Psychotherapy for Psychosis with Dr. Michael Garrett
May 19, 2023
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Dr. Michael Garrett discusses combining CBT and psychoanalytic treatments for psychosis. They explore patient experiences and challenges in therapy, including altered states of consciousness and imaginative manifestations. The podcast also delves into medication skepticism, tapering antipsychotic medication, and the importance of individualized therapy for better patient care.
Integrating CBT and psychoanalytic perspectives in treating psychosis can lead to effective outcomes by exploring the literal falsity and emotional meaning of delusional beliefs.
Emphasizing personalized, empathetic approaches in psychotherapy for psychosis, including engaging family members and developing trust, is crucial even in cases of coerced treatment.
Understanding psychotic symptoms through parallels with normal human experiences, emphasizing curiosity, empathy, and exploring psychological structures, can improve psychotherapeutic outcomes for patients.
Deep dives
Psychodynamic Roots and Therapeutic Approach
The psychiatrist discussed his journey through psychiatry, highlighting his transition from psychoanalytic to CBT approaches. His therapeutic method integrates CBT and psychoanalytic perspectives, focusing on examining the literal falsity and emotional meaning of delusional beliefs, leading to effective treatment outcomes.
Clinical Practice and Patient Engagement
The psychiatrist's current professional focus involves supervising first episode psychosis teams, teaching, and maintaining relationships with difficult cases worldwide. He emphasizes empathizing with patients' suffering, engaging family members, and developing trust even in cases of coerced treatment, highlighting the need for personalized approaches and non-coercive communication.
Insightful Interpretations and Normalizing Experiences
The discussion delves into interpreting psychotic symptoms such as paranoia or delusions by drawing parallels with normal human experiences like deja vu or unfounded fears, suggesting a shift from labeling lack of insight to understanding the compelling nature of patients’ altered realities. The importance of curiosity, empathy, and exploring underlying psychological structures shines through in the psychiatrist's approach.
The Complexities of Psychotherapy in Psychosis
Psychotherapy in treating psychosis is a multi-faceted concept that involves understanding the nuanced interactions between medication and therapy. The podcast highlighted the challenges psychiatrists face in balancing medication dosages and the implementation of supportive psychotherapy. It emphasized the importance of individualized treatment plans and revealed the need for a deeper understanding of each patient's unique needs. The discussion also touched on the impact of stress on psychotic symptoms, highlighting the dynamic nature of symptom severity based on environmental factors.
The Role of Psychotherapy in Challenging Psychiatric Practice
The episode delved into the evolving landscape of psychiatric practice, specifically focusing on the increasing interest in psychotherapy among professionals. It outlined a shift towards a more integrated approach combining psychotherapy with medication light, aiming for higher success rates and patient satisfaction. The importance of individualized treatment and the potential benefits of ambitious psychotherapy were underscored, suggesting a reevaluation of traditional treatment modalities. The conversation advocated for a revolution in care provision, proposing a model where psychotherapy plays a central role in public psychiatry.
In this week's episode of the podcast, we interview Dr. Michael Garrett, Professor Emeritus of Clinical Psychiatry and former Vice Chair and Director of Psychotherapy Education at SUNY Downstate Medical Center, Brooklyn, NY. He also wrote a book called, Psychotherapy for Psychosis: Integrating Cognitive-Behavioral and Psychodynamic treatment. He is husband to the prior beloved presenter, Dr. Nancy McWilliams. In this episode, we will discuss how psychotherapy can be effective for patients experiencing psychosis.
