The Mutual Development of Intersubjectivity and Metacognitive Capacity in the Psychotherapy for Persons with Schizophrenia

The Experience of Childhood Trauma and Its Influence on the Course of Illness in First-Episode Psychosis

“…Their narrative accounts of self and other people are often more complex and nuanced and include a synthesis of both negative and positive aspects. According to Lysaker et al (2013;2007), this would be characteristic of persons with high metacognitive capacity. Metacognition refers to the capacity to create complex accounts of self and others' thoughts and feelings, including the use of this understanding to solve complex emotional and interpersonal problems (Dimaggio and Lysaker 2010;Semerari et al, 2003).…”

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

“…Consistent with work on the role of metacognition in general reflectivity and insight, there has also been increasing interest in metacognitive-oriented psychotherapies to promote insight [123][124][125][126][127][128][129]. Although there are similarities with REFLEX in that many of the same issues are addressed, metacognitive-oriented therapies more directly target metacognitive deficits.…”

“…In order to stimulate metacognition using MERIT, eight interrelated processes should occur within every session. These include positioning the patient's agenda as primary, sharing of the therapist's thoughts without disrupting dialogue, eliciting a narrative episode(s), defining a psychological problem, discussing interpersonal processes in session, evaluating progress, stimulating reflective activities about the self and others, and finally, stimulating thoughts about how best to understand and to respond to psychological and social challenges [129]. Thus far, the evidence of feasibility of such approaches includes multiple case reports [125-129; 136-140] and a formal trial is currently underway [135].…”

Interpersonal stance and dialogue in psychotherapy for schizophrenia: A supervisory approach

“…This includes attention to traditional psychoanalytic concepts such as countertransference (Itzhaky, Karin, & Ribner, 2001), with others focusing more broadly on the development of therapeutic rapport (Huszonek, 1987) or intersubjective processes (Yerushalmi, 2012). Intersubjective processes, broadly defined as what occurs between the two minds of the therapy dyad, have been suggested as central to psychotherapy in general (Aron, 2006), and particular attention has been paid to the implications of intersubjective processes on the psychopathology of schizophrenia and their role in its treatment and recovery (e.g., Buck, Buck, Hamm, & Lysaker, 2015;Hasson-Ohayon, 2012;Lysaker et al, 2012;Stanghellini & Lysaker, 2007). Specific aspects of intersubjective processes have been highlighted as particularly relevant to the supervision of psychotherapy for schizophrenia.…”