the necessary condition for the others. another person who is not willing to change. During these years he was also engaged in the What kind of life does our patient want to live? situation for the patients who had to be confined His next book, “Dynamic Psychiatry”, is a far- What kind of person does she want to be? Those in the hospital ward – especially those who suffe- reaching text-book that covers psychiatry as a of us who have chosen to try to help those who red from psychosis. This had a special meaning whole. At the same time it gives place for personal seek our help, first of all have to support her in for Johan Cullberg as one of his brothers became vignettes including empathy and understanding, reaching the goals she has set for herself. We schizophrenic and was locked in a hospital ward it gives directions as to medication and diagnostic are not there to cure or correct other people to and treated with hundreds of electroconvulsive considerations. make them fit our model for a normal person.
8 Vol. no. 9 - Spring Issue 2005 newsletter FRANCE
SPAIN X Annual Course of Schizophrenia PORTUGAL of Madrid 2004 Madrid The X Annual Course of Schizophrenia, that was on Psychotherapies and Early interventions in schizophrenia, led to an enormous expectation by professionals from all over Spain and Portugal. More than 600 persons attended and there were interesting debates and reflections on the interven- AFRICA tions, considering the limited resources and few early intervention programs existing in Spain and Portugal. By Isabel Rodriguez Gorostiza The attention given to the presentations by the therapeutic approach of the first episodes in the foreign professors, and especially the development General University Hospital “Gregorio Marañón” of health care policies that allow for the implemen- of Madrid, where a program of combined therapies, tation of early approach and preventive programs mainly group and with integrating perspective, are of psychosis stood out. conducted. The first one referred to the specific characteristics of group therapy and its benefits in In the first place, among the foreign invited speak- the first psychotic episodes. Dr. García Cabeza pre- ers, Professor Jan Olav Johannesen presented the sented the comparative results of treat-ment course principles and objectives of the ISPS to the Spanish in patients with first episodes after six years in com- public and then developed the bases and results of bined therapy or who receive conventional the Norwegian TIPS Program for early intervention treatment. in first psychotic episodes. He focused his interest on presenting the work being conducted in Stavan- Other Spanish professors participated in the Course. ger, Norway, to reduce the duration of untreated Professor Manuel Gómez Beneyto et al. from Valen- psychosis. cia, with a Family Intervention Program and the results of its follow-up. They supplied significant Professor Bent Rosenbaum, from Denmark, presen- data on the importance of empathic attitude of the ted the Danish Project on Schizophrenia, with his family in relapses. psycho-therapeutic interventions. He dedicated another lecture to the semiotic reflections on the Professor Oscar Vallina also participated. He collabo- origin of language and though of the schizophrenic rated with doctors Jane Edwards and Patrick Mc patient. Gorry in the Multicenter Project to assess the efficacy of cognitive interventions in prodromic phases of Another one of the early intervention projects dealt psychosis. During his lecture in this course, he ex- with in this Course was that presented by Professor plained the characteristics and initial results of his Lyn Chua from Singapore, a country where the experience in the early intervention program in religious, cultural and ethnic diversity cause these psychosis of Torrelavega, Cantabria, in the north of aspects to occupy an extremely important place in Spain. the therapeutic approach. Finally, Professor Alfonso Chinchilla, from Madrid, The intervention of Professor John Bola from Cali- presented the factors that lead us to treat or not fornia was preceded by a Homage to Professor Loren treat pre-morbid experiences of schizophrenic R. Mosher, recently deceased, which not only stressed psychoses based on his experience, giving an exten- his professional virtues but also, and especially, his sive theoretical review on it. human value. From the scientific point of view, he also presented a statistical review of the results ob- As generally occurs in the Schizophrenia Courses tained by the California SOTERIA project, in which of Madrid, those attending received a bibliographic a community approach without neuroleptics, or at Dossier with abundant documentation on the sub- least without them as the main treatment method, jects dealt with. This year, a special Dossier on showed better evolution of the patients with schizo- "homage to Loren Mosher" was also distributed. It phrenic psychosis in their initial phases versus those included the biography and most important publi- treated with a more conventional approach. cations of this tireless fighter for mental patients. The more than 600 persons attending the Course November 26th Professor Manuel González de Chávez and also received the Spanish translation of the book Professor Ignacio García Cabeza participated among by Jane Edwards and Patrick McGorry “Early and 27th - 2004 the Spanish speakers. They presented the psycho- intervention in psychosis.”
