Journal of Psychotherapy Integration, Vol 32(4), Dec 2022, 377-389; doi:10.1037/int0000271
Historical and contemporary perspectives have argued that alterations in self-experience in psychosis can be reversed with the help of psychotherapy. Less is known about the particular forces that spur such change, though it has been argued that intersubjectivity in the therapy dyad contributes to shared meaning making that enables movement toward recapturing a sense of self. To date, it is unclear how exactly the therapist establishes and then maintains an intersubjective connection in psychotherapy with persons with psychosis. In this article, we offer a three-step hierarchical model that describes observable therapist activities that promote intersubjectivity and facilitate the recovery process for individuals experiencing psychosis. We suggest the therapist activities needed to build mutual sense making include a foundational therapist openness to experience, which leads to the development of a dialectic of acceptance-challenge to fragmentation, and ultimately joint reflection that contributes to recovery of sense of self. The clinical implications and challenges of incorporating these types of interventions into clinical practice are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)