Dare Psychotherapists Reinterpret a Mental Illness Diagnosis?

This month the group came having read a chapter from Isabel Clarke’s Psychosis and Spirituality, published by Wiley-Blackwell in 2010.

The chapter was entitled ‘Transformative Crisis ‘ written by Caroline Brett.


This theme came about from the recognition that clients who present with a diagnosis given by a psychiatrist, for example, can bring also the fear that they are  ill, and a reluctance to engage in ameliorative therapy for fear of the return of former symptoms.

We recognised that therapists are more familiar than some other mental health practitioners with comparisons of spiritual crisis or transforming experiences with those attributed to mental illnesses, and we wondered about the similarities with those who do not make a meaning of their experience in this way. The latter however, can be helped to think of their previous distress in different paradigms. We shared evidence from our own practices.

Familiarity with the ‘window of tolerance’ could invite awareness that hyper-arousal of the autonomic nervous system can be alarming but is in truth the human mind-body protecting that individual from intolerable stress.  Managing stress differently means that that arousal will not re-occur and medication may not be appropriate. Awareness of different ego-states and dissociative identity disorders, and the way in which dissociated ego states come into existence often, albeit mistakenly, to protect another part of that person, can become the insight that brings about the integration of those separate parts which have led to extravagant and diagnosable behaviours.

Some therapists in private practice, and this was true our group, can be a little nervous  because they are aware of the presence in the consulting room of ‘white coated’ mental health practitioners who have given their client a DSM category and treated them according to current NICE guidelines. Having the courage to explore alternative paradigms to make meaning of the client’s experience is what we do in therapy and such an approach anticipates what therapeutic experience has shown, namely that clients do reinterpret their experience given the constructs they need in order to do so and no longer think of themselves as mentally ill.

One of our number was fortunate enough to be offered supervision from members of a mental health team in a frontline psychiatric hospital. Encouragement was gratefully received when it was noted that the team concerned was asking the same questions about the meaning of mental illnesses. That team is using EMDR therapy with those formerly labelled psychotic and schizophrenic patients and indeed looking at the role of anti-psychotic drugs. The changes in perception encouraged by emerging neuro-biological research is evident. The challenge to all therapists must be therefore to try to keep up to date with that research. A significant challenge.

A useful reference work is that by Paul William Miller, EMDR Therapy for Schizophrenia and other psychoses, published in 2016 by Springer Publishing Company.

The value of supervisory processes taking place across the divide between private and institutional practice is recognised therefore within the group and should be promoted.

Dare Psychotherapists Reinterpret a Mental Illness Diagnosis?