Clinical Handbook of Mindfulness (101 page)

Pia,
2007),
developed and validated in collaboration with the Italian National Institute of Health. Our purpose was not to get a quantitative psychopathological score (assessing the eventual presence of delusions and/or hallu-

cinations), but rather to have patients focus their attention on their own

responses to voices and/or other (delusional) beliefs.

Patients are in fact asked to answer questions about a certain (delusional)

idea, which was previously identified:

How often do you think about this idea?, how does this idea make you feel?,

to what extent does this idea affect your relationship with others or interfere

with your everyday actions
?

About the voices
:

How often do you hear the voices?, do you think they are other people’s

voices?, do they make you feel stressed and nervous? or do they make you

feel good?, do they ordain you? And do you obey?, to what extent do they

interfere with your relationship with others and your everyday activities
?

and so on.

In order to check the extent to which their answers and those of patients

overlap DV-SA can also be completed by therapists The goal is knowing

patients better, in order to improve therapist-patient attunement and make

the most of therapy: not everything that therapists assume to know about

their patients matches with what they actually feel or think, especially if

patients have communication issues or fear to lay themselves bare. This can

thwart relational attunement and prevent therapists from grasping every-

thing that makes a patient’s inner world.

DV-SA questionnaire can be useful both as a diagnostic and therapy tool,

assuring patients an initial distancing from triggering factors, which is an

364

Antonio Pinto

important step towards dis-identification and experiential practice of decen-

tred awareness
(Segal et al., 2002).

Conclusion

Therapists attempts to make “strange” signs and symptoms disappear at any

cost has too long been the core of a therapeutic relationship with psychosis

patients and this has led to clinicians feeling impotent and frustrated. Inex-

orably, this state of things has affected the course of the pathology itself,

which was thereby relegated among incurable illnesses.

Whereas, the core of CBT and mindfulness is people, and getting to know

and understand all of their manifestations rather than finding an explanation

of them.

Perhaps, this increases the possibility to establish a therapeutic relation-

ship that is first of all human; a relationship that is based on comparing

lives and experiences that are often very hard, be they real or imaginary.

Regardless of the extent to which suffering characterizes and permeates

every aspect of our life, it is still authentic, natural and therefore shareable.

Clinical evidence for our research has still to be provided, yet, perhaps, if

we manage to encourage patients to learn to accept things for what they are,

without judging them, this message might soon translate into acceptance of

themselves and others and we would have helped another human being leave

loneliness and otherness behind, coming through a private, unapproachable

dimension that is relentlessly doomed to be out of space and time.

References

Allen, N., & Knight, W. E. J. (2005). Mindfulness, compassion for self, and compassion

for others. In P. Gilbert (Ed.).
Compassion
. London and New York: Routledge.

American Psychiatric Association (2000).
Diagnostic and Statistical Manual of Men-

tal Disorders (DSM IV TR)
. Washington, DC: American Psychiatric Association.

Andreasen, N. C., Arndt, S., Alliger, R., Miller, D., Flaum, M. (1995). Symptoms of

Schizophrenia. Methods, meanings, and mechanisms.
Archives of General Psychi-

atry, 52
, 341–351

Bach, P., & Hayes, S. C., (2002). The use of acceptance and commitment therapy to

prevent the rehospitalization of psychotic patients: A randomized controlled trial.

Journal of Consulting and Clinical Psychology, 70
(5), 1129–1139.

Beck, A. T. (1970).
Cognitive therapy: Nature and relation to Behavior therapy.

Behavior Therapy 1
, 184.

Beck, A. T. (1976).
Cognitive therapy and emotional disorders
. New York: Interna-

tional Universities Press.

Bedrosian, R. C., & Beck, A. T. (1980). Principles of cognitive therapy. In M. J.Mahoney

(Ed.) “
Psychotherapy process
”: New York: Plenum Press.

Bellack, A. S., & Mueser, K. (1993). Psychosocial treatment for schizophrenia.

Schizophreni Bulletin, 19
, 317–336

Bellack, A. S., Mueser, K., Gingerich, S., Agresta, J. (1997).
Social skills training for

schizophrenia. A step by step guide. New York
: The Guilford Press.

Binswanger,L. (1928). Lebensfunktion und innere Lebensgeschichte.
Monatsschrift

f¨

ur Psychiatrie und Neurologie, 68
.

