Towards the recovery of a sense of self: An interpretative phenomenological analysis of patients’ experience of body-oriented psychotherapy for schizophrenia

Abstract

We discuss the clinical implications for each theme and bring the findings together by describing therapeutic change in schizophrenia as a recovery of sense of self at different but interlocked levels. Moreover, we put forward recommendations for both specific and common factors for schizophrenia therapy. Clinical or methodological significance of this article: The clinical significance of this study is twofold. On the one hand, the findings of this analysis might inform the theory and practice of BPT and might directly feedback into a further development of the manual guidelines. On the other hand, common helpful factors have been identified thatmight also be relevant for the more general clinical practice concerning patients with schizophrenia. Here, we summarize our key messages for the clinical practitioner emerging from the findings: The inclusion of bodily aspects and a focus on pre-reflective experience in psychotherapy can help persons with schizophrenia recover the sense of being a body-mind unity. Empowering persons with schizophrenia, instead of instructing them, seems to foster a sense of agency and self-confidence, which are crucial to the recovery process. A twofold therapeutic stance characterized by openness towards the other and authenticity was experienced by patients as facilitating the rapport building. This might help persons with schizophrenia engage in the relation. Social inclusion might enhance therapeutic change and recovery in schizophrenia. Group therapy might be helpful for fostering a feeling of social belonging, but the inclusion in the wider social and community context remains a critical issue. The experience of joyful moments in psychotherapy might positively contribute to therapeutic change in that it fosters a sense of hope for the future. Overall our paper contributes to the literature aiming at expanding the range of therapeutic modalities, focussing on the creation and use of mixed models of therapy within and beyond talking practices.

A Phenomenological Paradigm for Empirical Research in Psychiatry and Psychology: Open Questions

“…Recent research has incorporated phenomenological interviews to describe therapeutic change processes in body-oriented therapy for schizophrenia, thus explaining the relationship between processes and outcomes ( Galbusera et al, 2018 ). Unsurprisingly, the phenomenological interviews revealed an understanding of change as a recovery of a “sense of self” in patients with schizophrenia ( Galbusera et al, 2019 ).…”

Contributions of complementary therapies and other strategies to the treatment of schizophrenia: an integrative review

“…Psychotherapy was also one of the results of this review, being a strategy focused mainly on the implicit and pre-reflexive experience, using non-verbal techniques. The main themes addressed in psychotherapy articles were: body-mind connection; be agile and capable; being unique and worthy (accepted for who you are); changing interactions (engaging in authentic interpersonal contact); being part of a group (feeling integrated); hope and investment in the future (Galbusera, et al, 2017). Thus, such practice introduced to schizophrenic patients demonstrated reductions in general psychiatric symptoms, with improvements after therapy ( Table 1).…”

“…The effectiveness of body-oriented psychotherapy (BPT) was assessed in a study that found significant improvement in negative symptoms of schizophrenia (Table 1). According to Galbusera, et al, (2017) the results are significant, considering the lack of effective treatment for negative symptoms, in addition to the side effects of drug treatment. Another study identified an artificial therapy program called "going beyond schizophrenia" (GBTS) in prisoners with schizophrenia in mainland China, which despite the limitations of the study, the capture of quantitative data allowed to support the benefits of this therapy in prison settings (Table 1; Aziz, et al, 2016;Galbusera, et al, 2017).…”

“…The qualitative nature of this study allows us to go in addition to a mere endorsement or rejection of BPT. A better understanding and further development of BPT in schizophrenia is needed (Galbusera, et al, 2017).…”

Psicopatología de la ipseidad y la corporalidad: a propósito de un caso de esquizofrenia cenestopática.

“…etapas tempranas de la enfermedad, es de sumo interés realzar que investigaciones actuales están demostrando el beneficio de terapias basadas en la corporalidad (Body-oriented Psychotherapy; Dance and Movement Therapy) en la evolución temprana de la esquizofrenia, en cuanto a los disturbios de la descorporalización, pero asimismo registran prometedor efecto terapéutico sobre los síntomas negativos, lo que abre una novedosa perspectiva en el arsenal de tratamientos contra esta patología (24)(25)(26).…”