Schizophrenia

Two leading experts, one with a broad range of experience of institutional settings and cultures using psychodynamic, behavioral, and psychopharmacological modalities, the other an experienced psychoanalyst, bring together the complex history, causes, and treatments of schizophrenia in an easy-to-read and academically rigorous text

Kevin Volkan and Vamik Volkan present a comprehensive study of schizophrenia using a psychoanalytic lens on the existing interdisciplinary research. Over the last seventy years, mainstream research on the causes, prevalence, and treatment of schizophrenia has greatly diverged from psychoanalytic thinking. However, the emergence of the field of neuropsychoanalysis brings hope that psychoanalytic metapsychology and clinical theory may once again provide valuable insight into understanding schizophrenia. Psychoanalytic treatment may not be appropriate for many sufferers but psychoanalysis does provide insight to inform and improve treatment. It can also illuminate what aspects of schizophrenia are common across cultures, where they present unique characteristics, and just how cultural variations occur. For any future improvement in understanding and treating schizophrenia, the cultural underpinnings and expressions of schizophrenic illness need to be made clear. For clinicians in the field, the authors’ aim is to deepen insight and promote the use of psychotherapy and integrated treatments, while increasing sensitivity to cultural variations in schizophrenic disease. Accordingly, this book is divided into four sections. The first gives a brief overview and outline of the mainstream understanding of schizophrenia. The second drills down to focus on general psychoanalytic ideas about schizophrenia, culminating with a focus on problems with early object relations. The third looks at how psychoanalytic treatment can be successful in some cases. The fourth and final part discusses how views of the disorder and the disorder itself are affected by culture. The authors hope to generate insight and understanding of schizophrenic disorders which could lead to new approaches to treating and possibly preventing schizophrenia. It is a must-read for all clinicians and trainees working in the field and presents interesting ideas to anyone with an interest in the subject.

About the authors About this book Part I: Schizophrenia: Epidemiology, causes, neurobiology, pathophysiology Chapter 1: Introduction and overview of schizophrenia Chapter 2: Causes of schizophrenia Chapter 3: Neurobiology of schizophrenia Chapter 4: Brain structure and schizophrenia Chapter 5: Cognition and schizophrenia Chapter 6: Social-cognitive and emotional recognition impairment in schizophrenia Chapter 7: Treatment of schizophrenia Chapter 8: Non-psychodynamic therapeutic approaches to treating schizophrenia Chapter 9: Recovery from schizophrenia Chapter 10: Prevention of schizophrenia Part II: The psychoanalytic metapsychology of schizophrenia Chapter 11: Neuropsychoanalysis and schizophrenia Chapter 12: Early psychoanalytic approaches to understanding schizophrenia Chapter 13: A review of object relations and severe psychopathology Chapter 14: Schizophrenic etiology and organismal panic Chapter 15: The infantile psychotic self Chapter 16: Flawed ingredients Chapter 17: Fates of infantile psychotic selves Part III: Psychoanalytic approaches to treating schizophrenia Chapter 18: Psychodynamic approaches to treating schizophrenia Chapter 19: Psychoanalytic treatment of adult schizophrenia Chapter 20: Fusing-disconnecting and internalization-externalization cycles Chapter 21: Development of a steady identification with the "good" analyst Chapter 22: "Sophisticated" identifications and externalizations Chapter 23: Permanent elimination of the infantile psychotic self? Chapter 24: Oedipal issues and superego identifications Part IV: Cultural elements in schizophrenia Chapter 25: Schizophrenia and culture Chapter 26: Causes and beliefs about schizophrenia Chapter 27: Object relations and culture Chapter 28: Culture-bound schizophrenia Chapter 29: Psychoanalysis and syndromes of culture-bound schizophrenia Last words References Index,

About the authors

About this book

Part I: Schizophrenia: Epidemiology, causes, neurobiology, pathophysiology

Chapter 1: Introduction and overview of schizophrenia

Chapter 2: Causes of schizophrenia

Chapter 3: Neurobiology of schizophrenia

Chapter 4: Brain structure and schizophrenia

Chapter 5: Cognition and schizophrenia

Chapter 6: Social-cognitive and emotional recognition impairment in schizophrenia