Vol. no. 9 - Spring Issue 2005 9 newsletter
Schizophrenia. Innovations BOOK in Diagnosis and Treatment By Colin A. Ross, MD Published by The Haworth Maltreatment and Trauma review Press: New York-London-Oxford, 2004, 288 pp.
“We do know that schizophrenia firm the brain disease standpoint. He con- tends that this assertion should be removed Does the author expose us to an Ame- is not caused by bad parenting, from all future guidelines for treatment of rican/Canadian problem that contrasts trauma, abuse, or personal schizophrenia. For the treatment of with our situation in Europe? I don’t think psychotic symptoms in the dissociative so, because the way psychiatrists all over weakness”. subtype of schizophrenia it is his thesis that the world score psychotic symptoms is more properly designed psychotherapy can be or less the same. In spite of an ubiquitarianUnused space This conclusive statement by McEvoy, as effective as medication. On this point DSM-way of diagnosing schizophrenia, Scheifer, and Frances (1999) has been a your reviewer has some difficulties in there are opportunities enough for alter- guideline for decades for researchers in following the sympathetic standpoint of native views, differences in and critics on psychiatry. This canonical assertion lacks Colin Ross. Why is psychotherapy only this ruling psychiatric model. references, data, analysis of the literature, meant for the dissociative type and not for or argument of any kind to support this the rest of the schizophrenic group? Colin Ross wrote a challenging book claim. Colin Ross disagrees with this state- about psychotherapeutic possibilities for ment and presents references, data, and In times of protests by professionals and schizophrenic patients. His arguments are analysis of the proposition that bad paren- patients as well against the diagnostic term concise and based on data from literature ting, trauma, and abuse are major etiolo- ‘schizophrenia’, the author pleas for a spe- and from his own research. gical factors in schizophrenia. The author cification of the diagnostic terminology in says further that this contention is an ide- this field. In Europe the criteria for the Many people will consider Colin Ross’ ological assertion, not a scientific or diagnosis ‘schizophrenia’ were more strict proposal for a psychotherapeutic treatment medical fact. then the broader interpretation of our of the so-called “dissociative schizophrenia”, colleagues in the USA. Nowadays – after a very radical point of view. For me, it This book undermines the urban legend one generation of psychiatrists got familiar would have been acceptable to be even that schizophrenia is a brain disease with with the DSM criteria – Europe has moved more radical, by including all in the direction of our American friends. a genetic basis and that the interaction “schizophrenics”. with the environment is independent of An undifferentiated group of schizophre- the start and development of this disorder. nias has been developed and Colin Ross Jos A.M. de Kroon, M.D., Ph.D. Colin Ross demonstrates in a convincing is one of the authors who see the oppor- is psychiatrist-psychoanalyst and former Head of manner that the biological basis of schizo- tunity to deconstruct ‘schizophrenia’ a Residency Training. He is a member of the board phrenia is not so grounded as professionals further in favour of a dissociative subcate- of the Dutch-Flemish ISPS and working in a private as well as laymen believe. Furthermore the gory that is merely accessible for psycho- practice. environmental influence is bigger than therapeutic interventions. generally thought. In the group of schizo- phrenias a considerable part is due to The author uses a lot of statistical arguments Do you subscribe to psychological traumata. As a consequence, and a close reading of Bleulers ‘Dementia there is a category of psychotic patients praecox oder Gruppe der Schizophrenien’ ISPS-INT information/ that is accessible for psychotherapeutic to convince the reader that he is right by discussion group? treatment. So far so good. But what about proposing a new diagnostic category. the other psychotics, the ‘core schizo- While reading this book I was getting tired The international email group ISPS-INT, of the amount of data and repeated argu- phrenics’? Are they excluded from psycho- which was set up after ISPS Melbourne ments in favour of his own point of view. logical or psychotherapeutic treatment? 2003, is available to all ISPS members. In my opinion, they are not, be it that one Suppose Colin Ross is right in concluding There are over 150 members from over method can be adjunctive to the other. that there is no biological basis for schizo- phrenia, on what else other than on pheno- 20 different countries who share This discussion puts us in the middle of menological grounds can a diagnosis of announcements and discuss current an interesting and contemporary dispute. schizophrenia be established? The DSM is issues relevant to our field. This will help Through the whole book Colin Ross argues based on arbitrary criteria and one hopes prepare for Madrid 2006. The group is that the categories cover clinical entities. against a monothetic claim that schizo- well moderated and posts are limited phrenia is an endogenous brain disease One can ask whether this enterprise can to 3 per day. If you want tojoin, email that leaves no possibilities for psychological give a fundament for a diagnostics based and psycho-therapeutic interventions. clinical practice or that it proves to be Antonia Svensson [email protected] He argues that there are no data that con- quicksand.
