The Struggle for Connection and Place Among Patients Designated Psychotic

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Length: 47 minutes

Michael O'Loughlin, PhD; Marilyn Charles, PhD, ABPP; Jill Clemence, PhD; Gail M. Newman, PhD

This work is part of a long-term inquiry, the Follow Along Study, into characteristics of persons with psychotic type disorders at Austen Riggs Center.  We are an interdisciplinary team of four researchers who are engaged in an intensive study of a small group of patients from the larger study.  Important to our method is our access to research interviews with these patients via audio- and videotape which we are able to analyze together.  In this presentation Marilyn Charles and Michael O’Loughlin present brief case studies of two patients on whom extensive data are available.  Our interest is in the impasses that set the stage for the kinds of derailments that have led to hospitalization and chronic difficulties. What is the particular dilemma for each patient? What kind of solution did each patient develop to attempt to speak to this dilemma?  What led to the breakdown of the solution? And, now, in therapy, what seems to be happening vis a vis this patient’s capacity to reconnect with self in order to begin to rebuild intersubjective capacity?  Jill Clemence discusses characteristics of the psychodynamic therapeutic milieu, and focuses on ways in which that milieu facilitates or inhibits the patient’s capacity to address the impasse that inhibits connection, using the aforementioned case studies as exemplars. She also presents data on the long- and short-term outcome of each case.  Gail Newman, looking across patient narratives in their responses to projective tests, examines how language use and, especially, gaps and leaps in narrative might provide insight into patients’ experiential subjectivity.

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