Soteria represents an alternative approach to the treatment of acute psychosis providing a community-based social milieu, personal relationships (“being-with”), and meaningful shared activities (“doing-with”) along with minimal neuroleptic medication. In this review article, we analyze Soteria’s potential to adapt to and restore self-disturbances, a central element of phenomenological conceptions of the schizophrenia syndrome. Based on typical difficulties of psychotic patients in responding adequately to situational demands, in relating to others, and in utilizing skills, we analyze how the architectural and social context, being-with, and doing-with take account of self-disturbances. The central elements of the Soteria approach all appear to carry the potential to adjust to self-disturbances and even offer opportunities for their relief. We suggest that it is precisely this property of the Soteria paradigm that induces sustained relaxation in patients, allowing for symptom relief, thereby specifying a central claim of “affect-logic” to explain the antipsychotic effect of Soteria.

1.
Calton
T
,
Ferriter
M
,
Huband
N
,
Spandler
H
.
A systematic review of the Soteria paradigm for the treatment of people diagnosed with schizophrenia
.
Schizophr Bull
.
2008
Jan
;
34
(
1
):
181
92
.
[PubMed]
0586-7614
2.
Ciompi
L
.
The psyche and schizophrenia.
The bond between affect and logic Cambridge/Mass. (USA) and London (GB), Harvard University Press,
1988
.
3.
Ciompi
L
.
The Key Role of Emotions in the Schizophrenia Puzzle
.
2015
;
41
:
318
22
.
4.
Ciompi
L
. Soteria Bern: Konzeptuelle und empirische Grundlagen, Wirkhypothesen. In:
Ciompi
L
,
Hoffmann
H
,
Broccard
M
, editors
.
Wie wirkt Soteria?
Heidelberg
:
Carl-Auer-System-Verlag
;
2011
. pp.
43
68
.
5.
Ciompi
L
,
Hoffmann
H
,
Broccard
M
.
Wie wirkt Soteria?
Heidelberg
:
Carl-Auer-System-Verlag
;
2011
.
6.
Sass
LA
,
Parnas
J
.
Schizophrenia, consciousness, and the self
.
Schizophr Bull
.
2003
;
29
(
3
):
427
44
.
[PubMed]
0586-7614
7.
Merleau-Ponty
M
.
Phénomenologie de la perception.
Paris, Gallimard. Engl. Transl. by Colin Smith: Phenomenology of perception. London, Routledge and Kegan Paul,
1962
.
8.
Thoma
S
,
Fuchs
T
. A phenomenology of sensus communis. Outline of approach to social psychiatry. Social relations, psychopathology, and Husserl’s philosophy. In:
Englander
M
, editor
.
Phenomenology and the social context of Psychiatry
.
Social (New York)
:
Bloomsbury
;
2018
.
9.
Conrad
K
.
Die beginnende Schizophrenie: Versuch einer Gestaltanalyse des Wahns
.
Stuttgart
:
Thieme
;
1958
.
10.
Stanghellini
G
,
Bolton
D
,
Fulford
WKM
: Person-Centered Psychopathology of Schizophrenia : Building on Karl Jaspers ’ Understanding of Patient ’ s Attitude Toward His Illness
2013
;39:287–294.
11.
Bergstein
M
,
Weizman
A
,
Solomon
Z
.
Sense of coherence among delusional patients: prediction of remission and risk of relapse
.
Compr Psychiatry
.
2008
May-Jun
;
49
(
3
):
288
96
.
[PubMed]
0010-440X
12.
Parnas
J
,
Møller
P
,
Kircher
T
,
Thalbitzer
J
,
Jansson
L
,
Handest
P
, et al
EASE: Examination of Anomalous Self-Experience
.
Psychopathology
.
2005
Sep-Oct
;
38
(
5
):
236
58
.
[PubMed]
0254-4962
13.
Sass
L
,
Pienkos
E
,
Skodlar
B
,
Stanghellini
G
,
Fuchs
T
,
Parnas
J
, et al
EAWE: examination of anomalous world experience
.
Psychopathology
.
2017
;
50
(
1
):
10
54
.
[PubMed]
0254-4962
14.
Fuchs
T
.
Corporealized and Disembodied Minds
.
Philos Psychiatry Psychol
.
2005
;
12
:
95
107
.1071-6076
15.
Blankenburg
W
.
Der Verlust der natürlichen Selbstverständlichkeit. Ein Beitrag zur Psychopathologie symptomarmer Schizophrenien
.
Stuttgart
:
Enke
;
1971
.
16.
Mishara
AL
,
Lysaker
PH
,
Schwartz
MA
.
Self-disturbances in schizophrenia: history, phenomenology, and relevant findings from research on metacognition
.
Schizophr Bull
.
2014
Jan
;
40
(
1
):
5
12
.
[PubMed]
0586-7614
17.
Kyselo
M
.
The enactive approach and disorders of the self – the case of schizophrenia
.
