The Soteria project recounted by Mosher and its clinical resonances today

BACKGROUND

The American psychiatrist Loren R. Mosher has passed to posterity as an eager proponent of a psychosocial approach to psychosis. The best example of this is the Soteria project that he founded in San Jose, California, in the 1970s. The contribution of Alma Zito Menn, ACSW, also merits attention as project director of Soteria and for her links to the Mental Research Institute, Palo Alto. She was later replaced as program director by Voyce Hendrix, LCSW, when she turned to other preoccupations linked to the grant continuation of Soteria. Equally, the nonprofessional staff of the facility should receive appreciation.

AIM/OBJECTIVE

Bearing this in mind, the main aim of this paper is to reflect upon the Soteria project, giving voice to Mosher himself, while simultaneously connecting his ideas with other empirical works that have been published on this topic in recent decades.

METHODS

Using a selection from the extant literature assessing the implementation and outcomes of adapting Soteria-elements to different settings, I present here provisional results obtained from current research. First, I expound what Mosher hoped to achieve in creating Soteria and why it worked. In this respect, I go beyond what is commonly reported in scholarly works, where the Soteria project is considered without paying too great attention to its main architect, as if the project could be separated from the man who created it.

RESULTS AND CONCLUSIONS

As I have corroborated here, there is today growing and promising scientific evidence validating the principles of the Soteria project. Undoubtedly, this would not have been possible without the pioneering work of Mosher, who, imbued with the tenets of interpersonal phenomenology, shook the psychiatric establishment, leading others to follow the path that he had begun.

Laing and Rogers in London: An unfortunate meeting or something else?

BACKGROUND

In the summer of 1978 a large 1-day event was scheduled to take place in the Grand Ballroom at the Hilton Hotel in Park Lane, London between the psychotherapists Carl R. Rogers (1902-1987), and his associates, and Ronald D. Laing (1927-1989) and his group. From among all the eyewitness accounts of that meeting, I have found only the testimonies of Maureen O'Hara, Ian Cunningham, Charles Elliot, and Emmy van Deurzen. According to O'Hara, Laing behaved in a rude, impolite, and aggressive way toward his American colleague Rogers. For his part, Cunningham says that Rogers came over as he had expected: a genuinely nice, caring, humane person. Laing, though, was even more impressive in person than in his books. Similarly, Elliot observes that Laing and Rogers held a genuine encounter, one in which both sat like two real mutually respecting persons who asked each other questions, while the perspective of van Deurzen is more in line with that of O'Hara than that of Elliot.

AIMS

Taking into account the different versions given on the Laing-Rogers event, I will analyze whether this encounter was only an unfortunate meeting or something else.

METHODS

Narrative review; combining eyewitness accounts with the few sources found in the literature on this topic.

RESULTS/CONCLUSIONS

As I will show here, all these accounts taken jointly paint a picture of Laing as a brilliant clinician and as a terrible man. Without exculpating Laing for committing all sorts of mischief, I will offer a tentative account of his behavior sustained by his own psychic dynamics. In doing so, I will attempt to explain why Laing reacted in so censurable a way, going beyond Thomas S. Szasz's (1920-2012) condemnation in his essay on antipsychiatry, which gives credence only to O'Hara's version without quoting more sources or posing more questions.

Debating asylum psychiatry: Did Szasz misrepresent the Basaglian psychiatric project?

BACKGROUND

The Italian anti-institutional psychiatric movement is closely associated with the name of F. Basaglia, whom Szasz in his 188-page essay on antipsychiatry labels a 'real phony' (in similar terms to others considered antipsychiatrists such as D. Cooper, R. Laing, E. Goffman and M. Foucault). Specifically, Szasz says of Basaglia and his work in psychiatry that it's a 'prevarication-illusion about the end of asylum psychiatry in Italy'.

AIM/OBJECTIVE

The aim of this paper is to determine whether Szasz's assessments were reliably based on scholarly knowledge of Basaglia's psychiatric work, or can better be attributed to Szasz's misrepresentation of his Italian colleague.

METHODS

In considering this question, the paper is timely but, more importantly, it is also unique in considering Basaglia and Szasz together. It is beyond the scope of this article to examine Basaglia's career in detail, and references to it will be made only to clarify Szasz's assertions regarding Basaglia.

RESULTS AND CONCLUSIONS

As I will show here, Szasz misconstrued the Basaglian project for a new kind of psychiatry, and for the transformation and closure of the old asylum system. This erroneous view of Basaglia by Szasz is partly associated with his idea that Basaglia and other antipsychiatrists were supported by the modern socialist-therapeutic State.

CULTURAL HISTORY OF PSYCHOANALYSIS IN THE AGE OF NEUROSCIENCE

In this paper I have chosen the topic of psychoanalysis in the age of neuroscience, with the aim of showing why the cultural history of psychoanalysis still matters. To make myself better understood I shall refrain from evaluating the current findings in neuroscience and limit myself to reporting briefly on them. Although I do not regard myself by any means as an expert in that field, I may be permitted to offer a few ideas about it. In this regard, there is presently a significant predominance of biological ideologies and practices regarding the treatment of mental illness, which implies an increase in the interest in etiology, nosology, definitions, and the effectivity of treatments. Even so, those psychoanalytic historians and/or analysts among us who are committed to psychoanalysis and its therapeutic implications, irrespective of what drugs might be prescribed and what the research findings might conclude, believe that patients still want to be listened to in depth and always will. For that reason, it is justified to ask why the cultural history of psychoanalysis still matters in a contemporary mental health environment that is ever more oriented towards the neurosciences.

In honor of Jurgen Ruesch: Remembering his work in psychiatry

BACKGROUND

In a highly technical civilization like ours, in which the interest in human communication transcends academic barriers and clinical practice, it seems necessary to look back to Ruesch's work in psychiatry. The main reason of it rests upon the idea that he was one of the few truly outstanding clinicians, researchers, and theoretical in the field of normal and abnormal communication. In fact, he did not only present a wealth of observational and clinical data; more importantly, he used these data to formulate creative hypotheses about the conflict between man and other human beings.

AIM/OBJECTIVE

The main purpose of this article is to pay tribute to Dr. Jurgen Ruesch (1909-1995), distinguished psychiatrist, communications experts and psychotherapist. For that reason, here we want to pay tribute to the enormous value of his work for the promotion of mental health and the clinical assessment of normal and pathological communication behavior.

METHODS

In working out his theoretical stance toward communication, all Ruesch's works here have been reviewed. In line with this, the author also mentions similarities between Ruesch and other psychiatric/psychotherapeutic authors. Also similarities have been established between Ruesch and Frank on "non specific factors in psychotherapy", and tensions within contemporary training of psychiatrists, almost predicted by Ruesch.

RESULTS AND CONCLUSIONS

While some of Ruesch's ideas about the nature and origins of communication has been discounted, many of his preoccupations are now part of the mainstream, and it is to here that we should look for evidence of his legacy. In fact, he has been the author of rich and fruitful ideas, which are essential to clinical understanding of mental diseases and their treatments. It is not surprising, therefore, that Ruesch's burning interest in the clinical assessment of normal and pathological communicative behavior finds a significant echo in today's proliferation of books, papers, and conferences on communication. For all that, we should honor him.