Psychotherapy and schizophrenia: An analysis of requirements of an individual psychotherapy for persons with profoundly disorganized selves

Many emerging views of outcome from schizophrenia emphasize that persons must recover a sense of their own identity, agency, and personal worth. While this is intuitively appealing and consistent with a wide range of literature, it raises the issue of how best to facilitate this. In this article we explore how integrative psychotherapy might address issues of narrative and recovery from schizophrenia among persons experiencing more profound levels of disorganization. Illustrated with a case example we explore in particular the barriers posed to psychotherapy by a client's cacophonous self-presentations. We then describe techniques from an integrative perspective that might help therapists enter dialogue with persons so afflicted. Our claim is that psychotherapy can revitalize dialogues within the client and between the client and others that enable the reconstruction of a personal narrative from which a life plan might be articulated.