10 Vol. no. 9 - Spring Issue 2005 10 newsletter
Report from
by Kathy Taylor, Associate Committee Member, ISPS-UK national conference UMIST ISPS-UK Manchester 13th-14th September 2004 to promote better functioning for the per- In this session, three presenters from diffe- “Tuning into Psychosis: son with psychosis. In particular, the stance rent orientations (psychoanalytic, cognitive- is taken that the family should not feel behavioural and drama therapy) talked ways of listening, ways implicated in the causation of illness. about how they saw the differences between Audience debate raised the sharp diffe- their approaches. The audience debate of seeing, ways of being rence between this position and that of afterwards demonstrated how complemen- with” Professor Bentall, on the role of environ- tary these approaches could be, in achie- mental factors. It was dis-appointing that ving broader methods of communication Professor Barrow-clough did not discuss with those experiencing psychosis. her views on this – it felt like a missed Additional conference ingredients The national residential conference of opportunity to think about the issues raised included: ISPS-UK was successfully held last Sep- by the differing perspectives. The launch of a new nursing section tember. It was well attended by a stimulating for ISPS-UK. I heard this was very mix of mental health professionals, in- The third plenary session was presented successful. cluding a significant group of creative by Professor Vamik Volkan, from the Univer- therapists. It was also interesting to have a sity of Virginia, USA. He spoke movingly An opportunity to meet in median- number of users and carers attending, and from his experience of analytic work with size groups, at the end of the first day, there was an expectant, open and respectful psychosis, using his model of ‘the psychotic to reflect on and digest the experience atmos-phere amongst the delegates and core’. His perspective, so firmly focused of the day. This seemed to be valued, speakers. The conference facilities were on potential internal psychogenic causes and perhaps quite a powerful space in conveniently arranged, creating a welcom- of illness, seemed to be challenging for which our own needs to tune into each ing environment despite the indifferent many in the audience. I felt it was a rare other could be met. and valuable opportunity to hear from an English weather! It was Brain Martindale’s For those who were up to it, meeting last major ISPS-UK event before stepping experienced analyst who is still practising intensive work with individuals with schizo- at 8.15am on the second day for the down as Chair, and he took the opportunity ISPS-UK AGM! to set the scene, introducing some recently phrenia; it was very interesting to hear about the ways in which the patient might elected new committee members. he conference was crowned by a con- need to use the analyst, and how this might T be experienced, at a personal feeling level, ference dinner, held in the splendour of The conference programme was packed the banqueting hall of Manchester Town by both parties. full, involving three major plenary sessions, Hall on the first evening. An unexpected three workshop sessions and several other felt there was an interesting tension and early finish to dinner led to a wait for the events. I balance between the three very different return coach, during which various dele- gates, including Brian Martindale, dipped The first plenary talk was given by Professor viewpoints represented by the plenary into their repertoire of entertainment skills! Richard Bentall, of Manchester University. sessions. Indeed, perhaps it offered a firm Another human touch to this very ‘real’ He spoke from his approach, which I think 3-D structure for the conference, within conference. could be summarised as a listening perspec- which there could be space to explore different views constructively. It certainly tive, to clinical work with individuals expe- o round off the conference, a play-back seemed that a healthy diversity could be T riencing psychosis. He supported his posi- theatre group improvised the dramatisation fostered through the creative and thought- tion with findings from experimental of individual stories from experience of ful programming, and that different groups psychology, in particular focusing on the the conference. By reviewing personal could begin to learn to communicate better high co-incidence of trauma and abuse in themes emerging from the conference this with each other, something which can only the histories of those later developing involving and moving session went some be of benefit in services for psychosis. I psychosis. It was exciting and convincing way to providing that much needed