Treating the "Untreatable": Healing in the Realms of Madness

In this era of treating schizophrenic and delusional patients with a primarily antipsychotic drug oriented approach, a more thorough exploration of the meaning to the patient of his psychosis―with judicious antipsychotic use, when indicated―leads to internal character and external behavioral change that is far more lasting than with antipsychotic use alone. With such a psychodynamic approach, some of these previously chaotic, disturbed and heavily medicated people were able to understand the symbolism and the origin of their psychotic productions and go off antipsychotic medication altogether.

Treating the 'Untreatable' provides an overview of the chaotic world of the schizophrenic or delusional patient, a history of intensive psychotherapy with such patients, and thirteen case histories demonstrating varying degrees of recovery, healing and cure. Some of the patients were able to integrate delusional systems that had persisted for many years and give up previous extensive antipsychotic medication, as they understood and worked through psychological issues underlying their psychotic orientation.

Treating the’Untreatable’ offers compelling stories for the general reader and teaching tales for students and mental health practitioners who want to work in the realm of madness. These clinical cases demonstrate the efficacy of an intensive psychotherapy of schizophrenia and delusional states, combined with the judicious use of antipsychotics. These tales show that even seemingly "untreatable" and "hopeless" psychotic patients may recover and heal in the course of an inquiring psychodynamic psychotherapy aimed at understanding and working through the symbolic meaning of his or her hallucinations, delusions and bizarre thoughts and actions. Such an approach has led to some maintaining their gains for decades.

Treating the 'Untreatable' ultimately questions why patients who responded to an insight oriented psychotherapy were previously viewed as 'untreatable' and given high doses of antipsychotic medication. In addition, the book talks about some of the factors that have led the field of psychiatry to pursue a primarily antipsychotic medication approach in patients so disturbed, rather than integrating a potentially healing dynamic psychotherapy into one's therapeutic armamentarium.