From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress.

The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.

The Soteria Project: A forerunner of "a third way" in psychiatry? / Projekt Soteria: zwiastun "trzeciej drogi" w psychiatrii?

The article presents a somehow forgotten, yet largely controversial, experiment and therapeutic phenomenon known as Soteria Research Project. History, circumstances and main methodological assumptions of the experiment are briefly presented. Theoretical inspirations behind therapeutic model of Soteria are discussed and analyzed, and the results of the experiment are shortly described. The Soteria Research Project is placed in historical and contemporary context and compared to other theoretical propositions and practical solutions. A summary of critical arguments against Soteria is presented. Results of the Soteria Research Project suggest that therapeutic methods employed there were at least as effective as hospital treatment as usual, despite a radical reduction in, or even a complete lack of, pharmacotherapy. These results are still very important in the context of the debate concerning effective and ethical treatment of psychiatric disorders. It is claimed that Soteria was an attempt of restoring the importance of subjective experiences and subjectivity of a psychiatric patient in organized mental health care and a forerunner of contemporary postpsychiatric approaches, which postulate larger autonomy of patients, criticize sole reliance on pharmacotherapy and contemporary diagnostic systems, and underline the importance of psychotherapeutic interventions.

Ways of understanding of religious delusions associated with a change of identity on the example of identification with Jesus Christ. / Sposoby rozumienia urojen religijnych zwiazanych ze zmiana tozsamosci na przykladzie identyfikacji z Jezusem Chrystusem.

Identification with Christ among psychiatric patients is an example of a complex and multifaceted phenomenon. As a delusion it includes a misidentification (change of identity) in the layer of content and, usually, grandiosity and/or paranoid traits in the formal aspect. What is more, it fits in the category of religious delusions, which are perhaps the most controversial type of delusions and as such require special sensitivity as well as knowledge beyond psychology or psychiatry. The aim of the articleis to show the phenomenon of identification with Christ among psychiatric patients, taking into account different ways of its explaining and understanding. Papers relating to the topic, both theoretical considerations and case studies, found in the EBSCO database were analyzed. Searching for the articles the following key words were used: identity, identification, delusion, Jesus/Christ/Messiah, psychosis, schizophrenia. The analysis included all (actually not numerous) articles except for the one linked to cognitive approach which did not significantly contribute to the issue. Given the multiplicity of ways of explaining and understanding the experience of identification with the figure of the Messiah, it seems to be a mistake to hold both objectivist and one-sided, based on one theory, attitude towards it. Such an experience should be recognized in the context of the history of patient's life and the all possible mechanisms leading to its occurrence, as well as the meanings hidden beneath the symptom, should be take into account. It is also important to be well-oriented in the system of religious beliefs and spiritual needs of the patient.