bridge wondered how successful this was for the to hear an empirical, cognitive psychologist between the experiences of professionals, users and carers attending. It may be that exploring the role of environmental factors service users and carers. in the genesis of schizophrenia. His talk this was just the beginning and more work provoked some interesting debate on the needs to be done to make useful links with quality of the evidence pointing to trauma these groups. as a key causative factor. Each workshop session offered 9–10 alter- Professor Christine Barrowclough, also of native parallel talks or workshops. I found Manchester University, presented her it very difficult to choose: the quality and approach to understanding the perspective range of presentations and speakers was of relatives, from her considerable experi- very high. One stand-out experience for ence of family work. The work focuses on me was attending a workshop called ‘You current relationships in the family, in order are awful but I could like you!’
Vol. no. 9 - Spring Issue 2005 11 O C A L G R newsletter S L O U P I S P S News from ISPS Local Groups
Norway early professional life ‘biased’ him in this severity of the disturbance and ‘schizophre- direction and he has now gathered an im- nic’ symptoms. In abused psychiatric in- ISPS- Norway has been established, and pressive amount of research evidence show- patients the content of 54 % of the hallu- will have its' secretariat functions in conne- ing the role of childhood trauma and con- cinations and delusions is related to the ction with the psychiatric services in Hamar, textual factors like poverty, discrimination abuse. These findings of course have im- Norway. We made a significant surplus and social isolation in the etiology of psyc- plications for what kind of treatment will from our nationwide conference in the hosis. John pointed out that the destigma- be helpful. In Auckland John Read has autumn 2004, and have now employed a tisation programs saying “mental illness is trained his clinical staff to ask about possible a part-time secretary. We are an illness like any other” actually try to per- trauma and abuse. The important thing is establishing a membership suade people they are wrong since if you to communicate that you heard what the database currently. Trondheim ask the public about mental health pro- person said. You don’t have to get all the We have also started NORWAY blems they think it is caused by bad things information and you don’t have to fix it. planning our next Bergen Hamar happening to you. nationwide ISPS- The seminar with John Read gave us a Oslo SWEDEN Norway symposi- Stavanger John talked about the historical context profound reminder of the importance of um which will take Stockholm of the invention of ‘schizophrenia’ and considering life events and circumstances place 2nd–3rd seriously questioned the scientific require- in the treatment of patients with psychotic February 2006 in Hamar, ments for the existence of this concept. symptoms. We felt vitalized and strength- with the theme: "Det terapeutiske He also addressed the taboo of research ened by the passion and knowledge John mangfold" ("The therapeutic manifold"). into family factors and the fear of ‘family- Read so generously shared with us. blaming’. Actually it is not helpful to try Margit Olsson, psychologist at the first episode Sweden to convince families that they have not psychosis unit of the Psychiatric Clinic of On March 11th it was time for the fourth contributed to the problem because that Södertälje. annual meeting of the Swedish ISPS group. is not what they think themselves. It is a We started in 2002 and the meetings attract very contradictory message that is given New Zealand members from all parts of Sweden. A sense in psycho-educational programs when we The NZ branch was formally proposed at of friendship and belonging has been say “it’s not in any way your fault, but we the 2004 Making Sense of Psychosis confe- emerging in the group as we have been want you to change your behavior so it rence. The steering group is meeting month- exchanging experiences and developing doesn’t happen again.” ly to establish a bank account, constitution ideas. The annual meetings in the spring and to work on registering the organisation are for members only, to give a possibility with the Government. Individual member- to deepen the understanding of important ship of the local group should be ready to issues concerning psychological work with commence in April. An admin assistant, psychotic patients. The autumn meeting Melissa Tiatimu, has been employed on a is arranged outside Stockholm, inviting casual basis to assist with these arrange- other people as well to listen to some well- ments. The