Unbearable Affect A Guide to the Psychotherapy of Psychosis

Unbearable Affect What happens when emotion becomes unbearable? In some psychotic patients, delusions, hallucinations, and incoherence are the result, while others suffer from negativism, autism, or emotional paralysis. In this remarkable book, Dr. David Garfield builds on the work of Semrad, Jung, and Bleuler in identifying affect as "the driving force behind all our actions and omissions" and in using emotion as the focus and guide for healing psychotic patients. This is particularly important in an age when antipsychotic drugs and modern neuroscience have rendered many patients less symptomatic, but still dysfunctional. The book is divided into three sections, which correspond with the three stages of psychotherapy of psychosis. The first section deals with finding and understanding unbearable affect in the initial clinical work with psychosis. Unbearable affect is seen as the focal point around which psychosis turns. The book explores techniques for identifying affect in the patient's first communications; examines the precipitating event that brought the patient to clinical attention; and establishes links among primary mental processes, affect, and psychosis. The second section outlines techniques for helping patients contain and transform unbearable affect. These include special techniques for dealing with"shame, pride, and paranoid psychoses" as well as persecutory states. This section also addresses the therapist's role as the missing eyes and hands of the patient, and the necessity that the patient make contact with the emotionality of the clinician. The book's third section is geared toward keeping patients out of psychosis once they have stabilized. It illustrates how healthy emotional change can enable patients to enlist the help of others in difficult affect-laden situations, contrasts theories of change in the psychotherapy of psychosis with the affect-centered approach, and addresses the issue of posttreatment access to the therapist. Built on a solid theoretical foundation and furnished with clinical experience and practical advice, Unbearable Affect provides a powerful tool through which to approach the healing of psychotic patients. Mental health professionals who work with psychotic patients in hospitals, prisons, shelters, clinics, or private practice will find this sensitive book highly illuminating.Garfield, David A. S. is the author of 'Unbearable Affect A Guide to the Psychotherapy of Psychosis', published 1995 under ISBN 9780471025368 and ISBN 0471025364.