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The Prepsychotic or Postpsychotic Young Adult and His Parents

Herta A. Guttman, MD

Arch Gen Psychiatry. 1973;29(3):352-355.

Abstract
Conjoint family therapy is not helpful and can be harmful in treating extremely anxious young patients who are on the verge of decompensating into or have scarcely recompensated from an acute psychotic breakdown. This is probably because the person's already overwhelming anxiety is increased and his ability to express his feelings is correspondingly decreased when he is made aware of his enormous ambivalent dependency on his parents and of their rejecting attitude.

It might be important to vary the type of therapy at different stages of treatment. Therapy should be more supportive and directive at times when the patient is about to decompensate and more insight and affect-oriented only at later stages of treatment, when the patient's defenses are sufficiently reconstituted and he has enough objectivity to tolerate this type of therapy.

Author Affiliations
Montreal

From the Department of Psychiatry, Jewish General Hospital, Montreal.

Footnotes
Accepted for publication April 9, 1973.

A shortened version of this paper was read before the Fifth World Congress of Psychiatry, Mexico City, November 1971.

Reprint requests to Institute of Community and Family Psychiatry, 4333 Cote St, Catherine Rd, Montreal 249, Canada (Dr. Guttman).

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