Problems Inherent in the Study of Psychotherapy of Psychoses

Conclusions from a Community Psychiatric Action Research Study
  • Yrjö O. Alanen
  • Viljo Räkköläinen
  • Juhani Laakso
  • Riitta Rasimus


The methodological problems inherent in the study of psychodynamics and psychotherapy of the psychoses deserve a critical examination because of the influence they have on the results achieved. Our research culture, based, as it is, on the methodologies of natural science, easily devaluates observations which rest on a case-specific approach difficult to confirm by experimental methods. Still, much of the most creative and clinically useful work in this field has been based on penetrating observations of individual cases relatively few in number; an excellent example of this being the classic study of seventeen families of schizophrenic patients carried out at the Yale University Department of Psychiatry by Lidz, Fleck, and Cornelison.1 Such a study, inseparably linked with an extended clinical situation, would not have been possible to execute by making use of simultaneous and matched control material. Employing a natural scientific method, the observational angle would have been more narrow and superficial, of necessity. While saying this, we do not deny the significance of experimental research design (e.g. in verifying the observations based on a case-specific approach).


Schizophrenic Patient Disability Pension Psychotherapeutic Treatment Psychotic Patient Psychiatric Clinic 
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  1. 1.
    Lidz T, Fleck S, Cornelison AR: Schizophrenia and the Family. New York, International Universities Press, 1965.Google Scholar
  2. 2.
    Alanen YO, Laine A, Räkköläinen V, et al: Evolving the psychotherapeutic community: Research combined with hospital treatment of schizophrenia, Paper presented at the Conference on Schizophrenia: The Implications of Research Findings on Treatment and Teaching. Washington, D.C., NIMH, 1970.Google Scholar
  3. 3.
    Alanen YO, Laine A: Development of hospital centered community psychotherapy service for schizophrenic patients: Evaluation of the first phase, in Wing JK, Häfner H (eds): Roots of Evaluation: The Epidemiological Basis for Planning Psychiatric Services. London, Oxford University Press, 1973, pp 309–327.Google Scholar
  4. 4.
    Salonen S: On the technique of the psychotherapy of schizophrenia, in Jorstad J, Ugelstad E (eds): Schizophrenia 75. Oslo, Universitetsforlaget, 1976, pp 115–133.Google Scholar
  5. 5.
    Räkköläinen V: Psychodynamic and interpersonal aspects of the onset of psychosis, in Jorstad J, Ugelstad E (eds): Schizophrenia 75. Oslo, Universitetsforlaget, 1976, pp 1–70.Google Scholar
  6. 6.
    Räkköläinen V: Onset of Psychosis: A clinical study of 68 cases. Ann Univ Turku Ser D, 7:1–70, 1977.Google Scholar
  7. 7.
    Salokangas RKR: Skitsofreniaan sairastuneiden psykososiaalinen kehitys (The Psychosocial Development of Schizophrenic Patients). Kansaneiakeläitoksen julkaisuja Sarja AL 7, Turku 1977, English summary pp 329–377.Google Scholar
  8. 8.
    Salokangas RKR: Psychosocial prognosis in schizophrenia. Ann Univ Turku, Ser D, 9:1–174, 1978.Google Scholar
  9. 9.
    Alanen YO: The psychotherapeutic care of schizophrenic patients in a community psychiatric setting, in Lader MH (ed): Studies of Schizophrenia. Br J Psychiat Spec Pub 1 No 10, 1975, pp 86–93.Google Scholar
  10. 10.
    Alanen YO: In search of the interactional origin of schizophrenia. The Stanley R Dean Award Lecture, in Hofling CK, Lewis JM, (eds): The Family: Evaluation and Treatment. New York, Bruner/Mazel, 1980, pp 285–313.Google Scholar
  11. 11.
    Achte KA: On Prognosis and Rehabilitation in Schizophrenic and Paranoid Psychoses. Acta psychiatr Scand 43 (suppl 196): 1–217, 1967.CrossRefGoogle Scholar
  12. 12.
