Phenomenology often looks at psychosis as a defined pathological state. In this paper, psychosis is not seen as a (pathological) state but as a way to respond in extreme stress. It is psychological functioning of the embodied and relational mind, and psychotic experience can be seen as one form of affective arousal among any other affects. Taken the point of views of Emmanuel Levinas and Mikhail Bakhtin about the primacy of living in responsive relationships, psychotic behavior is seen as emerging in relationships that do not guarantee adequate responses and thus the subject is imposed to isolate from social relationships and developing odd behavior. If dialogical responses are guaranteed, recovery from psychotic behavior can occur. Some guidelines for such dialogues are given.

1.
Seikkula
J
,
Karvonen
A
,
Kykyri
VL
,
Penttonen
M
,
Nyman-Salonen
P
.
The Relational Mind in Couple Therapy: A Bateson-Inspired View of Human Life as an Embodied Stream
.
Fam Process
.
2018
Dec
;
57
(
4
):
855
66
.
[PubMed]
0014-7370
2.
Abettan
C
.
The current dialogue between phenomenology and psychiatry: a problematic misunderstanding
.
Med Health Care Philos
.
2015
Nov
;
18
(
4
):
533
40
.
[PubMed]
1386-7423
3.
Carman
T
.
Merleau-Ponty
.
London, New York
:
Routledge
;
2008
.
4.
Levinas
E
.
Otherwise than Being, or, Beyond Essence
.
Pittsburgh
:
Duquesne University Press
;
1998
.
5.
Bergström
T
,
Seikkula
J
,
Alakare
B
,
Mäki
P
,
Köngäs-Saviaro
P
,
Taskila
JJ
, et al.
The family-oriented open dialogue approach in the treatment of first-episode psychosis: nineteen-year outcomes
.
Psychiatry Res
.
2018
Dec
;
270
:
168
75
.
[PubMed]
0165-1781
6.
Moncrieff
J
,
Leo
J
.
A systematic review of the effects of antipsychotic drugs on brain volume
.
Psychol Med
.
2010
Sep
;
40
(
9
):
1409
22
.
[PubMed]
0033-2917
7.
Robbins
M
. Affect, emotions and the psychotic mind. In A. Gumley, A, Gillham, K. Taylor and M. Schwannauer (Eds.) Psychosis and Emotions. The role of emotions in understanding psychosis, therapy and recovery. London: Routledge.
2013
; p. 149 -163.
8.
Holma
J
,
Aaltonen
J
.
The sense of agency and the search for a narrative in acute psychosis
.
Contemp Fam Ther
.
1997
;
19
(
4
):
463
77
. 0892-2764
9.
Ricoeur
P
. Life in quest of narrative. In:
Wood
D
, editor
.
On Poul Ricoeur: Narrative and interpretation
.
London
:
Routledge
;
1991
. pp.
20
33
.
10.
van Os
J
,
Hanssen
M
,
Bijl
RV
,
Ravelli
A
.
Strauss (1969) revisited: a psychosis continuum in the general population?
Schizophr Res
.
2000
Sep
;
45
(
1-2
):
11
20
.
[PubMed]
0920-9964
11.
Dilks
S
. Linking dialogues and emotions in thisapy in psychosis. In A. Gumley, A, Gillham, K. Taylor and M. Schwannauer (Eds.) Psychosis and Emotions. The role of emotions in understanding psychosis, therapy and recovery (pp. 40 - 55), London: Routledge.
2013
; p. 40 -55.
12.
Lysaker
P
,
Lysaker
J
.
Psychosis and the disintegration of dialogical self structure: problems posed by schizophrenia for the maintenance of dialogue
.
Br J Med Psychol
.
2001
;
74
(
1
):
23
33
. 0007-1129
13.
Seikkula
J
.
Open dialogues with good and poor outcomes for psychotic crises: examples from families with violence
.
J Marital Fam Ther
.
2002
Jul
;
28
(
3
):
263
74
.
[PubMed]
0194-472X
14.
Avdi
E
,
Lerou
V
,
Seikkula
J
.
Dialogical Features, Therapist Responsiveness, and Agency in a Therapy for Psychosis
.
J Constr Psych
.
2015
;
28
(
4
):
329
41
. 1072-0537
15.
Karon
BP
.
The tragedy of schizophrenia without psychotherapy
.
J Am Acad Psychoanal Dyn Psychiatry
.
2003
;
31
(
1
):
89
118
.
[PubMed]
1546-0371
16.
Karon
B
,
Vandenbos
G
.
Psychotherapy of schizophrenia. The treatment of choice
.
New York
:
Jason Aronson
;
1981
.
17.
Morrison
G
. Humanism, Education and Spirituality: Approaching Psychosis with Levinas. Australian EJournal of Theology.
