Transactional Analysis of Schizophrenia: The Naked Self

Author(s) : Zefiro Mellacqua

Transactional Analysis of Schizophrenia: The Naked Self

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In Transactional Analysis of Schizophrenia: The Naked Self, Zefiro Mellacqua presents a full assessment of the relevance and value of transactional analysis in understanding, conceptualizing and treating schizophrenia in contemporary clinical settings.

Opening with a review of Eric Berne's ideas, Mellacqua applies theory to the understanding and psychotherapeutic treatment of people suffering from first-episode schizophrenia and to those already living with more long-lasting psychotic levels of self-disturbance. The chapters address a series of crucial methodological themes, including the need for both intensive and extensive analytic sessions; the therapist's tolerance of uncertainty and not knowing; the informative quality of both therapist's and patient's embodiment(s); the emergence of the transference-countertransference relationship; the link between silent transactions and unconscious communication; dream analysis; and the value of regular supervisions. Mellacqua's approach incorporates meetings with family and caregivers, as well as emphasising multidisciplinary work with patients in a variety of settings, such as in hospitals, outpatient clinics, and psychiatric home treatment. The book is illustrated with engaging clinical case studies throughout, which illuminate the schizophrenic experience and provide examples of how these tools can be used to help patients.

Transactional Analysis of Schizophrenia demonstrates how those who suffer from acute schizophrenia, especially those at their very first episode of psychosis, can make an effective recovery and live a satisfying life through the therapeutic application of transactional analysis. It will be essential reading for transactional analysts, psychodynamically oriented psychotherapists, psychologists, psychiatrists, nurses, social workers, academics and all mental health professionals working with people suffering from schizophrenic psychoses.

Reviews and Endorsements

"Zefiro Mellacqua's book is a cornerstone in contemporary Transactional Analysis for the understanding and treatment of the broad spectrum of psychotic disorders.

The Author provides a well-founded summary of Berne's transactional analysis theory and basic approach and then he develops his own innovative ideas which help understand psychosis in a new frame of reference, well connected to recent theories on relational traumas, and the importance of context (family, society, professional network) to cure psychotic patients.

At the core of Mellacqua's sensible approach we find the body as the unconscious theater of primal affective, sensory-motor relationships, very traumatic for the psychotic patient. The body may also communicate the starting point for a co-constructive search of meaning and direction which deeply involves both the therapist and the patient.

A close analysis of the transferential-countertransferential relationship and a review of specific Bernian techniques propose excellent methodological-technical tools for the clinical treatment.

The Author gives many interesting and touching examples taken from his clinical practice, which allow to better understand the nature of the relational processes that he has developed in his research on the treatment of psychotic patients.

Through Mellacqua's narratives we can capture his courage, passion, humanity and creativity that found his clinical work, and which seem to be an expression of the 'real philosophy of hope' that he sees at the core of Berne's revolutionary ideas: 'the hope of being able to share the almost ineffable human experience of being as "I" with a more or less large group of people, including those who are mentally suffering.'" - Maria Teresa Tosi, PhD, licensed psychotherapist, TSTA, Past-President European Association of Transactional Analysis.

"This book is a must read for anyone working with, or touched by, the unfathomable experience of schizophrenia. Examining research findings, theoretical debates, and rich case illustrations through his lens as a transactional analyst, Mellacqua enriches, and transforms, both our understanding of the phenomena he investigates and of the theory he draws on. Through the book, schizophrenia comes to light and to life as a deeply relational phenomenon, and even an avenue to examine the broader question of how selves emerge-or vanish or get fragmented-from bodies in relationships. Mellacqua's gifted writing humanizes the suffering of mental illness without romanticizing it. He combines the observations of an astute clinician, the erudition of a seasoned scholar, the finesse of an acute theorist, and the sensitivity of a poetic writer into a volume of exceptional clarity and humanity. This book's theories, like its stories, are an invitation to relate and examine relating. Both help approach, rather than dismiss, the uniqueness of selves longing, and failing, to do just that." - Gianpiero Petriglieri, MD, Associate professor of organisational behaviour, INSEAD.

About the Author(s)

Zefiro Mellacqua is a psychiatrist and transactional analyst. He is a former researcher at the Institute of Psychiatry, King’s College London, and psychiatrist with Lambeth Home Treatment Team, South London & Maudsley NHS Trust, UK. He is now leading the first Home Treatment Team for the Cantonal Sociopsychiatric Organization, Ticino, Switzerland.

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