Stranger In the City
The International Society for Psychological and Social approaches to Psychosis (ISPS) organises her 21st conference in Rotterdam the Netherlands, August 28 – September 1, 2019, the theme being:
Stranger In the City; On the Circular Relationships between Psychosis and Alienation and the Healing Power of Human Reconnection.
Psychosis, migration status and cultural transition. Metastudies have shown that for (forced) immigrants the relative risk to receive a diagnosis of schizophrenia is up to eight times to that of others. In clinical practice in the Netherlands immigrants seem to be overly and chronically medicated for psychotic-like symptoms while there is no or limited access to new and successful psychological and social approaches. Lack of cultural sensitivity and biased diagnostic methodology are, in part, to blame for this.
How does it feel to be a non-Western immigrant in a Western country? What are the dynamics of becoming psychotic, what insights does this bring? How to understand what it means for the offspring of immigrants to grow up within a family with scarce social connections and a low social status?
The connection between social exclusion and psychosis
Someone with psychosis can become a stranger for the people who surround her or him. However, more and more research shows that this relationship is circular: being treated as and feeling a stranger promotes psychosis, makes one in other words psychosis prone. The risk is for instance much higher when you:
- originate from a non-Western country and are living in a Western country. The chances to become psychotic appear to be much higher for immigrants (esp. those of colour) than for people who have been living for generations in the same country, esp. when one has felt discrimination;
- moved a lot within a Western country or countries when young;
- were bullied or otherwise excluded;
- grew up in a city or neighbourhood where people didn’t care about each other and were demoralized;
- are homosexual and do not dare to ‘come out’;
- are hard of hearing or deaf.
In short: when you don’t feel ‘at home’ or to belong you run a high risk to become psychotic.
In Western psychiatry psychosis is seen as a dangerous disease which must be treated thoroughly and quickly, primarily by medication and seclusion. Psychiatrists and other mental health professionals who want to cure can easily be experienced as enemies. Hospitalisations and esp. forced seclusions can be traumatic, while medication dulls emotions and often does not help in curing the problems that are bothering the person, like difficulty with thinking and functioning in study or work. Medication can make these problems even worse. Because of this, a vicious circle may start that makes people more and more alienated from themselves and their surroundings.
A different view on psychosis
Contrary to many psychiatrists and mental health professionals, the people that are themselves afflicted by a psychosis can have a view and an understanding of their experiences as being intense and real and closer to their real self. Some understand and give meaning to their psychotic experiences as presenting a developmental crisis, a turning point in their lives, that brings them insight. Also, in other times and cultures, there seems to have been more occasion for psychotic experiences to be seen in a more positive light, e.g. as becoming a shaman or as representing special wisdom.
The 2019 ISPS conference is meant to discuss the nature of psychosis and alternative psychological and social ways to deal with it, and to empower the people afflicted by psychosis, especially the more vulnerable ones. Scholars, scientists and clinicians, will talk about their findings. An especially important place is reserved for those who themselves have had a psychosis or who are psychosis prone and can talk from experience and combine these experiences with their professional background and education.
Important subthemes are:
Addressing family members and others the focus will be on reconnecting the psychotic person with them and with larger society. In this conference there will be much attention given to different modes of expression and to approaches and ways by which to reconnect as well as to alternative ways that people with psychotic experiences may find helpful, like addressing their bodily sensations.
Psychological approaches do not aim to fight the psychotic experiences but to cope with them and to come to terms with their special nature. For instance, someone with psychotic experiences can learn to find ways for these experiences not to take over. Or they can discover how memories of traumatic experiences can trigger them.
Connecting different therapeutic and cultural ways of understanding
In confronting and connecting the different views of therapeutic schools of thought, like cognitive-behaviour therapy and psychoanalysis, with what works, with what kind of problem, when and how, we hope to get a clearer view on the differences and the similarities and esp. their possible complementarity.
Prevention of psychosis: a political issue
A lot happens in early development and involves infant mental health while adolescence is also a critical period. More research is needed but we do know that it is important for parents and children to live in a safe neighbourhood and in an extended network, buffering stress. A safe community is the responsibility of people from all origins as well as of policy makers, mayors, teachers, policemen and neighbours.
ISPS membership for 2019?
