Paul H. Lysaker
Indiana University, Roudebush VA Medical Center, Indianapolis (IN), USA

E-mail:plysaker@iupui.edu

 

DIALOGICAL AND NARRATIVE TRANSFORMATIONS IN THE PSYCHOTHERAPY
OF PERSONS WITH SCHIZOPHRENIA

 

In recent papers (Lysaker & Lysaker 2001; Lysaker, Wickett, Wilke & Lysaker (in press)) we have suggested that people with schizophrenia have difficulty presenting themselves as agent-protagonists in their life narratives because they have difficulties negotiating the internal and external conversations that constitute the self whose life is being narrated. Said otherwise, perhaps those with schizophrenia experience difficulties maintaining a stable and coherent sense of self and personal narrative because they have grave difficulty purposively synthesizing the various self-positions that are the touchstones of their life. One implication is that perhaps psychotherapy may be able to help persons with schizophrenia achieve a more coherent and empowering narrative of their lives by helping to revive dialogical processes otherwise collapsed or compromised. In the current paper we explore this possibility by first reviewing the theoretical bases for assuming a relationship between narrative and a dialogical disturbance in schizophrenia and then by reporting the results of a qualitative study of changes in the dialogical and structural qualities of narrative of an adult with schizophrenia over the course of 14 months of individual psychotherapy. Using the musical metaphor, it is suggested that the person with schizophrenia may be seeking in psychotherapy less to alter the themes of his or her story and more to deepen the counterpoint and harmonics that animate those themes. Theoretical and clinical implications are discussed.

 

Lysaker, P.H. & Lysaker, J.T. (2001). Psychosis and the disintegration of dialogical self-structure: Problems posed by schizophrenia for the maintenance of dialogue. British Journal of Medical Psychology 74, 23-33

Lysaker, P.H., Wickett, A., Wilke, N. & Lysaker, J.T. (In press). Narrative incoherence in schizophrenia: The absent agent-protagonist and the collapse of internal dialogue. American Journal of Psychotherapy