PURPOSE: The purpose of this study is to find common points of view between the results of qualitative studies researching stages of the recovery process in persons with psychosis and mental changes in a therapeutic relationship in psychoanalytically oriented psychotherapy. CONCLUSIONS: Both concepts correspond one to another. The added psychoanalytical perspective highlights milestones in psychic change: attainment of mental differentiation; integration of self together with the transformation of psychotic grandiosity into decentration, which implies responsibility for illness and own life. PRACTICE IMPLICATIONS: These conclusions highlight the importance of supporting relationships for people suffering from psychoses.

Department of Psychiatry and UHSL 1st Faculty of Medicine Charles University Prague Czech Republic

ESET Psychotherapeutic and Psychosomatic Clinic Prague Czech Republic

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Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J. 1993;16(4):11-23. https://doi.org/10.1037/h0095655

Harding CM. Changes in schizophrenia across time: paradoxes, patterns, and predictors. In: Davidson L, Harding C, Spaniol L, eds. Recovery From Severe Mental Illnesses: Research Evidence and Implications for Practice. 1. Boston, MA: Center for Psychiatric Rehabilitation, Sargent College of Health and Rehabilitation Sciences, Boston University; 2005:27-48.

DeSisto MJ, Harding CM, McCormick RV, Ashikaga T, Brooks GW. The Maine and Vermont three-decade studies of serious mental illness. I. Matched comparison of cross-sectional outcome. Br J Psychiatry. 1995;167(3):331-338. https://doi.org/10.1192/bjp.167.3.331

Heilbronner U, Samara M, Leucht S, Falkai P, Schulze TG. The longitudinal course of schizophrenia across the lifespan: clinical, cognitive, and neurobiological aspects. Harv Rev Psychiatry. 2016;24(2):118-128. https://doi.org/10.1097/HRP.0000000000000092

Savill M, Banks C, Khanom H, Priebe S. Do negative symptoms of schizophrenia change over time? A meta-analysis of longitudinal data. Psychol Med. 2015;45(8):1613-1627. https://doi.org/10.1017/S0033291714002712

Leonhardt BL, Huling K, Hamm JA, et al. Recovery and serious mental illness: a review of current clinical and research paradigms and future directions. Expert Rev Neurother. 2017;17(11):1117-1130. https://doi.org/10.1080/14737175.2017.1378099

Stuart SR, Tansey L, Quayle E. What we talk about when we talk about recovery: a systematic review and best-fit framework synthesis of qualitative literature. J Ment Health. 2017;26(3):291-304. https://doi.org/10.1080/09638237.2016.1222056

Davidson L, Strauss JS. Sense of self in recovery from severe mental illness. Br J Med Psychol. 1992;65:131-145. https://doi.org/10.1111/j.2044-8341.1992.tb01693.x

Young SL, Ensing DS. Exploring recovery from the perspective of people with psychiatric disabilities. Psychiatr Rehabil J. 1999;22(3):219-231. https://doi.org/10.1037/h0095240

Davidson L, Roe D, Andres-Hyman R, Ridgway P. Applying stages of change models to recovery from serious mental illness: contributions and limitations. Isr J Psychiatry Relat Sci. 2010;47(3):213-221.

Baxter EA, Diehl S. Emotional stages: consumers and family members recovering from the trauma of mental illness. Psychiatr Rehabil J. 1998;21(4):349-355. https://doi.org/10.1037/h0095289

Hancock N, Smith-Merry J, Jessup G, Wayland S, Kokany A. Understanding the ups and downs of living well: the voices of people experiencing early mental health recovery. BMC Psychiatry. 2018;18:121. https://doi.org/10.1186/s12888-018-1703-1

Pettie D, Triolo AM. Illness as evolution: the search for identity and meaning in the recovery process. Psychiatr Rehabil J. 1999;22(3):255-262. https://doi.org/10.1037/h0095236

Spaniol L, Wewiorski NJ, Gagne C, Anthony WA. The process of recovery from schizophrenia. Int Rev Psychiatry. 2002;14:327-336. https://doi.org/10.1080/0954026021000016978

Andresen R, Oades L, Caputi P. The experience of recovery from schizophrenia: towards an empirically validated stage model. Aust N Z J Psychiatry. 2003;37:586-594. https://doi.org/10.1046/j.1440-1614.2003.01234.x

Bourdeau G, Lecomte T, Lysaker PH. Stages of recovery in early psychosis: associations with symptoms, function, and narrative development. Psychol Psychother. 2015;88:127-142. https://doi.org/10.1111/papt.12038

Andresen R, Caputi P, Oades L. Stages of recovery instrument: development of a measure of recovery from serious mental illness. Aust N Z J Psychiatry. 2006;40:972-980. https://doi.org/10.1111/j.1440-1614.2006.01921.x

Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199:445-452. https://doi.org/10.1192/bjp.bp.110.083733

Bachmann S, Resch F, Mundt C. Psychological treatments for psychosis: history and overview. J Am Acad Psychoanal Dyn Psychiatry. 2003;31(1):155-176. https://doi.org/10.1521/jaap.31.1.155.21930

Freud S. On narcissism: an introduction. In: Strachey J, In Freud A, Richards A, eds. The Standard Edition of the Complete Psychological Works of Sigmund Freud. 14. London, UK: Hogarth Press; 1914:67-102.

