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Schizophrenia and ST in Forensic Work 

by Christian Eigner, and Chiara Simeone-DiFrancesco 

Working with prison inmates is always a challenge, especially when it comes to serious violent crimes based on psychosis and paranoid schizophrenia.
In practical therapeutic work, however, two factors seem to be particularly relevant: First, a relationship in which the therapist is consistently in the role of the healthy adult and is not afraid to think for the client. And secondly, the "production" of structure and language, which places special emphasis on "factuality".
Why this is the case needs to be understood - to which schematherapy can contribute a great deal. Especially in an extended form, on which I have been working for many years – and which is based on the following concept:
- Human life is fundamentally determined by the representation of the outside world; in principle, life is always (also) a matter of representing the world.
- Schemas are a representation of the world in which our core emotions such as lust or anger "have the say".
- They are, so to speak, a special type of representation of the world; the representation that finds its realization here is an "isomorphic-identificatory" one.
- There are also other forms of representation of the world; concretely abstract-symbolic ones, as produced by our language, or more precisely: our use of signs.
- The semiotics of Charles Sanders Peirce describe linguistic sign production or more generally: sign production in general very precisely: it is always a three-step process based on the fact that icons, indeces and interpretations interact. Icons are the part of the sign that (via an evolutionary chain that begins with pictograms and ends with abstract words) shares certain characteristics with objects (such as a black stove), while an index has a dynamic connection with an object (for example, the weathercock turns with the wind and thus indexically indicates it; the same applies to the "black" that is mentioned when looking at a stove). After all, the interpreter is the one or the other who connects these parts of the sign with concrete objects in order to generate statements.
- It is now argued that schemata do NOT follow this logic of signs; precisely because they are determined by emotions, schemata are at best something like indeces, but they lack the interpreter (as a sign phenomenon), since interpretation always requires rules, laws and more, for which abstraction is necessary; emotion is incapable of any interpretation.
- Human development before this background is to be seen as a development from an "index relationship" to an "interpretation relationship" - what is expressed in the world of schematherapy with the development of the healthy adult.
- It is therefore about the development from one form of representation of world to another. In the case of paranoid schizophrenia, schizophrenia ultimately means incorporating the index reference contained in schemata into language and using it there as an index. This then leads to the bizarre nature of schizophrenia, i.e. the representation of the world in schematic images that are at the same time part of a linguistic grammar.
- Thus the function of schemata in schizophrenia is essentially different from that of personality disorders: In schizophrenia, on the other hand, the schema is used as an index of a dominant symbolic representation of the world.
- In addition, it becomes clear that in the case of schizophrenia two "dimensions" may have to be treated: A that of the personality disorder, which is formed by schemata, and B that of the "false indexation", which occurs at the level of the "adult", but for this purpose falls back on schemata as indexes.
- Using a concrete example from the field of forensics, in the planned presentation will be shown how this model has promoted the client's understanding and self-understanding and opened up a technical approach to him.
- It also adds a new approach to schema therapy that has not yet been explored.

Expected Points of Discussion:
1.Role of Schemata in Schizophrenia
2.New Model of Schizophrenia
3.Consequences for Forensic Work

This Skill Class is intended for: 


About the Presenters:

Christian Eigner

•Training in "Infant Child Observation" at the "Psycho analytische Akademie Wien" (Psycho analytical Academy Vienna),
•training in "Psycho analytical Counselling, Coaching and Supervision" (Psycho analytical Counselling, Coaching and Supervision; IPOM, Munich);
•training in "Clinical Teaching in the Tradition of the Tavistock Clinic" at Ross A. Lazarin Munich; •integration of Schema Therapy into Kleinian Psycho analysis since 2013; poster presentation on this topic at the World Congress for Schema Therapy 2016 in Vienna; first text publications on this topic with summer 2019.

Chiara Simeone-DiFrancesco

Chiara Simeone-DiFrancesco was licensed as a psychologist in 1990, practicing in Wisconsin, USA anda second license as a Clinical Psychologist in the State of Virginia. Prior to becoming a psychologist she specialized in healing memories and dialogue as a paraprofessional actively providing groupworkshops with her husband on a large scale basis in California and Virginia. With world renownedmentors and extensive training, she developed a special expertise in connecting with diverse multi-cultural populations and facilitating reconciliation and understanding/acceptance. Highly entrepreneurial, Chiara became established as a Chief Psychologist in the Wisconsin Prison system, and soon after launched private practice, continued with her start-up non-profit, and later trade-marked“Connect-Talk®”in the USA and abroad. “Connect-Talk®”is the culmination of her integration of Schema Therapy and Mode awarenesswiththe intricacies of equal-to-equal positive connecting and inner and outer dialogue.Chiara has a passion for Schema Therapy in its application with individuals, couples, families and organizations. (Co-author of Schema Therapy with Couples/ A Practitioner’s Guide to Healing Relationships and founder of the Couples ST SIG and the Schema Therapy for Organizational Development SIG.) She sees the brilliance of ST’s conceptual ability to bring healing and awareness with multimodal reparenting interventions, and provides training and educational consultation in the model at the Advanced and Trainer level for both ST individual and Couples.She is affiliated with ST-Frankfurt.Chiara is a member of a number of professional organizations and has respect for clients coming from differing religious persuasions, incorporating meaning in life and positive examples into their quest for Healthy Adult mode functioning.

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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