The next issue of the ISPS journal #psychosis will on its way to our members in just a couple of weeks. Ensure you renew your membership of ISPS now, to enjoy uninterrupted membership benefits.
Haven’t joined ISPS yet?
Here are 4 good reasons why you should join us:
1) Members enjoy reduced delegate fees at ISPS conferences, such as Stranger in the City in Rotterdam this summer #isps2019
2) Members receive 4 issues of Psychosis per year and also have online access to previous issues of the journal
3) 20% discount on books in the ISPS series published by Routledge
4) By joining ISPS you can connect with over 1,500 people around the world – who share your interest in psychosocial treatments for #psychosis – through our email discussion groups and regional meetings
De sprekers van de preconference workshops zijn nu bekend. We zijn nog in onderhandeling of zij 2 workshops van een halve dag of een van een hele dag zullen geven. Er zijn 6 workshops en een excursie :
• Open Dialogue, georganiseerd door Dienke Boertien en Dag van Wetter. Wat is open dialogue? Zie in het kort wat Jaakko Seikula daarover zegt.
Acceptance en Commitment therapy door Joe Oliver.
Joe Oliver is een van de belangrijkste ontwikkelaars van deze benadering. Dankzij bemiddeling door Joris Corthouts hebben we hem kunnen strikken. Wat is ACT? Bekijk het filmpje Demons on the boat.
Verstandig omgaan met (afbouw van) medicatie, Will Hall.
Zie pharmaceuticals risk and alternatives. Voor bezorgde psychiaters: Will’s workshop is een schitterend voorbeeld van motiverende gespreksvoering.
Verstandig omgaan met weed door Devi Hisgen.
Veel mensen met psychose ervaring willen graag weed blijven gebruiken, om kalmer van te worden? De Nederwiet zit helaas vol met psychose verwekkend THC. Wat is verstandig om te doen? Ga in gesprek en op excursie met ervaringsdeskundige herstelmedewerker Devi Hisgen.
Hersteldeskundige bij Pameijer
Nieuwland,, Provincie Drenthe, Nederland
Omgaan met djinns/ het cultural formulation interview met Victor Kouratovsky
Transculturele therapie is voor mij een roeping. Ik werk voor het ETT omdat ik verder wil bijdragen aan goede hulp voor mensen van diverse achtergrond en afkomst.
Opleiding en werkervaring:
Ik ben Klinisch psycholoog en ruim 30 jaar werkzaam in het centrum van Rotterdam; vooral met vele van de 170+ nationaliteiten en afkomsten.
Onderscheiding: In 2015 onderscheiden voor mijn bijdragen aan de interculturele psychologie.
dr. Victor Kouratovsky
Patients’ self-reports of explanatory models (EMs) are sensitive to distortions, particularly as a result of social desirability, uncertainty towards one’s own beliefs, and ethnic disparities with the interviewer. In contrast, reaction-time-based indirect measures are thought to be less sensitive to such factors. This article reports on two studies that applied direct (interview) and indirect (reaction-time-based association task) measures of EMs. Study 1 found evidence for the convergent validity of the direct and indirect measures, indicating that the two measures were essentially related. Furthermore, social desirability and uncertainty towards one’s beliefs affected the association between the measures on two categories of EMs. Study 2 showed that, unlike the self-reports of EMs, indirect measures were less sensitive to the ethnicity of the interviewer. The nature of the indirect measure, and the construct that it measures, are discussed.
Hoe overbrug je de kloof met mensen met psychose ervaring en hun familie uit een andere cultuur?
- Hoe leiden trauma’s tot psychose?
King’s College London and South London and Maudsley NHS Foundation Trust · Institute of Psychiatry, Psychology and Neuroscience
(aangeraden door David van de Berg) deed er onderzoek naar.
Stijn Vanheule samen met Peter Dierinck.
Wat is kwartier maken?
Ze kan zaterdag 19 januari in de ochtend een workshop houden in Rotterdam. Belangstelling? Laat het ons weten!
Kosten 50 euro.