Chapter 7: Treatment of schizophrenia

Chapter 8: Non-psychodynamic therapeutic approaches to treating schizophrenia

Chapter 9: Recovery from schizophrenia

Chapter 10: Prevention of schizophrenia

Part II: The psychoanalytic metapsychology of schizophrenia

Chapter 11: Neuropsychoanalysis and schizophrenia

Chapter 12: Early psychoanalytic approaches to understanding schizophrenia

Chapter 13: A review of object relations and severe psychopathology

Chapter 14: Schizophrenic etiology and organismal panic

Chapter 15: The infantile psychotic self

Chapter 16: Flawed ingredients

Chapter 17: Fates of infantile psychotic selves

Part III: Psychoanalytic approaches to treating schizophrenia

Chapter 18: Psychodynamic approaches to treating schizophrenia

Chapter 19: Psychoanalytic treatment of adult schizophrenia

Chapter 20: Fusing-disconnecting and internalization-externalization cycles 

Chapter 21: Development of a steady identification with the “good” analyst

Chapter 22: “Sophisticated” identifications and externalizations

Chapter 23: Permanent elimination of the infantile psychotic self?

Chapter 24: Oedipal issues and superego identifications

Part IV: Cultural elements in schizophrenia

Chapter 25: Schizophrenia and culture

Chapter 26: Causes and beliefs about schizophrenia

Chapter 27: Object relations and culture

Chapter 28: Culture-bound schizophrenia

Chapter 29: Psychoanalysis and syndromes of culture-bound schizophrenia

Last words

References

Index

• By (author) Kevin Volkan
• By (author) Vamık Volkan

The description of schizophrenia has a history – if you want to know this history, you will find it in this magnificent book. The causes of schizophrenia have been debated, from infectious, to genetic, to object relations disturbance in early childhood – if you are interested in all those debates, look no further. The treatments of schizophrenia have a long history, too, from surgeries to neuroleptics – they are skillfully and engagingly discussed in a form anyone can read. Finally, if you want to see the principles for treating, as the authors note, some schizophrenics with psychoanalytic approaches, these are described in fascinating and persuasive detail. And, by the way, if you want some evidence-based references to bolster the authors’ representations, there are 42 pages of bibliography. Not just a reference book, this is a stunning work of readable, accessible, and fascinating scholarship.

— Jerome S Blackman, MD, FIPA, Professor of Psychiatry, Eastern Virginia Medical School, Norfolk

‘Kevin Volkan, PhD and Vamık Volkan, MD bring their scholarly and clinical knowledge to the project of understanding the history, science, and treatment of schizophrenia. In this highly readable and accessible book they provide a comprehensive review of the scientific literature on schizophrenia and how the illness is affected by culture. Volkan and Volkan review, critique, and update psychoanalytic formulations of schizophrenia, showing how early Freudian, ego, and object relations psychoanalytic theories have evolved into modern psychoanalysis and psychoanalytic psychotherapy. They advocate for the place of modern psychoanalytic psychotherapy in the treatment of schizophrenia, where symptoms and suffering can be understood in the context of the inner and the outer world of the patient, and may take place in conjunction with other treatment modalities. Integrative approaches to understanding and treating schizophrenia maximize the possibility of recovery and this book advocates for a broad and thoughtful approach to treatment.’

— Jane G. Tillman, PhD ABPP, Evelyn Stefansson Nef Director, Erikson Institute for Education and Research, Austen Riggs Center, Stockbridge, Massachusetts

‘[C]ompelling and progressive, with the authors striking exactly the right balance between theory and practice. Key psychoanalytic concepts and thinkers are invoked to help make sense of schizophrenia. There is something much more human here – a search for meaning that can sometimes be lacking in strictly medical or pharmacological models. […] Vamik Volkan’s clinical vignettes, used to illustrate the process, are a pleasure and inspiration to read. […] by bringing together psychiatry, psychology, psychoanalysis and culture, this book is a convincing manifesto for a multidisciplinary approach to treating schizophrenia.’

— Emmanuelle Smith, psychodynamic psychotherapist in the NHS and private practice, 'Therapy Today' October 2022