Psychotherapeutic and relational processes and the development of metacognitive capacity following five years of individual psychotherapy: A case study of a person with psychotic symptoms

摘要

Interest has arisen in the possibility that psychotherapy might help persons diagnosed with schizophrenia to develop both a richer and more adaptive self-concept by improving metacognitive capacity. However, a model of the processes by which psychotherapy might affect metacognition is lacking. To explore this issue, we examined transcripts of a case of long-term psychotherapy of a man experiencing psychotic symptoms. Analyses suggested a secure attachment to the therapist allowed for the articulation of painful affects, the recognition of the complex interrelationship between positive and negative emotions, and ultimately a richer narrative of the client as an active agent in life whose affective experiences make sense in a historical context. Implications for practice and theory are discussed.