Freud S. The unconscious. In: Strachey J, In Freud A, Richards A, eds. The Standard Edition of the Complete Psychological Works of Sigmund Freud. 14. London, UK: Hogarth Press; 1915:159-215.

Bleuler E. Autistic thinking. In: Rapaport D, ed. Organization and Pathology of Thought, Selected Sources. New York, NY: Columbia University Press; 1913:399-437.

Bleger J. Schizophrenia, autisms, and symbiosis. Contemp Psychoanal. 1974;10:19-25. https://doi.org/10.1080/00107530.1974.10745308

Sas SA. Ambiguity as the route to shame. Int J Psychoanal. 1992;73:329-341.

Ogden TH. On the concept of an autistic-contiguous position. Int J Psychoanal. 1989;70:127-140.

Anzieu D. Autistic phenomena and the skin ego. Psychoanal Inquiry. 1993;13:42-48. https://doi.org/10.1080/07351699309533921

Stern DN. The Interpersonal World of the Infant: A View from Psychoanalysis and Development. New York, NY: Basic Books; 1985.

Robbins M. Experiences of Schizophrenia: An Integration of the Personal Scientific, and Therapeutic. New York, NY: The Guilford Press; 1993.

Anzieu D. A discussion of the paper by Gisela Pankow on “The Body Image in Psychosis”. Int J Psychoanal. 1974;55:415-416.

Ogden TH. On the nature of schizophrenic conflict. Int J Psychoanal. 1980;61:513-533.

Bion WR. Differentiation of the psychotic from the non-psychotic personalities. Int J Psychoanal. 1957;38:266-275.

O'Connor JA, Ellett L, Ajnakina O, et al. Can cognitive insight predict symptom remission in a first episode psychosis cohort? BMC Psychiatry. 2017;17(1):54. https://doi.org/10.1186/s12888-017-1210-9

Ramu N, Kolliakou A, Sanyal J, Patel R, Stewart R. Recorded poor insight as a predictor of service use outcomes: cohort study of patients with first-episode psychosis in a large mental healthcare database. BMJ Open. 2019;9(6):e028929. https://doi.org/10.1136/bmjopen-2019-028929

Hamm JA, Lysaker PH. Application of integrative metacognitive psychotherapy for serious mental illness. Am J Psychother. 2018;71(4):122-127. https://doi.org/10.1176/appi.psychotherapy.20180033

De Jong S, van Donkersgoed RJM, Timmerman ME, et al. Metacognitive reflection and insight therapy (MERIT) for patients with schizophrenia. Psychol Med. 2019;49(2):303-313. https://doi.org/10.1017/S0033291718000855

Pec O, Lysaker PH, Probstova V, Leonhardt BL, Hamm JA, Bob P. The psychotherapeutic treatment of schizophrenia: psychoanalytical explorations of the metacognitive movement. J Contemp Psychother. 2020. https://link.springer.com/article/10.1007/s10879-020-09452-w

Searles HF. Phases of patient-therapist interaction in the psychotherapy of chronic schizophrenia. In: Searles HF, ed. Collected Papers on Schizophrenia and Related Subjects. London, UK: Karnac; 1986:521-559.

Bion WR. Elements of Psycho-Analysis. London, UK: Karnac; 1984.

Gedo JE. Forms of idealization in the analytic transference. J Am Psychoanal Assoc. 1975;23:485-505. https://doi.org/10.1177/000306517502300302

Rosenbaum B, Alberdi F, Haahr U, Lindhardt A, Urfer-Parnas A. Psychodynamic psychotherapy of patients with schizophrenia spectrum psychosis. Ugeskr Laeger. 2019;181(3):V06180425.

Orfanos S, Banks C, Priebe S. Are group psychotherapeutic treatments effective for patients with schizophrenia? A systematic review and meta-analysis. Psychother Psychosom. 2015;84(4):241-249. https://doi.org/10.1159/000377705

Frank AF, Gunderson JG. The role of the therapeutic alliance in the treatment of schizophrenia. Relationship to course and outcome. Arch Gen Psychiatry. 1990;47:228-236. https://doi.org/10.1001/archpsyc.1990.01810150028006

Valbak K, Køster A, Larsen KA, Nielsen JR, Norrie B Danish National Multicenter Schizophrenia Project. The Danish National Multicenter Schizophrenia Project: assessment of psychotic patients for dynamic psychotherapy (APPP). Nord J Psychiatry. 2003;57:333-338. https://doi.org/10.1080/08039480310002651

Pec O, Bob P, Pec J, Hrubcova A. Psychodynamic day treatment programme for patients with schizophrenia spectrum disorders: dynamics and predictors of therapeutic change. Psychol Psychother. 2018;91:157-168. https://doi.org/10.1111/papt.12153

Rosenbaum B, Harder S. Psychosis and the dynamics of the psychotherapy process. Int Rev Psychiatry. 2007;19(1):13-23. https://doi.org/10.1080/09540260601080854

Cohen MR, Anthony WA, Farkas MD. Assessing and developing readiness for psychiatric rehabilitation. Psychiatr Serv. 1997;48(5):644-646. https://doi.org/10.1176/ps.48.5.644

Farkas M, Sullivan S, A, Gagne C. Introduction to Rehabilitation Readiness. Boston, MA: Center for Psychiatric Rehabilitation, Boston University; 2000.