Return from Madness: Psychotherapy with People Taking the New Antipsychotic Medications and Emerging from Severe, Lifelong, and Disabling Schizophrenia

by Kathleen Degen, Ellen Nasper

Overview

By the mid-eighties, the provision of psychotherapy for people who could not get out of bed, bathe, get dressed, prepare meals, and manage their own money had diminished. Treatment centered on case management and rehabilitation. This virtual elimination of psychotherapy made sense economically as well as therapeutically: traditional psychotherapy had little success with people suffering from schizophrenia. However, the advent of novel antipsychotic medications has created a need for psychotherapy tailored to this population. Sudden reduction in pervasive, persistent delusions and hallucinations, and recovery of motivation, energy, volition, and the ability to experience pleasure from something other than cigarettes is a mixed blessing. Patients are relieved of terrible suffering but left with new problems. Shedding the lifelong identity of a mental patient, they no longer need case management but require help adjusting to major changes in their thinking and functioning. Kathleen Degen and Ellen Nasper describe group therapy that helps patients identify and cope with unexpected, intense feelings such as sadness or painful memories of childhood trauma, increase their interpersonal skills, and advance their sense of self beyond that of their label as mental patients. The authors show how to build on the phenomenal changes that the new medications provide.

Product Details

ISBN-13:	9781568216256
Publisher:	Aronson, Jason Inc.
Publication date:	07/01/1996
Series:	Developments in Clinical Psychiatry
Edition description:	New Edition
Pages:	248
Product dimensions:	5.94(w) x 8.52(h) x 0.84(d)

About the Author

Kathleen Degen, M.D., is director of the Tardive Dyskinesia Clinica and the Clozeril Program at the Greater Bridgeport Community Mental Health Center. She is also assistant clinical professor of psychiatry at the Yale University School of Medicine. Ellen Nasper, Ph.D., is director of intake at the Greater Bridgeport Community Mental Health Center and director of the Dialectical Behavior Therapy Project of the Connecticut Department of Mental Health and Addiction Services. She is assistant clinical professor of psychology in psychiatry at the Yale University School of Medicine.

What People are Saying About This

Robert M. Galatzer-Levy

Return from Madness is a profound and moving book. In the tradition of Oliver Sacks' Awakenings it tells the dramatic story of patients suddenly liberated from lives destroyed by mental illness. Most of Degen and Nasper's patients are forced to organize life around the illness, their psychological and social development cut short by its onset. The authors not only describe the startling relief Clozaril provides for symptoms of chronic schizophrenia, but understand that relief from schizophrenic symptoms demands deep reorganizations of living as the patients resume development and mourn decades lost to illness. This intelligent, compassionate, and engaging book brings us close to their patients' experience. It clarifies the psychotherapeutic tasks that must be accomplished for even so potent a medicine as Clozaril to truly heal. Not only those of us who work professionally with severely psychiatrically disturbed people but any reader who wants to understand the world of the recovering schizophrenic will find a superb guide in this fine volume.

Stephen Fleck

Kathleen Degen and Ellen Nasper have produced a cogent and timely treatise on the problems and issues confronting patients who recover almost unexpectedly from prolonged psychotic states of withdrawal and nonparticipation in the world around them. The authors portray the not always pleasant behaviors and circumstances of these long-suffering patients as well as the complex difficulties confronting them once their psychotic state has receded. The case presentations are exemplary, sometimes gripping, sometimes almost whimsical. The book then turns to therapeutic issues inherent in drug treatment and the authors' group therapy with these patients, a welcome success story on the whole. Anybody prescribing the latter-day antipsychotic medications for chronic patients cannot afford to miss this superbly written volume that illustrates the multisystemic needs of patients, an important paradigm for community mental health services.

Editorial Reviews

Return from Madness is a profound and moving book. In the tradition of Oliver Sacks' Awakenings it tells the dramatic story of patients suddenly liberated from lives destroyed by mental illness. Most of Degen and Nasper's patients are forced to organize life around the illness, their psychological and social development cut short by its onset. The authors not only describe the startling relief Clozaril provides for symptoms of chronic schizophrenia, but understand that relief from schizophrenic symptoms demands deep reorganizations of living as the patients resume development and mourn decades lost to illness. This intelligent, compassionate, and engaging book brings us close to their patients' experience. It clarifies the psychotherapeutic tasks that must be accomplished for even so potent a medicine as Clozaril to truly heal. Not only those of us who work professionally with severely psychiatrically disturbed people but any reader who wants to understand the world of the recovering schizophrenic will find a superb guide in this fine volume.

Robert M. Galatzer-Levy

Argues in a very compelling manner for the importance of understanding the inner experience of patients who respond well to some of the newer neuroleptic drugs and are thus challenged to move beyond the disabilities of chronic mental illness. Using the format of group therapy for patients receiving clozapine, the authors illustrate the remarkable changes that may occur when this novel medication is combined with a sensitivity to the re-emergence of developmental tasks that have long lain dormant. A very timely and helpful work.

Malcolm B. Bowers

Kathleen Degen and Ellen Nasper have produced a cogent and timely treatise on the problems and issues confronting patients who recover almost unexpectedly from prolonged psychotic states of withdrawal and nonparticipation in the world around them. The authors portray the not always pleasant behaviors and circumstances of these long-suffering patients as well as the complex difficulties confronting them once their psychotic state has receded. The case presentations are exemplary, sometimes gripping, sometimes almost whimsical. The book then turns to therapeutic issues inherent in drug treatment and the authors' group therapy with these patients, a welcome success story on the whole. Anybody prescribing the latter-day antipsychotic medications for chronic patients cannot afford to miss this superbly written volume that illustrates the multisystemic needs of patients, an important paradigm for community mental health services.

Stephen Fleck