In this unique book, Andrew Lotterman describes a creative approach to the psychotherapy of people diagnosed with schizophrenia and other forms of psychosis. Lotterman focuses on specific techniques that can be used in psychological therapy with people who have symptoms such as hallucinations, delusions, paranoia, ideas of reference, looseness of association and pressured speech. Formerly titled Specific Techniques for the Psychotherapy of Schizophrenic Patients, this edition updates research on the biology and psychology of psychosis and explores the many controversial issues surrounding diagnosis. It also includes two new chapters on the psychology and treatment of paranoia and on the experience of having a shattered self and the delusion of being the Messiah.

Lotterman’s innovative approach aims to help patients with one of the most debilitating symptoms of psychosis: the collapse of language use. By restoring language as a way of communicating the patient’s meaningful inner life to himself and to others, the patient is then able to undertake a more traditional form of verbal psychotherapy. The book presents detailed case histories of patients who have benefited from this method, highlighting the specific techniques used and the psychological improvements that followed. The approach presented here complements medication-based treatments that have only had partial success, as well as other psychological approaches such as cognitive behavioural therapy, family therapy and social skills training.

Psychotherapy for People Diagnosed with Schizophrenia will be a valuable text for clinicians working with people suffering from psychosis, including psychotherapists, psychoanalysts, psychologists, physicians and social workers. It will also be of great interest to academics and students.

Monday, 27 January 2014 19:55

January 2014 E-Newsletter

Wednesday, 11 December 2013 20:38

Gaetano Benedetti

(Biography written at time of nomination)
Professor Gaetano Benedetti noted:
“Over half century of psychodynamic research has proved that schizophrenia is not only a medical disorder, but a biographical facet of the human being - it is a challenge to the whole of society to understand, accept and reintegrate the psychotic patient amongst us.” (Ninth International Symposium on the Psychotherapy of Schizophrenia)
“It is in the psychotic’s suffering that the most serious problems of the human mind are encountered. Tackling them means illuminating the human being with signification and sense, gaining a better understanding of the human being in general, not only of the psychotic person.” (Tenth International Symposium for the Psychotherapy of Schizophrenia)
Gaetano Benedetti was born in 1920 in Catania, Sicily. He joined the psychiatric staff at the Zurich University Clinic Burghölzli in Switzerland in 1947, where he increasingly focused his work on the psychoanalytic psychotherapy of psychotic patients. He worked closely with Gustav Bally, Medard Boss, Marguerite Sechehaye, and Christian Müller. Benedetti and Müller co-founded the International Symposium for the Psychotherapy of Schizophrenia (ISPS) in 1956 at the psychiatric clinic at the University of Lausanne in Switzerland. The ISPS has evolved into the currently thriving International Society for the Psychological Treatments of the Schizophrenias and Other Psychoses ( and The impetus for founding ISPS was Benedetti and Müller’s dissatisfaction with the predominantly reductionistic orientation of European psychiatry and they had sought the aid of psychoanalysis to find a different approach to the schizophrenias.
In 1956, Benedetti was also appointed professor of psychotherapy at the University of Basel. He continued his work with persons diagnosed with schizophrenia until he retired in 1985. However, Professor Benedetti remains active into the present in his teaching and supervision of clinicians engaged in psychosis psychotherapy. His favorite book has been translated into many languages, in German it is called “Todeslandschaften der Seele” (1998), and in Italian, “Alienazione E Personazione Nella Psicoterapia Della Malattia Mentale”(1980). His collected papers were published in English under the title “Psychotherapy of Schizophrenia” in 1987 by New York University Press. Professor Benedetti has published a multitude of articles covering such topics as gender differences in psychosis psychotherapy, the use of a therapeutic assistant, emergency interventions in psychotic crises, facilitating factors in psychosis psychotherapy, the ego structure and self-identity of the person with schizophrenia and the task of psychoanalysis, and mirror-image experiences in psychosis psychotherapy.
Benedetti moved psychoanalysis with psychotic persons away from the primary emphasis on transmission of cognitive insight, to the transmission of therapeutic transforming images, of transitional subjects, of mirror phenomena, of patient-therapist symmetries, of therapeutic dreams, of progressive psychopathology. He believes that our concept of psychosis psychotherapy must be broad enough to include our psychological concern for the schizophrenic human being as differentiated from, but not divorced from the study of the neurobiological processes observed in schizophrenia. Benedetti sees therapeutic transforming images as arising from the therapist’s ability to identify with the catastrophes occurring within the patient, to live them as if they were our own, to the point in which the therapist’s latent psychotic nuclei may be mobilized. However, these become part of the dialogic interweave, which is ‘antipsychotic.’ The therapist’s containment and consubstantiability with the negative, anxiety-ridden, aspects of the patient helps the latter to gain awareness of the positive aspects of her or his self. It is then that the “transitional subject” emerges within the unconscious or conscious mental processes of both patient and therapist. This also signifies that a “progressive psychopathology” is proceeding, in which previous psychopathological phenomena, such as transitivism and appersonation, become therapeutically transformed, e.g., a patient may still hallucinate, but the hallucination may be an empathic, correct interpretation of the patient’s situation.
Recently, in describing the role of the therapeutic symbiosis, Benedetti commented:
“The dynamic of symbiosis is based upon transference and countertransference; special however is the kind of object, caused by the therapeutic setting, to which the self of the patient relates. The object here is a therapeutic one. This means, basically, that it does not ‘invade’ the patient’s self with its own wishes, demands and expectations, but mirrors back his own positivized image. The fragile psychotic ego is not confronted with demands and fragmented by a stranger. It encounters itself, its own healing origin, in the positivizing mirror of the therapist” (personal communication).
For Benedetti, delusions are a sort of existential truth for the patient. Therapists allow themselves to be pulled into the delusion in order to stand in the same place as the patient before confronting the patient with her or his delusions. By this, one gains a kind of citizenship within the closed world of the patient. The less dangerous, non-fragmenting therapeutic object is gradually experienced by the patient as a kind of second self, which helps the patient withstand panic and feelings of helplessness. Therapeutic devotion is experienced by the patient as a “niche” for her or his own identity. Paradoxically, Benedetti believes, that only the deep experiencing of symbiosis between patient and therapist can lead to the overthrow of symbiotic confusion in the patient. Most recently, Professor Benedetti is concerned with negative and positive self-images, therapeutic mirror-images, self-objects and transitional subjects in the dreams and in the imaginations of psychotic patients.
Benedetti’s influence on European psychosis psychotherapy has been very great, especially in Italy and Switzerland and in the Nothern European countries as well. For the past almost 20 years, Benedetti has collaborated with his colleague Maurizio Peciccia. In 1986 they developed a psychotherapeutic method referred to as “progressive mirror drawing.” Benedetti and Peciccia hypothesized that the core psychological deficits in schizophrenia are two incompatible nuclei of the self. One is characterized by excessive symbiotic needs and the other by excessive needs for separation which can take on autistic-like coloring. There is a de-integration of the separate and symbiotic selves in schizophrenia. Psychosis psychotherapy, according to this model, is oriented towards an integration of the symbiotic (interdependent) and separate (autonomous) selves. Between 2000 and 2005 Benedetti and Peciccia have, according to the latter, “extended the principle of symbiotic/separate self integration and sensorial integration not only to psychotherapies but also to the rehabilitation of psychotic patients using new techniques in new therapeutic contexts” (personal communication, Maurizio Peciccia).
Brian Koehler PhD
New York University
80 East 11th Street #339
New York NY 10003
Monday, 09 December 2013 13:03

