Integrative Psychotherapy of Patients With Schizophrenic Spectrum Disorders: The Case of a Musician Suffering From Psychotic Episodes

Psychotherapy of patients suffering from schizophrenic disorders remains controversial. There are promising descriptions of treatments, and some empirical studies show that different forms of psychotherapy are effective. However, there are few models to combine different psychotherapeutic strategies in a comprehensive way. Here we propose a model of integrative psychotherapy that is based on the therapeutic alliance and the general principles of understanding and communication. It comprises cognitive-behavioral, psychodynamic, and existential elements. These aspects are applied hermeneutically to the narrative of a case of schizophrenia. After remission of the acute symptoms, integrative psychotherapy played the major role in the recovery of the patient. It is shown how therapeutic alliance and understanding and communication in a general sense interacted with behavioral, cognitive, psychodynamic, and existential strategies. The patient himself assessed these strategies and approved his case report. General principles of psychotherapy gain contextual meaning by the analysis of individual narratives. In the case of schizophrenia, the gap between hermeneutics and science can be bridged by an interdisciplinary concept of coherence.