Table 1: Stages in the Psychological Resolution of Schizophrenia.

 

Stages of Psychological Therapy of Schizophrenia: Dr. Michael Robbins

PPCC Model of patient's mind: Dr. Gillian Steggles

Stages in the patient's experience

1.

Protopathosymbiosis (parasitism): patient's identity is invested in her psychotic state.

Patient is unable to function healthy using her impoverished representational world.

Patient feels alienated in her environmental world, suffering from painful schizophrenic confusion.

2.

Engagement: patient's sense of individuality is threatened.

Patient unconsciously includes analyst in her representational world.

Patient attempts to engage with analyst: she may be well-defended.

3.

Pathosymbiosis: may lead to collusion and Stage 3b: Therapeutic Stalemate.

Patient's 'blocked' schizophrenic mindset may prevent insightful interaction with analyst.

Tendency towards comfortable (but false) assumptions with analyst: reality cannot be contemplated.

4.

Disengagement from pathological symbiotic collusion.

Patient succeeds in rejecting her previous maladaptive relationships and unhealthy engagements in her representational world.

Patient works at reviewing her relationships and contemplating reality.

5.

More Normal Symbiosis: growth-promoting.

Patient is awakened to the reality of her life in all its (painful) aspects of Time, Place and Person in context.

Patient is able to address reality with her analyst; she suffers intolerable experience of herself; she begins to understand her conflicts; she absorbs good feelings from the analyst; she begins to experience her own self-identity positively.

6.

Psychic Differentiation and Integration

Patient evolves into a discrete, integrated individual.

Patient can contain her own emerging integrated mental life successfully as a discrete individual, relating well to the analyst and individuating from him. Patient evolves into her own independent autonomy.

7.

Therapeutic Termination.

Patient's mind is self-sufficient.

Patient leaves therapy with her difficulties resolved.