Monday, February 11, 2008

What are the curative factors in recovery from mental illness?

Link to a very interesting article in the Washington Post on Feb. 10, by Charles Barber, a mental health worker at Yale:

Barber describes his own journey to recovery from an incapacitating mental condition, and draws some observations from his own experience and from research into the conditions that facilitate recovery. He speaks against the "medical model" of attempting to alleviate symptoms through the use of drugs, and instead focuses on the healing effects of "social context." He notes that outcomes from even such severe mental illnesses as schizophrenia are better in developing countries, where "patients get more support from family and society." His is an argument against pharmacotherapy and "therapist as expert," and instead, an argument for immersion in a supportive social mileau.

Barber does not use the language of self psychology or relational analytic theory but, using these schools of thought as lenses, what he says becomes readily explainable. A self psychologist would recognize all of the curative factors Barber lists as sustaining selfobject relationships that lead to restoration of cohesion to the disequilibrated self. What Barber describes as curative is the restoration of the "selfobject mileau."

Near the end of his article, Barber states that "Listening to patients [the curative factor] cuts against the establishment grain." Here, he speaks of what Kohut and others have termed "empathic immersion" in the patient's experiential world. (Cf. also Donna Orange et al.)

How would other schools of psychoanalytic thought explain what Barber describes in his article? Post your thoughts, reactions, and other musings on how best to explain the important observations about what constitute the curative factors that Barber describes.

Note that Barber has a newly-published book in which he elaborates on these ideas.

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