steering group is: Mike Ang known authority of the field. and Patte Randall, psychologists Jim Geekie At the annual meeting this year we agreed and John Read and occupational therapist that the project for the future will be to put Dale Rook. Plans are already underway for even more emphasis on being a network the 3rd Making Sense of Psychosis confe- - creating meeting places for the members John Read, Sonja Levander, Karin Hallén and Maria Sundvall rence on October 18th and 19th, 2005. but also extending to other people from The international keynote society like artists and authors. Our hope speaker this year will be Auckland is to facilitate the possibilities for dialogue, psychiatrist Dr Colin Ross, the generating of opinions and the exchan- a prominent U.S. researcher ging of experiences. and clinician in the fields of NORTH ISLAND The theme for the fourth annual meeting psychosis, dissociation and was psychosis and trauma and we were very trauma, and author of se- Wellington happy to welcome John Read, member of veral books. Several NZ the ISPS executive committee and editor ISPS members are colla- NEW ZEALAND of the book “Models of Madness”. John borating on a New came all the way from a sunny New Zealand Zealand chapter Christchurch Margit Olsson, Lance Cederström, Lisbeth Palmgren to a snowy Stockholm to inspire us in our and Margareta Brynolf for the forth- SOUTH ISLAND struggle for a more psychologically orien- coming book, Invercargill ted approach to psychosis challenging the John presented several studies about the edited by Yrjo dominating traditional illness model of prevalence of child abuse in psychiatric Alanen on the history and future of ISPS. schizophrenia. Some experiences in his patients and how abuse is related to the
12 Vol. no. 9 - Spring Issue 2005 C A L G R newsletter S L O O U P I S P S
Israel Those from outside the United States are ISPS UK A new local ISPS group has been set up in enthusiastically encouraged to send in abstracts. The details for submissions are Having steered ISPS UK from its birth to Israel. A conference was held at the Shal- a vibrant organization with charitable status vata Mental Hospital on June 15th and posted on our newly re-designed website, at our same address: www.isps-us.org. and over 400 members, Brian Martindale 16th, 200 people attended. The first day decided to step down from Chair of ISPS consisted of lectures, the second of super- We have a hard act to follow, given the UK last September (though he vision sessions. The honoured guest spea- hugely positive response to our Chicago remains our link with the ker was Ann-Louise Silver. meeting last year, chaired by David Garfield. International committee). Further details about the developing ISPS Lorraine Ellis has completely redesigned We had our first General local group available from our website, making it closely resonant Meeting at our bi- UNITED KINGDOM Orna Ophir-Shacham, email: with that of www.isps.org, with many strong annu-al residential [email protected] interconnections. It is more tightly orga- Conference in Manchester nized, and includes features such as access September (see to Amazon, as well as Paypal. Thus, people Kathy Taylor’s separate London can purchase relevant texts by members report) when the results and others, displayed and described at our of elections for the new committee were website. We will continue posting more announced: Janey Antoniou, Trish Barry, articles and references, and enlarging our John Gale, Siobhan O’Connor, Chris web-link list. We will continue posting Brian Burford, Steffan Davies, Grainne Faden, Koehler, Ph.D.’s scholarly and wide-reach- Sheila Grandison, David Kennard and ing contributions to our listserve. It’s our Brian Martindale. A bit later the white “Koehler blog.” And our membership list smoke went up (excuse the topical joke now includes links to members’ publica- that indi-cates the omnipotent fantasy of tions available on the internet. We hope taking over the chair from Brian) and the to make our website a valued resource for committee chose me to succeed Brian as ISPS-US students, clinicians in the mental health chair, plus John Gale as treasurer and field, and others interested in psychological Sheila Grandison as secretary. treatments of psychotic disorders. "THE VALIDITY OF EXPERIENCE" The committee has reviewed its aims for Michael Robbins, M.D. is leading our on- ISPS-US meeting (7th annual symposium) the UK Network, and rank ordered them line seminar on psychoanalysis and psych- as follows: in Boston November 11–13th osis. We are now reading through Chapter 7 of Freud’s The Interpretation of Dreams. 