title: A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.
abstract: Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach.
authors.affiliation: The Austen Riggs Center, Stockbridge, MA 01262, USA. jane.tillman@austenriggs.net
authors.forename: Jane G
authors.initials: JG
authors.lastname: Tillman
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001318:Authoritarianism; D003131:Combined Modality Therapy; D003674:Defense Mechanisms; D005196:Family Therapy; D006117:Grief; D006801:Humans; D007207:Individuation; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy / Q000379:methods*; D011618:Psychotic Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D012559:Schizophrenia / Q000209:etiology / Q000628:therapy*; D012565:Schizophrenic Psychology; D014167:Transference, Psychology
chemical_list: D014150:Antipsychotic Agents