Phenomenol Cogn Sci
.
2016
;
15
(
4
):
591
616
. 1568-7759
18.
Van Duppen
Z
.
The interactive dimension of schizophrenia
.
Philos Psychiatry Psychol
.
2017
;
24
(
4
):
399
418
. 1071-6076
19.
Hur
JW
,
Kwon
JS
,
Lee
TY
,
Park
S
.
The crisis of minimal self-awareness in schizophrenia: a meta-analytic review
.
Schizophr Res
.
2014
Jan
;
152
(
1
):
58
64
.
[PubMed]
0920-9964
20.
Henriksen
MG
,
Parnas
J
.
Clinical manifestations of self-disorders and the Gestalt of schizophrenia
.
Schizophr Bull
.
2012
Jun
;
38
(
4
):
657
60
.
[PubMed]
0586-7614
21.
Nelson
B
,
Thompson
A
,
Yung
AR
.
Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis “prodromal” population
.
Schizophr Bull
.
2012
Nov
;
38
(
6
):
1277
87
.
[PubMed]
0586-7614
22.
Skodlar
B
,
Parnas
J
.
Self-disorder and subjective dimensions of suicidality in schizophrenia
.
Compr Psychiatry
.
2010
Jul-Aug
;
51
(
4
):
363
6
.
[PubMed]
0010-440X
23.
Haug
E
,
Øie
M
,
Andreassen
OA
,
Bratlien
U
,
Raballo
A
,
Nelson
B
, et al
Anomalous self-experiences contribute independently to social dysfunction in the early phases of schizophrenia and psychotic bipolar disorder
.
Compr Psychiatry
.
2014
Apr
;
55
(
3
):
475
82
.
[PubMed]
0010-440X
24.
Stanghellini
G
,
Ballerini
M
,
Mancini
M
.
Other Persons: On the Phenomenology of Interpersonal Experience in Schizophrenia (Ancillary Article to EAWE Domain 3)
.
Psychopathology
.
2017
;
50
(
1
):
75
82
.
[PubMed]
0254-4962
25.
Borda
JP
,
Sass
LA
: Phenomenology and neurobiology of self disorder in schizophrenia : Primary factors. Schizophr Res 2015;
2015
;169(1-3):464-473.
26.
Nischk
D
,
Dölker
C
,
Rusch
J
,
Merz
P
.
From theory to clinical practice: a phenomenologically inspired intervention for patients with schizophrenia
.
Psychopathology
.
2015
;
48
(
2
):
127
36
.
[PubMed]
0254-4962
27.
Gibson
JJ
.
The ecological approach to visual perception
.
New York
:
Psychology Press
;
1979
.
28.
Tronick
EZ
.
The neurobehavioural and social emotional development of infants and children
.
New York
:
Norton
;
2007
.
29.
Fuchs
T
,
Jaegher
H
.
Enactive intersubjectivity: participatory sense-making and mutual incorporation
.
Phenomenol Cogn Sci
.
2009
;
8
(
4
):
465
86
. 1568-7759
30.
Mueser
KT
,
Bellack
AS
,
Douglas
MS
,
Morrison
RL
.
Prevalence and stability of social skill deficits in schizophrenia
.
Schizophr Res
.
1991
Sep
;
5
(
2
):
167
76
.
[PubMed]
0920-9964
31.
Wallace
CJ
,
Liberman
RP
,
Tauber
R
,
Wallace
J
.
The Independent Living Skills Survey : A Comprehensive Measure of the Community Functioning of Severely and Persistently Mentally Individuals.
Schizophr Bull
2000
;26(3):631–666.
32.
Anderson
JR
.
Cognitive psychology and it implications
.
New York
:
Worth Publishers
;
2009
.
33.
Wykes
T
,
Huddy
V
,
Cellard
C
,
McGurk
SR
,
Czobor
P
.
A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes
.
Am J Psychiatry
.
2011
May
;
168
(
5
):
472
85
.
[PubMed]
0002-953X
34.
Moritz
S
,
Burnette
P
,
Sperber
S
,
Köther
U
,
Hagemann-Goebel
M
,
Hartmann
M
, et al
Elucidating the black box from stress to paranoia
.
Schizophr Bull
.
2011
Nov
;
37
(
6
):
1311
7
.
[PubMed]
0586-7614
35.
Stanghellini
G
,
Lysaker
PH
.
The psychotherapy of schizophrenia through the lens of phenomenology: intersubjectivity and the search for the recovery of first- and second-person awareness
.
Am J Psychother
.
2007
;
61
(
2
):
163
79
.
[PubMed]
0002-9564
36.
Nordgaard
J
,
Nilsson
LS
,
Sæbye
D
,
Parnas
J
.
Self-disorders in schizophrenia-spectrum disorders: a 5-year follow-up study
.
Eur Arch Psychiatry Clin Neurosci
.
2018
Oct
;
268
(
7
):
713
8
.
[PubMed]
0940-1334
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