    Niskanen P, Achté KA: The Course and Prognosis of Schizophrenic Psychoses in Helsinki: A Comparative Study of First Admissions in 1950, 1960, and 1965. Monographs from the Psychiatric Clinic of the Helsinki University Central Hospital, No 4, 1972.Google Scholar
  13. 13.
    Achté KA, Niskanen P, Lönnqvist J: The prognosis of schizophrenic psychoses in Helsinki, first admission in 1950, 1960, 1965 and 1970 with five-year follow-up, in Psy-chiatria Fennica, 1980 (Yearbook), in press.Google Scholar
  14. 14.
    Lehtinen V, Salokangas RKR, Holm H, et al: Need and realization of the open care of mental health disorders. Sosiaalilääketieteellinen Aikakauslehti (Journal of Social Medicine in Finland) 16:280–291, 1979 (with English summary).Google Scholar
  15. 15.
    May PRA: Treatment of Schizophrenia. New York, Science House, 1968.Google Scholar
  16. 16.
    May PRA, Tuma AH, Yale C, et al: Schizophrenia: A follow-up study of results of treatment. Arch Gen Psychiatry 33:474–486, 1976.PubMedCrossRefGoogle Scholar
  17. 17.
    Alanen YO, Räkköläinen V, Rasimus R, et al: Indications for different forms of psychotherapy with new schizophrenic patients in community psychiatry, in Müller C (ed): Psychotherapy of Schizophrenia. Excerpta Med Int Cong Ser No 464, pp 185–202, Amsterdam-Oxford, 1979, p. 185.Google Scholar
  18. 18.
    Sullivan HA: The modified psychoanalytic treatment of schizophrenia. Am J Psychiatry 88:519–540, 1931.Google Scholar
  19. 19.
    Federn P: Psychoanalysis of psychoses. Psychiatr Q 17:3–19, 246–257, 470–487, 1943.Google Scholar
  20. 20.
    Sechehaye MA: A New Psychotherapy of Schizophrenia. New York, Grune & Stratton 1956 (French original in 1947).Google Scholar
  21. 21.
    Müller C: Die Psychotherapie Schizophrener an der Zürcher Klinik. Versuch einer Vorläufigen katamnestischen Übersicht. Nervenarzt 32:354–368, 1961.Google Scholar
  22. 22.
    Schulz CC: A follow-up report on admissions to Chestnut Lodge: 1948–1958. Psychiatr Q 37:220–233, 1963.PubMedCrossRefGoogle Scholar
  23. 23.
    Lidz T, Cornelison AR, Fleck S, et al: The intrafamilial environment of schizophrenic patients: II. Marital schism and marital skew. Am J Psychiatr 114:241–248, 1957.PubMedGoogle Scholar
  24. 24.
    Alanen YO: The mothers of schizophrenic patients. Acta Psychiatr Neurol Scand 33 (Suppl 124): 1–361, 1958.CrossRefGoogle Scholar
  25. 25.
    Wynne LC, Ryckoff IM, Day JR, et al: Pseudomutuality in the family relations of schizophrenics. Psychiatry 21:205–220, 1958.PubMedGoogle Scholar
  26. 26.
    Wynne LC, Singer MT, Toohey ML: Communication of the adoptive parents of schizophrenics, in Jorstad J. Ugelstad E (eds): Schizophrenia 75. Oslo, Universitetsfor-laget, 1976, pp 413–451.Google Scholar
  27. 27.
    Stierlin H: Family dynamics and separation patterns of potential schizophrenics, in Rubinstein D, Alanen YO (eds): Psychotherapy of Schizophrenia. Amsterdam, Excerpta Medica 1972, pp 169–180.Google Scholar
  28. 28.
    Alanen YO, Rekola JK, Stewen A, et al: The family in the pathogenesis of schizophrenic and neurotic disorders. Actapsychiatr Scand 42 (suppl 189): 1–654, 1966.Google Scholar
  29. 29.
    Alanen YO, Kinnunen P: Marriage and the development of schizophrenia, Psychiatry 38:436–465, 1975.Google Scholar
  30. 30.
    Grinspoon L, Ewalt JR, Shader R: Schizophrenia: Pharmacotherapy and Psychotherapy. Baltimore, Williams & Wilkins Co, 1972.Google Scholar
  31. 31.
    Ugelstad E: Possibilities of organizing psychotherapeutically oriented treatment programs for schizophrenia within sectorized psychiatric service, in Müller C (ed): Psychotherapy of Schizophrenia. Excerpta Medica Int Cong Ser No 464, pp 253–258, Amsterdam-Oxford, 1979.Google Scholar

Copyright information

© Plenum Publishing Corporation 1980

Authors and Affiliations

  • Yrjö O. Alanen
    • 1
  • Viljo Räkköläinen
    • 1
  • Juhani Laakso
    • 1
  • Riitta Rasimus
    • 1
  1. 1.Department of PsychiatryUniversity of TurkuTurkuFinland

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