2008
; (12): http://www.acu.edu.au/__data/assets/pdf_file/0005/107528/Morrison_Education_and_Humanism.Levinas.pdf
18.
van der Kolk
BA
,
Fisler
R
.
Dissociation and the fragmentary nature of traumatic memories: overview and exploratory study
.
J Trauma Stress
.
1995
Oct
;
8
(
4
):
505
25
.
[PubMed]
0894-9867
19.
van der Kolk
BA
,
McFarlane
AC
,
Weisaeth
L
, editors
.
Traumatic stress
.
New York (NY)
:
Guilford
;
2006
.
20.
Gould
LN
.
Auditory hallucinations and subvocal speech; objective study in a case of schizophrenia
.
J Nerv Ment Dis
.
1949
May
;
109
(
5
):
418
27
.
[PubMed]
0022-3018
21.
Read
J
,
Goodman
L
,
Morrison
A
,
Ross
C
,
Aderhold
V
. Childhood trauma, loss and stress. In J.Read, L. Mosher & R. BVentall (eds.) Models of Madness.
2004
; 223- 253. New York: Brunner- Routledge.
22.
Green
MF
,
Kinsbourne
M
.
Subvocal activity and auditory hallucinations: clues for behavioral treatments?
Schizophr Bull
.
1990
;
16
(
4
):
617
25
.
[PubMed]
0586-7614
23.
Tiihonen
J
,
Hari
R
,
Naukkarinen
H
,
Rimon
R
,
Jousmäki
V
,
Kajola
M
.
Auditory hallucinations may modify activity of the human auditory cortex
.
Am J Psychiatry
.
1992
;
149
:
255
7
.
[PubMed]
0002-953X
24.
van der Gaag
M
.
A neuropsychiatric model of biological and psychological processes in the remission of delusions and auditory hallucinations
.
Schizophr Bull
.
2006
Oct
;
32
Suppl 1
:
S113
22
.
[PubMed]
0586-7614
25.
Seikkula
J
,
Alakare
B
,
Aaltonen
J
.
Open Dialogue in psychosis I: an introduction and case illustration
.
J Constr Psych
.
2001
;
14
(
4
):
247
66
. 1072-0537
26.
Lysaker
PH
,
Lancaster
RS
,
Lysaker
JT
.
Narrative transformation as an outcome in the psychotherapy of schizophrenia
.
Psychol Psychother
.
2003
Sep
;
76
(
Pt 3
):
285
99
.
[PubMed]
1476-0835
27.
Roe
D
,
Davidson
L
.
Self and narrative in schizophrenia: time to author a new story
.
Med Humanit
.
2005
Dec
;
31
(
2
):
89
94
.
[PubMed]
1468-215X
28.
Avdi
E
.
Negotiating a pathological identity in the clinical dialogue: discourse analysis of a family therapy
.
Psychol Psychother
.
2005
Dec
;
78
(
Pt 4
):
493
511
.
[PubMed]
1476-0835
29.
Harper
DJ
.
Discourse analysis and ‘mental health’
.
J Ment Health
.
1995
;
4
(
4
):
347
58
. 0963-8237
30.
Markova
I
.
The Dialogical Mind. Common Sense and Ethics
.
Cambridge
:
Cambridge University Press
;
2016
.
31.
Nelaon
,
JT
. The Ethics of Dialogue: Bakhtin and Levinas. College English.
1997
; Vol. 59, No. 2 (Feb., 1997), 129-148.
32.
Bakhtin
M
.
Problems of Dostojevskij’s poetics: Theory and history of literature
.
Volume 8
.
Manchester, UK
:
Manchester University Press
;
1984
.
33.
Shotter
J
.
Cultural politics of every day life. Social constructionism, rhetoric and knowing of the third kind
.
Buckingham, UK
:
Open University Press
;
1993
.
34.
Anderson
H
.
Conversation, language, and possibilities
.
New York
:
Basic Books
;
1997
.
35.
Trimble
D
.
Emotion and voice in network therapy
.
Netletter
.
2000
;
7
(
1
):
11
6
.
36.
Voloshinov
V
.
Marxism and the philosophy of language (6th printing)
.
Cambridge (MA)
:
Harward University Press
;
1996
.
37.
Seikkula
,
J.
&
Arnkil
,
TE.
Open dialogues and anticipations.
Respecting otherness in the present moment. Helsinki: Thl;
2014
.
38.
Andersen
T
. Reflecting processes; acts of forming and informing. In:
Friedman
S
, editor
.
The reflecting team in action. New York
.
Guilford
;
1995
. pp.
11
37
.
39.
Cullberg
J
. Psychoses: An integrative perspective. London; Routledge; ISPS book series;
2000
.
40.
Freeman
D
,
Garety
P
.
Helping patients with paranoid and suspicious thoughts: a cognitive–behavioural approach
.
Adv Psychiatr Treat
.
2006
;
12
(
6
):
404
15
. 1355-5146
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