Biomaterial Database

Treatment alliance and the chronic schizophrenic. 1990

M A Selzer, and M Carsky

Department of Psychiatry, New York Hospital Cornell Medical Center, White Plains 10605.

When something in common can be found to establish relatedness; when therapists can trust that the patients will eventually be able to contain their destructiveness and that on some level they struggle with their pathology, then patients begin to identify with their therapists and with those aspects within themselves. This activity requires that first a climate of safety, based on a frame, be established. Once it is established, the search for the common "thing"--the organizing object--and the ability to work with it can go on with far less distraction. Along the way, therapists insist that words can be used to convey meaning, creating the climate for eventual interpretation. In the case described, the therapist made it clear that he disagreed with the patient's delusional viewpoint, but at the same time was interested in hearing the material as a source of ideas about how the patient experienced her world, and how to discover what remained of her capacity for self observation and nonpsychotic thought. The therapist's acceptance of the need for such a preliminary phase may make it possible for severely resistant patients to become engaged with those treating them.

UI	MeSH Term	Description	Entries
D010817	Physician-Patient Relations	The interactions between physician and patient.	Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D011613	Psychotherapy	A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication.	Psychotherapies
D011618	Psychotic Disorders	Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994)	Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D002908	Chronic Disease	Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).	Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012559	Schizophrenia	A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior.	Dementia Praecox,Schizophrenic Disorders,Disorder, Schizophrenic,Disorders, Schizophrenic,Schizophrenias,Schizophrenic Disorder
D012565	Schizophrenic Psychology	Study of mental processes and behavior of schizophrenics.	Psychology, Schizophrenic