Chestnut Lodge and the Psychoanalytic Approach to Psychosis

Abstract

The study of psychosis has a long history in psychoanalysis, as does the debate over the suitability of psychoanalysis for treating schizophrenia. For decades, Chestnut Lodge was not only a hospital but also a clinical research and educational institution. A unique patient-staff ratio--about twenty analytic therapists for a hundred patients--made possible prolonged and intense clinical work with schizophrenic and other severely disturbed patients. Interstaff discussions were encouraged and facilitated. This quasi-academic approach to in-depth individual case studies led to clinical findings and theoretical formulations that had a significant impact on developments in psychoanalysis, both here and abroad. Many of these findings and theoretical formulations are relevant to current studies and treatments of psychotic and nonpsychotic patients.

Medication-Free Treatment in Mental Health Care How Does It Differ from Traditional Treatment?

“…Some of the most well known are Chestnut Lodge , 9 Kastanjebakken , 10 Soteria (1969-ff), 11,12 and Open Dialogue (1980s-ff). 13 Common elements are the emphasis on relationships, 10,11,[14][15][16] flexibility and adaptation, a supportive environment, and finding meaning in the person's experiences. 11,[14][15][16] These treatments vary in therapeutic intensity.…”

“…13 Common elements are the emphasis on relationships, 10,11,[14][15][16] flexibility and adaptation, a supportive environment, and finding meaning in the person's experiences. 11,[14][15][16] These treatments vary in therapeutic intensity. 11,14,16,17 Although none of these treatment ban medications, they typically use them more sparingly than in traditional health care and believe that other elements are more central to long-term improvement.…”

“…11,[14][15][16] These treatments vary in therapeutic intensity. 11,14,16,17 Although none of these treatment ban medications, they typically use them more sparingly than in traditional health care and believe that other elements are more central to long-term improvement. [9][10][11][12]15,16 By 2018, medication-free treatment was offered at 25 locations in Norway.…”

Medication-free treatment in mental health care: How does it differ from traditional treatment?

“…Some of the most well known are Chestnut Lodge (9), Kastanjebakken (1977Kastanjebakken ( -2000 (10), Soteria (1969-ff) (11,12) and Open Dialogue (1980s-ff) (13). Common elements are the emphasis on relationships (10,11,(14)(15)(16), exibility and adaptation, a supportive environment and nding meaning in the person's experiences (11,(14)(15)(16)). These treatments vary in therapeutic intensity (11,14,16,17).…”

Medication-free treatment in mental health care. How does it differ from traditional treatment?

“…Common elements are the emphasis on relationships 13,14,[17][18][19] , exibility and adaptation, a supportive environment and nding meaning in the person's experiences 14,[17][18][19] . These treatments vary in therapeutic intensity 14,17,19,20 . Although none of these treatment ban medications, they typically use them more sparingly than in traditional health care and believe that other elements are more central to long-term improvement [12][13][14][15]18,19 .…”