Conflict Between Fantasy and Reality: A Patient and Therapist Talk About Psychotherapy and Schizophrenia

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Abstract

An individual with schizophrenia, and her therapist of 30 years, came to feel strongly that it is important for professionals to hear a patient’s view of the therapy experience and for them to have the opportunity to question both patient and therapist. This article is based on their panel at the American Psychological Association Division of Psychoanalysis meeting in New York, April 25, 2014, which included a discussion facilitated by Diana Diamond, which follows this article. The patient described how her relationship with her therapist and her own understanding of transference have grown and how these have affected her life, including the development of more complex images of herself and others and her relationships with internal and external figures and a stronger sense of self. The therapist describes and discusses her approach to the therapy, and Dr. Diamond comments on changes in object representations over time and on the process of change in psychotherapy.

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