1. Develop and promote a clear ISPS message to attract a wide cross-section Boston Meanwhile, David Garfield, M.D. has of members, with a view to achieving Chicago stepped down as head of our Chicago membership growth of 100 a year branch, in order to chair the Membership 2. USA Recruitment Committee. Garry Prouty, Organize or co-organize two D.Sc. is now heading the Chicago branch. conferences/workshops each year 3. Support the development of interest We are embarking on a research project Sections ISPS-US is which will begin with a clinical survey of 4. Develop groups in geographical areas now approaching our members. The ISPS-US Research seventh annual meeting, to be held in Committee, chaired by William Gottdiener, 5. Develop a training pack/workshop on Boston, chaired by Ron Abramson, M.D. Ph.D., has prepared a survey, which is now key issues in integrating psychological Its theme is “The Validity of Experience” being studied by an Internal Review Board. approaches to psychoses, that we can offer to professional training courses and our keynoter will be George Atwood, We hope that the results will lead to an and Trusts Ph.D., Professor of Psychology at Rutgers interesting publication. Meanwhile, we are University, whose writings concern the beginning to develop a manual on psycho- 6. Pull together information on the intersubjective view-point in psychoanalysis. dynamic work with people struggling with evidence base for aspects of psycho- logical approaches to psychosis We will meet at the Holiday Inn Brookline, psychosis. We hope then to be able to use MA (a suburb of Boston) from November this manual in a research project on the 7. Develop guidelines for Trusts on the 11–13, 2005 and are now welcoming re- effects of teaching these techniques, hoping employment of service users in a sponses to our call for papers, which must to apply for a grant to help fund the effort. consultant user capacity be received by June 30. Proposals should Thus, we are feeling increasingly strong 8. Survey members for other activities or be no more than 250 words in length, de- and stable, and are setting more long-term ‘services’ they would value scribing talks 30 minutes long, and should goals. 9. Review membership structure and fees be e-mailed to our executive director, Karen 10. Co-host a ‘schizophrenia day’ with an We will be contributing to the ISPS-Madrid Stern at [email protected], or mailed to NHS Trust meeting, with many symposia already ISPS-US, P.O Box 491, Narberth, PA 19072. submitted.
Vol. no. 9 - Spring Issue 2005 13 O C A L G R newsletter S L O U P I S P S
A number of these have begun to take shape. ISPS Netherlands-Flanders often seriously handicapped patients We have a new information leaflet that is has widened importantly. This being professionally produced. We are Network in 2004 measure will harm the further planning a conference for October 14 in In April 2004 the ISPS implementation of these treatment- London on Intercultural Therapy and Netherlands-Flanders modalities and undermine the Psychosis, convened by Trish Barry, aiming local group organised expertise that is neccesary for it. for a mix of contributions from the statu- a mini-symposium about Amsterdam The Dutch Society for Psychiatry was tory and voluntary sectors with clinical, family-treatment with not consulted for this measure. It was academic and research components. There psychosis in de GGZ THE NEDERLANDS taken on account of the recent report is another of our workshops co-hosted with Eindhoven. Suitability of Longer Lasting Psychotherapy Eindhoven the Institution of Group Analysis on Margreet de FLANDERS by the Gezond-heidsraad, the official November 19, this one entitled Psychotic Pater, psychia- scientific advisory board of the Minister of Experiences in Groups. There is a growing trist, held an inte- Health. The report is the first of the network for members in the north of Eng- resting lecture with a historic Gezondheidsraad on this subject. The land, based at The Retreat in York, which overview on this subject. She conclusion of the sub com-mittee that has holds three meetings a year. drew on her experience with family treat- written it, was that there are indications, Meanwhile our email discussion group, ment, her broad knowledge of the literature that longlasting psycho-therapy - i.e. well moderated by Chris Burford, contin- and her contacts with international experts psychotherapy of more than 20 sessions - ues to be very active, with between 80 and in this field. In her lecture a development is effective. Secondly it pleaded for more 120 contributions a month. The major re- became clear, in which the character of research and lastly it made some cent discussion point has been in response family-treatment has developed through recommandations concerning the appli- from one member’s suggestion to change the decades. This leads to the