Learn more about ISPS

NEW! ISPS WEBINAR "Neuropsychoanalysis and Psychosis: A Dialogue with Mark Solms" on Friday 27th January 2023. Register HERE
Jaison Haitana, from New Zealand, is the winner of the David B. Feinsilver award! Find out more
Did you miss the ISPS webinar "Learning from each other"? Watch the recording HERE
Letter of ISPS EC regarding the war "To all the people who suffer from the Ukraine war" READ MORE
"Modern Understanding of Psychosis: from brain disease to stress disorder" recent article in Psychosis by Dr Jan Olav Johannessen and colleagues
Recently published in the ISPS book series Open Dialogue for Psychosis
Did you miss the Open Dialogue and Psychosis conference? You can view the recordings of kenote presentations, feedback from workshops, panel and Q&A sessions here


ISPS supports:

A Call to Action on Racism and Social Justice in Mental Health

and Brian Koehler's petition to the American Psychiatric Association and World Health Organization to drop the highly stigmatizing, scientifically-challenged term "schizophrenia" read more

What's so special about ISPS Conferences?

ISPS: Our mission, history and what we do



Monday, 09 December 2013 12:55

October 2013 E-Newsletter

Monday, 07 October 2013 07:59

ISPS Suomi

To become a member of the new Finnish ISPS group contact Klaus Lehtinen  

Monday, 07 October 2013 07:51

Membership information

To become a member of the new Finnish ISPS group contact Klaus Lehtinen  



Monday, 07 October 2013 07:32

Membership information

To join the new Finnish ISPS group please contact Klaus Lehtinen

Thursday, 22 August 2013 10:08

ISPS Warsaw 2013

'Best practice in psychological therapies for psychosis: A contemporary and global perspective'

The 18th International Congress of ISPS

The Old Library

22nd - 25th August 2013

Warsaw, Poland

Thursday, 18 July 2013 08:30

Insanity and Divinity


How close is spirituality to psychosis?


Covering the interrelation of psychosis and spirituality from a number of angles, Insanity and Divinity will generate dialogue and discussion, aid critical reflection and stimulate creative approaches to clinical work for those interested in the connections between religious studies, psychoanalysis, anthropology and hagiography.


Bringing together an international range of contributors and covering many different types of religious experience, this book presents its theme in three parts:


Psychoanalysis, belief and mysticism


Anthropology, history and hagiography


Psychology, psychosis and religious experience.


Each section includes discussion of the hinterland between madness and religious experience from the perspective of a number of religions, autobiographical accounts of those who have experienced a psychosis in which spirituality played a key part and a comprehensive review of the position of psychology research into the meaning and function of spirituality in relation to the psychoses.


Insightful, enlightening and wide-ranging, Insanity and Divinity is ideal for clinicians, academics and chaplains working in clinical settings.


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ISPS Journal


The ISPS Journal Psychosis accepts personal and institutional subscriptions. All Individual Members of ISPS and members of regional ISPS groups receive quarterly issues of the journal as a membership benefit.