Gud eller Svensson : om en teori för psykos och utveckling av en behandlingsmetod

Sammanfattning: The two principal elements comprising this thesis are 1) a description of the development of a theory concerning schizophrenic psychosis and 2) an attempt to develop a treatment strategy based on this theory. The theory was developed by Palle Villemoes on the basis of the French psychoanalyst Lacan's work and may be described as an ego-structuring psychotherapy with its foundation in the castration complex. The psychosis is seen as a consequence of the child's inability, for various reasons, to a apt itself to symbolic castration - i e disappointment and frustration over not constantly having its own way, and over being required to subordinate itself to universal principles and authorities. The psychotic person has not subordinated under symbolic is castration but continues to exist in the original symbiotic relation with the imagined pre-oedipal mother, When the pressures of the teenage and early adult years make themselves felt, such an ego-weak person is unable to withstand and deal with them and develops a psychotic relation to her/his surroundings,The- treatment strategy described in this thesis, was developed by the author and colleagues at the treatment centre Norrgården in Härnösand. It is a milieu therapyoriented treatment during which the patient optimally passes through three phases. During the first - narcissistic - phase the aim is that the patient's contact person develop such a relationship with her/him that "idolization" of the contact person occurs. This idolization is achieved by means of interest on the part of the contactperson, and a non-polarized attitude. The contact person shows interest in the patient and in her/his situation, life-story and interests. The non-polarized attitude means that little or no importance is attached to differences, particularly those due to gender and power position. The contact person avoids provoking the patient in areas about which she/he is sensitive. When a balanced, conflict-free relationship with the patient bas been achieved, treatment moves into a so- called working phase. Now the establishing of her/ his own history in the patient takes over from the idolization built up in the course of the close relationship. The patient is to become the subject of her/his own life-story, to achieve which patient and contact person go through the story together. If all goes well the patient passes through the castration complex and is able to find a realistic place for her himself in the story, the culture, and the society that has to be lived in with all its relations towards other people. The patient now begins to view her/himself, with both possibilities and limitations, more and more realistically. She/he also begins to show interest in the future and in plans for a life after treatment.In the final phase, progressively more responsibility for decisions is left to the patient. The aim of this phase of the treatment is to consolidate the narcissism of the patient's own ego. She/he must be released from the symbiotic dyad with the contact person who now leaves it to the patient to make choices and decisions and to be aware of the passage of time.The thesis discusses the development of the theory in a dialectic relation to the practical experiences of treatment work during the earliest years at Norrgården. A central place in the thesis is occupied by 11 case descriptions of the first patients who completed the treatment at Norrgården.