conclusion, cation of psychotherapy, especially moni- the name of our society, with a range of that family-treatment should be regarded toring of it. But in the letter in which the skilful attempts to adapt the words while considering the specific features of each report of the sub-committee was presented retaining the initials. This wasn’t just about period. A more specific conclusion was, to the Gezondheidsraad, it was concluded, words, but about the contemporary use of that the ideas about family-treatment in that evidence for longlasting psychotherapy the terms psychosis and schizophrenia, the seventies seem not to match with these is lacking, and that therefore reserve and about our identification with psycho- times as much as for example the multi- should be taken with the application of it. therapies, psychological treatments, or a family-treatment by McFarlane. Ria Lenior, Essentially treatment possibilities have been more general mission. All this to be carried researcher at the Adolescenten-kliniek of limited to a level at which only prolonged forward to next year in Madrid, and it was the Academic Medical Center in Amster- crisis intervention and treatment for the helpful to have some wise con-tributions dam, lead by Don Linszen, reffered to her less serious psychiatric decompensations from overseas as well. One particular thesis of 2002, a 5-year-follow-up to the as well as for minor personality problems project deserves special mention. One of effect of family-treatment according to the is possible. The idea behind the Gezond- our members Glenn Roberts has worked principles of Falloon at the prognosis. The heidsraad-report appears, that nowadays with a theatre group to create a play called most important conclusion was, that family- clinical practice by professionals, though ‘On the Edge’ that portrays with great treatment helps the parents to support supported by nowadys clinical research, authenticity a young man going through their child with psychosis, which helps the would be not proven fully according to the the stages of a first psychotic breakdown, prevention of re-admission in the clinic. highest standards of research, in which and the unvarnished reactions of his Marijke Krikke, social worker who has done situation it would no longer be legitimate. parents, a school teacher, class mates and the family-supporting in the Adolescenten- The chairman of the sub-committee disso- girlfriend. Accompanied by a teaching clinic, illuminated this with her experiences ciated himself from this interpretation of resource pack, the excellent Extreme from practice of family-support. the work of his sub-committee in the Theatre Company has taken this round The Dutch government has supported a Monthly Magazine for Mental Health. It schools and colleges for six months. The project for Multidsciplinairy Guidelines appears also that research criteria for evi- project is now being evaluated in terms of for Mental Health Institutions. The Net- dence are strung up and prevail above the its 3 aims of raising awareness, reducing work has written a reaction to the concept- clinical practice of thousands of professi- stigma and encouraging help seeking, and guidelines for Schizophrenia. onals, trained for about ten years according to regulations that are agreed to the same has already shown signs of making a diffe- This government has unfortunately also government. This points to the great im- rence with some students coming forward dimished the amount of sessions for portance for monitoring by professionals after a performance to talk about their psychotherapy, that is payed for by the of the use of research by advisory and own experiences. This project is helping insurance from 90 to 25. In a letter to the governmental institutions as well as for to meet the wider goals of the 5 year Early Minister of Health the Network has made consultation to them. The Dutch Society Intervention Programme that is supported clear the devastating effect of this measure for Psychiatry has installed a Commission by our largest mental health charity Re- for especially the treatment of patients with for Longlasting Psychotherapy, that will think, and is a good example of a growing psychosis: they form a group that needs advise the board regarding the policy con- sense of common cause that is developing prolonged treatment. During the last de- cerning psychotherapy for this purpose across progressive elements in the mental cades more specific kinds of psychological and to safeguard the reimbursement for health field in the UK, of which ISPS is a treatments have been developed. As a result longlasting psychotherapy in the new part. of that, the scope for treatment of these health-insurance system that will run from