Birchwood, M. & Chadwick, P. (1997). The omnipotence of voices: Testing the valid-

ity of a cognitive model.
Psychological Medicine, 27
,1345–1353.

Birchwood, M., & Tarrier, N. (1992) (Eds.),
Innovations in the psychological man-

agement of schizophrenia
. Chichester: Wiley

Chapter 18 Mindfulness and Psychosis

365

Bleuler, E. (1911).
Dementia Praecox oder gruppe der Schizophrenien
. Deutick,

Leipzig.

Bowlby, J., (1969)
Attachment and loss
. London: Hogarth Press.

Bowlby J. (1988).
A secure base
. London: Routledge.

Burti, L. (1993). Commentary. In L. Burti
L
. (Ed.), Forum: Models of psychosocial reha-

bilitation for chronic psychiatric patients.
Italian Journal of Psychiatry Behav-

ioral Science, 3
, 147.

Callieri, B. (1984a). La Clinica come demitizzazione della psichiatria.
Psyche
, pag. 69,

Abano, Piovan.

Callieri, B. (1984b). La fenomenologia antropologica dell’incontro: il “noi” tra l’homo

natura e l’homo cultura. In C. L. Cazzullo, & C. Sini (Eds.),
Fenomenologia:

Filosofia e psichiatri
a (pp. 53–62). Milano: Masson.

Callieri, B. (1985). Antropologia e psichiatria Clinica.
Quaderni Italiani di Psichia-

tria
, IV, 3, pp.207–223.

Callieri, B. (1989). Dimensioni antropologiche della psicopatologia della “corporeità”.

Psyche
, 3.4., pp 213–223,

Callieri, B. (1993a). Aspetti antropofenomenologici dell’incontro con la persona deli-

rante. –
Riv. di psichiatria
, vol. 28, n. 6, novembre dicembre.

Callieri,

B.

(1993b).

Contributo

allo

studio

psicopatologico

dell’esperienza

schizofrenica di fine del mondo. In “
Percorsi di uno Psichiatra
”. Roma: Edizioni

Universitarie Romane, pp. 15–42.

Chadwick, P. (2006).
Person–based cognitive therapy for distressing psychosis
.

Chichester: Wiley & Sons.

Chadwick, P., Birchwood, M., & Trower, P.(1996) C
ognitive therapy of voices delu-

sions and paranoia
. Chicester, UK: Wiley

Ciompi, L., & Müller, C. (1976) Labenslauf und Alter der Schizophrenen: eine katam-

neische Lagzeitstudie bis ins Senium. Berlin: Springer.

Durham, R. C., Guthrie, M., R. V., et al. (2003). Taysyde-Fife clinical trial of cognitive-

behavioural therapy for medication-resistant psychotic symptoms: Results to 3-

month follow-up.
British Journal of Psychiatry
, 182,303–311.

Falloon, I. (1988). Expressed emotion: Current status.
Psychological Medicine, 18
,

269–274

Falloon, I., et al. (1985) Family management in the prevention of morbidity of

schizophrenia: clinical outcome of a two-year longitudinal study.
Archives of Gen-

eral Psychiatry, 42
, 887–896.

Fowler, D., Garety, P., Kuipers, E. (1995).
Cognitive behaviour therapy for psychosis:

theory and practice
. Chichester:Wiley.

Garcia Montes, J. M., Soriano, C. L., et al. (2004). Aplicacion de la terapia de acepta-

cion y Compromiso (ACT) a sintomatologia delirante: un estudio de caso.
Psi-

chothema, 16
(1), 117–124.

Germer, K. C. (2005). Mindfulness, what is it? What does it matter? In C. K. Ger-

mer, R. Siegel, P. R. Fulton (Eds.),
Mindfulness and psychotherapy
. New York: The

Guilford Press.

Guidano, V. F., & Liotti, G., (1983).
Cognitive processes and emotional disorders
.

New York: Guilford.

Gumley, A., O’Grady, M., & McNay, L. (2003). Early Intervention for relapse in

schizophrenia: Results of a 12-month randomized controlled trial of cognitive

behavioural therapy.
Psychological Medicine, 33
, 419–431.

Hayes, S. C., Kirk, D. S., & Wilson, K. G. (1999).
Acceptance and commitment ther-

apy
. New York: The Guilford Press.

