Schizophrenia and indeterminacy: The problem of validity

The paper attempts to account for the confusion over the validity of the concept of schizophrenia in terms of two closely related aspects of conceptual indeterminacy. Firstly, it is identified on the basis of a breakdown in intelligibility, but what constitutes such a breakdown is indeterminate. Secondly, the concept sits between the categories of natural disease or illness on the one hand, and character trait or moral failing or gift on the other. This entails an indeterminacy in attempting to define the role that physiological explanation could have. Light may be thrown on the concept by exploring a distinction between a life story in which the schizophrenic condition emerges as the conclusion of the story and a causal process in which the condition is the end result or final consequence.     

Toward a theory of verbal behavior

This paper is a reply to an accompanying set of six commentaries by Sidman; Hayes and Barnes; Schusterman, Kastak, and Reichmuth; Tonneau and Sokolowski; Lowenkron; and Moerk. Those commentaries were prompted by our article “On the Origins of Naming and Other Symbolic Behavior” (1996), which was, in turn, followed by 26 commentaries and a reply. In the course of the present reply, we further develop the naming account to embrace more complex verbal relations such as same, different, more, and less. We also examine what we see as the lack of conceptual coherence in equivalence theories, including relational frame theory, and the disparities between these accounts and the findings from empirical research.     

Fictions of the internal object

This paper examines internal objects in their role as theoretical constructs which analysts use to make sense of human experience. Object relations theory is based upon a vision that the personality is divided or split into parts. Clinical experience reveals that such splits are commonly expressed in the language of our analysing. However, a lexical reality is not a thing-in-itself, but a way of organizing and understanding experience. Jung's vision of the dynamics of the split self encompass a unique 'object relations theory' that is both similar and yet quite different from the object relations theories of Klein, Fairbairn, Winnicott and Thomas Ogden A clinical example is used to examine the way in which these different theoretical views explain the same clinical phenomenon. The last section of the paper is devoted to a narrational analysis of the place of internal objects in analytic theory. The split self, dynamic is seen as a narrative device - one that makes sense and provides coherence, but is neither the only view of psychic reality nor necessarily an accurate reflection of the nature of the internal world.     

The self-narrative and acute psychosis

The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.     

“Not with me you don't”: A story of narrative practice and dissociative disorder

This paper discusses issues relating to therapeutic practice based upon the narrative metaphor. A case of someone suffering the effects of Dissociative Identity disorder is used to illustrate the difficulties that clients can experience with the “expert” knowledge conception of therapy. The value of the “respectful” and “non-expert” emphasis of Narrative Practice emerges even when the therapist believes that he or she lacks expertise in the client's apparent “condition.” Three themes emanating from the case form the basis for the discussion: the client's experience of being recruited into accepting the diagnostic label of Dissociative Identity Disorder; the effects of being forced to accept a contract to eliminate self-abusive behaviour; and the therapist's dealing with a gun in the therapy room.     

Expressed Emotion In The Narrative Context of Family Photographs

This study aims to elucidate cognitive and contextual aspects of the EE (Expressed Emotion) concept. The EE levels of both parents of two first admission psychotic patients were rated from the Five Minute Speech Sample (FMSS), and the emotional responses were further analyzed in narratives of family photographs. The attribution model was found to provide an explanatory framework for understanding relatives' expressed emotions (EE) toward a family member suffering from psychotic disturbances. Four case reports indicated that family photographs induced parents to create narratives in which emotions, attributions, and strategies for coping with stressful aspects of the illness came forward as intertwined phenomena. The method can offer more comprehensive data for intervention strategies aiming to alter the prevailing atmosphere and interaction patterns within the high EE family.     

The Experience of Time in Acute Psychosis and Schizophrenia

From the narrative point of view the plot of a story configures time. In psychosis, when experiences remain unnarrated, experience being-in-time is also missing. Once experiences are given narrative form, they can be left behind as a part of individual's personal history, thus enabling present experiences to be narrated. Unnarrated experiences do not accumulate. Narrative history contains, however, enough redundancy to invite you to restory your past in a new way if you need to. Hence, from the narrative point of view, early, family- and network-centered intervention is of special value in cases of acute psychosis.