Debra zal een van de voorzitters zijn op de 2e congresdag van Stranger in the City, die zal gaan over de overbrugging van de kloof tussen iemand die psychotisch is en de anderen. Debra is zowel ervaringsdeskundige als docente aan de verpleegkunde opleiding van de universiteit van Auckland (Nieuw Zeeland) . Zie verder Wikipedia.en haar TED lezing
Ze is lid van het internationale bestuur van de ISPS en in dat kader komt ze voor een vergadering op 19 januari naar Nederland, deels op kosten van het congresbudget. We willen met haar de opbouw van de 2e dag doorspreken.
En door haar persoonlijke ervaring en door haar uitgebreide wetenschappelijke kennis over psychose is zij in staat hulpverleners en mensen met psychose ervaring te verbinden.
We organiseren haar workshop noodzakelijkerwijze op korte termijn. Als je belangstelling hebt laat het ons weten!
Cash prizes and a free book
for the 3 best posters at the biennial ISPS International Congress!
The awards committee will consist of three members of the ISPS International Executive Committee.
Winners will be informed by the Friday afternoon of the conference.
Each of the winners will also be invited to select a complimentary book of their choice from the ISPS book series, from the Routledge book stand, during the conference.
The winners will be announced during the closing ceremony of the conference.
The award money will be paid via bank transfer after the conference.
NB: All accepted posters will be considered for a prize, with the exception of posters that were not exhibited and presented by at least one author on the day of the poster presentations.
In Liverpool I also met with other participants from Chile and Argentina. This led to a desire to form an ISPS Latin America group, to make a real change happen in our countries. Despite the differences between Latin countries, we support the same principles: the emphasis psychological and social interventions and the need to decolonize mental health. The ISPS experience was a great opportunity to built networks. I’m glad to have had the opportunity to listen to professionals who guided my perspective about psychic suffering such as John Read. I also could learn more about different approaches to work with psychic suffering, such as Multi Family Group Therapy and the Open Dialogue interventions.
Finally, I could recognize the main personal change when I accepted that “I am a family member” for the very first time. At this conference, I didn’t feel judged or shamed. I felt proud of being a survivor and trying to do something useful with all the pain involved in being a daughter of someone who has suffered from mental illness. Because of all this, I want to share my gratitude for this support which has helped me to integrate my shadows and virtues making me a better human and a better psychologist.
ISPS Mayo is a newly formed ISPS group in Castlebar, County Mayo, Western Ireland. There are 10 members so far, composed of clinical psychologists, a psychiatrist, an art therapist, an employability worker and peer support workers.
The David B. Feinsilver Award: A scholarship to fund travel expenses to the ISPS Congress
David B. Feinsilver, M.D. was a long-time staff member at the Chestnut Lodge Hospital in Rockville, Maryland, U.S.A, where he chaired its Symposium Committee.
A former president of ISPS, the chair of its 1994 ISPS meeting in Washington, and the founder of ISPS-US, he established a fund before he died after a long illness. This fund grants a scholarship to fund travel expenses to each ISPS International congress, for the best research or clinical paper on the psychotherapeutic treatment of the severely disturbed.
Applications for the 2019 Award – If you are interested in applying for this grant you must indicate so during the abstract submission process. Applications will only be considered from people who cannot afford to attend the congress without financial support. The award will be given to the best research or clinical paper by a newcomer, who cannot otherwise afford to attend the congress. Abstracts must be received by 17th March 2019.
From the previous series editor
I first got to know of Alison not long after I was appointed as a Consultant Psychiatrist to an Early Intervention in Psychosis service in 2005. I was very keen to meet her as before that I did not know of any other person beside myself in such a post who had a psychodynamic training. It was a great relief and very exciting to find such a fine colleague with similar interests and ‘beliefs’ in the importance and relevance of psychodynamic understanding to psychosis. I was immediately impressed by her and I think I introduced her to ISPS UK and before long she was putting on a small ISPS UK conference in the North West of England drawing together a number of people who subsequently played an important part in ISPS UK, family members and members with experience of psychosis as well as professionals from different disciplines.
She subsequently organised a really memorable day bringing over the very talented Danish Psychiatrist Lars Thorgaard, not long before he passed away. Lars was brilliant in conveying how to make a therapeutic relationship with people experiencing psychosis and use psychodynamic understanding using everyday words and with such empathy.