Hogarty, G. E. (1998). L’integrazione degli interventi. In C. L.Cazzullo, M. Clerici, & P.,

Bertrando. (Eds.), “
Schizofrenia ed ambiente. Modelli della malattia e tecniche

di intervento
” (pp. 163–177). Milano: Franco Angeli.

Huber, G., & Schüttler R (1979).
Schizophrenie
. Berlin: Springer.

Jablensky, A. (1987) Multicultural studies and the nature of schizophrenia: A review.

Journal of Rojal Social Medicine, 80
, 162–167

366

Antonio Pinto

Jablensky, A. (1989). An Overview of the World Helath Organization Multi-Centre

Studies of Schizophrenia. In P. Williams, G. Wilkinson, & K. Rawnsley (Eds.),

The scope of epidemiological psychiatry: Essays in honour of michael sheperd
,

(pp. 225–239). Esat sussex: Routledge.

Jablensky, A. (1992). Schizophrenia: Manifestations, incidence and course in different

cultures. A world Health Organization ten-country study.
Psychological Medicine
.

Suppl.20.

Kabat-Zinn, J. (1990)
Full catastrophe living: using the wisdom of your body and

mind to face stress, pain, and illness
. New York: Dell.

Kabat-Zinn, J. (2005).
Coming to our senses: Healing ourselves and the word

through mindfulness
. New York. Hyperion

Kendall, P. C. (1984). Cognitive processes and procedures in behavior therapy. In C.

M. Franks, G. T. Wilson, P. C. Kendall, & K. D. Brownell.
Annual review of behavior

therapy; theory and practice
, (Vol. 10, pp. 123–163). New York: Guilford Press.

Kingdon, D. G., & Turkington, D. (1991). The use of cognitive behavior therapy with

a normalizing rationale in schizophrenia. Preliminary report.
Journal of Nervous

and Mental Disease, 179
(4), 207–211.

Kingdon, D. G., & Turkington, D. (1994).
Cognitive behavior therapy of schizophre-

nia
. New York: Guilford Press

Kingdon, D. G., & Turkington D. (2005).
Cognitive therapy of schizophrenia
. New

York: Guilford Press.

Kuipers, L., & Bebbington, P. (1988). Expressed Emotion research in schizophrenia:

theoretical and clinical implications.
Psychological Medicine, 18
, 893–909

Kuipers, E., Garety, P., Fowler,D., et al. (1997). London-East Anglia randomised con-

trolled trial of cognitive-behavioural therapy for psychosis: 1. Effects of the treat-

ment phase.
British Journal Psychiatry, 173
, 319–327.

Kraepelin E. (1919).
Dementia praecox and paraphrenia
. Livingstone, Edinbourgh.

Laszlo P., & Stanghellini G. (1993). La vulnerabilità e il suo impatto sui Servizi. In A.

Ballerini, F. Asioli, & G. Ceroni, (Eds.),
Psichiatria nella Comunit`

a
, (pp. 70–94).

Bollati Boringhieri, Torino.

Liddle P. F. Diagnosis and Pathophysiology of Schizophrenia (1999) In M. May, & N.

Sartorius (Eds.) S
chizofrenia
1.4; 45–47

Linehan, M. (1993)
Cognitive Behavioural treatment of borderline personality dis-

order
. New York: Guilford Press.

Liotti, G. (1995).
La dimensione interpersonale della coscienza
. Roma: NIS.

Lorenzini, R., & Sassaroli, S. (1992). Perchè si delira. In R. Lorenzini, & S. Sassaroli

(Eds.). “La
verit`

a privata. Il delirio e i deliranti
(pp. 39–49). – Roma: La Nuova

Italia Scientifica.

Lorenzini, R., & Sassaroli, S. (1998). Patogenesi e Terapia Cognitiva del disturbo deli-

rante. In C. Perris & P. D. McGorry (Eds.),
Cognitive Psychotherapy of Psychotic

and Personality Disorders
. Chichester: Wiley

Luoma, J. B. & Hayes, S. C. (2003). Cognitive defusion. In W. O’Donohue, J. Fisher, &

S. C. Hayes (Eds.),
Cognitive behaviour therapy: Applying empirically supported

techniques in your practice
. New Jersey: John Wiley & sons

McKenna, P., & Oh, T.,(2005).
Schizophrenic speech
. Cambridge: Cambridge Univer-

sity Press.

Merleau-Ponty M. (1945)
Ph´

enom´