14 Vol. no. 9 - Spring Issue 2005 newsletter C A L G R S L O O U P I S P S
January first 2006. The Network is repre- ISPS CROATIA sented in a supporting-group of this Committee. Maybe it is a good idea to have In the Inter-University Center Dubrovnik, a meeting at ISPS Madrid 2006 with mem- on May 4th-7th, ISPS CROATIA organised bers who deal with research and with policy- its 9th School of Psychotherapy of Psych- advisory and governmental action on the oses. Under the 'Leitmotif' – Toward Com- field of psychotherapy with psychosis. That prehensive Psychotherapy of Psychoses - would give an opportunity for exchanging this year the focus was on Psychodynamic suitable research-data and experience Understanding of Psychotic Symptoms. within ISPS for the sake of more effective The lecturers and participants were from action towards the governments and different parts of Europe: Greece, Italy, international organisations. United Kingdom, Denmark, Slovenia, In the Netherlands the psychotherapeutic Serbia and Montenegro, and Croatia. The branch of the education of psychiatrists is 2003 during which several issues were meeting included both lectures and case revised. The Network has directed a plea discussed, including the registration of the presentations in small groups, as well as a to the Dutch Society for Psychiatry for Singapore Chapter with the Registry of short tour through the historic heart of specific attention and demands in it for Societies, setting up a bank account, mem- Dubrovnik, to enable deeper contact and the psychotherapeutic approach of patients bership fees and the training programme understanding of this Croatian city which with psychosis. for the following year. Since then the Chap- is rich in history. In January the Network has made a con- ter has held two events. The first event was siderable attribution to a symposium held in January 2004 when Professor Max cooperated of the Section for Psychothe- Birchwood during one of his visits to Singa- rapy of the Dutch Society for Psychiatry pore from Birmingham, UK, conducted a on psychotherapy with psychosis. It was a short workshop on “CBT for patients with lively meeting, that was attended by about First Episode Psychosis”. In March 2004 75 psychiatrists. Dr Anthony Bateman from St Ann’s Hospi- June 15th John Read, professor of clinical tal in North London who was then on a psychology from New Zealand and co- visit to Singapore, addressed our local ISPS editor of Models of Madness, is giving a members on “Psychodynamic Psychothe- lecture for our Network about trauma and rapy in the Treatment of Schizophrenia”. psychosis. Also October this year - after "Kortenberg" 2003 - it’s the turn of the There are currently 22 members in our Netherlands to host our third Network local group. The local Chapter has encou- Conference. ntered several obstacles in the process of registering with the Registry of Societies Jan Leijten, independently established psychiatrist in Amsterdam and setting up a bank account and we have also lost our Secretary who is now pursuing postgraduate studies overseas. Hence, pro- gress for our local Chapter has been slow. There are, however, encouraging signs that the Chapter may pick up momentum soon At the end of the scientific programme and we are optimistic that we will survive the ISPS Croatia AGM was held. The 10th these adversities. School of Psychotherapy of Psychoses was planned for May 16th-20th, 2006 in IUC There is some interest from other countries Dubrovnik. Because of the anniversary an in Asia in forming local ISPS groups. Al- enlarged programme is planned, and the though several countries, including China, topic will be: "Patient-Therapist Japan and Malaysia have been keen, they Relationship as the Frame for Therapy’’. have encountered difficulties in gathering Some colleagues from abroad expressed together a group of people to initiate the their motivation to organize ISPS network formation of a local group; the nature of in their countries. The Singapore Chapter of the their work and the geography of the coun- try seem to be the main causes of the diffi- Ivan Urlic, Sladjana _trkalj-Ivezic ISPS culties. Colleagues in Hong Kong have [email protected] At the first meeting of the local Singapore started holding some gatherings which [email protected] Chapter of the ISPS on 5 Dec 2003 a pro- hopefully will evolve into the formation of tem committee of 9 was elected from the a local ISPS group. 27 interested mental healthcare professio- nals who were in attendance. The Comm- Lyn Chua ittee held its first meeting on 11 December ISPS Singapore
Vol. no. 9 - Spring Issue 2005 15 newsletter
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Vol. no. 9 - Spring Issue 2005
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