Alison and I had a lot of contact when she took the lead in trying to get off the ground a ISPS UK national research programme in supportive psychoanalytic psychotherapy for psychosis, this time using the research experience of another talented Danish psychiatrist and psychoanalyst Bent Rosenbaum who led the Danish research project to publication with its encouraging results I was very impressed with Alison’s organisational skills, her firm but so friendly handling of the group of interested persons and getting through a full agenda and how much energy she put into this project and capacity to attend to the tedious detail of the applications. It was a big disappointment to us all that we got knocked back for all kinds of seemingly spurious reasons by research allocation committees and in the end we gave up.
During this time I was the editor of the ISPS book series and I had no hesitation in Alison being at the top of my list when I felt the time was approaching for me to find a successor. I was, of course, delighted when she accepted and agreed to work alongside me for a year or so before I stepped back; it is such a source of satisfaction to me to have started a project such as the ISPS book series and to be able to hand it on with such confidence as I had in Alison and to see its continuing development. It is my impression that her rigour brought the quality of the books to a new high standard and furthermore she took important initiatives in the book series in a) making sure that there was no automatic use of the word schizophrenia and b) developing rigorous guidelines in making sure that if clinical work was described that any person mentioned gave their permission for publication. Amongst others, books published under Alison’s editorship include Art Therapy for Psychosis, edited by Katherine Killick, and a book on personal experiences (in press).
Alongside the responsibility for editor ship and co-editorship of the books, Alison, Bent and myself wrote what we regarded as a series of important articles for psychiatrists to help to know about the psychodynamics of psychosis, how to make a formulation of problems related to psychosis and to demonstrate a supportive psychotherapy for psychosis. (Advances in Psychosis Advances in psychiatric treatment (2013), vol. 19, 124–131 doi: 10.1192/apt.bp.111.009126, https://pdfs.semanticscholar.org/b0c2/ae943e883cb3375c5f04816f024ab891ebb0.pdf https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/using-psychodynamic-principles-in-formulation-in-everyday-practice/9E26EFED1AEDB0228C0585DE98B71382
Alison realised that a psychodynamic formulation is of much greater value than attempting to be precise in psychiatric diagnosis. I remember the fun the two of us had at an ISPS International conference quite a few years ago, demonstrating the value of formulation utilising Freud’s Schreber case using masks for the key characters. How she had time to take on and be such an active leader of ISPS UK during this time is beyond imagination! More about this from Alf Gillham, below.
Last but not least, Alison took the lead in the organising committees for the ISPS international meeting in 2017 in Liverpool. My having had the similar role in 1997, the first time the UK organised an ISPS international meeting, I did not envy her taking on this role. The responsibility is enormous. Alison got a really good group to work together and ensure that the responsibilities were well shared out. I think an outstanding aspect of the organisation was the way in which Alison continued her determination to have experts by experience of psychosis and family members taking major areas of responsibility in the organisation and content of the meeting. For me this has been one of the biggest changes in ISPS in the last twenty years and in my view the Liverpool ISPS conference was the most successful yet in this respect.
Past Chair ISPS, previous ISPS book series editor
On behalf of the ISPS EC
I remember well first meeting Alison at the 50th anniversary conference of ISPS International. I attended on my 50th birthday as a present to myself, as I was so impressed with ISPS and its history. I immediately recognised a fellow soul, who felt the same way about ISPS, and that psychotherapy had much to offer the understanding of psychosis. We both joined ISPS-UK committee at the same time and went on to work together on many projects. When David Kennard stepped down as Chair Alison stepped up to the plate and helped navigate ISPS-UK through some very difficult times. ISPS has much to thank her for this (and David). Always caring and able to listen to all views of the committee, it became and still is a very welcoming family. I know that I consider her a close and valued friend as well as a colleague.
Our last big collaboration was when she chaired the committee that organised ISPS-INT International Conference. A huge undertaking, I somewhat blindly agreed to chair the group putting the programme together. I can honestly say that without Alisons skills with helping with this, the conference would not have taken place. It placed an enormous strain on her, and the success of the conference is due largely to her input. She has left ISPS-UK in the very capable hands of Akiko Hart, another special person. It’s great how ISPS attracts such people. We both step down from the committee soon, but it going from strength to strength, a strong legacy, and important family.
ISPS UK Executive Committee