The Case Study Guide to Cognitive Behaviour Therapy of Psychosis

By David Kingdon; Douglas Turkington | Go to book overview

Chapter 6

DEVELOPING A DIALOGUE
WITH VOICES

Case 6 (Nicky): David Kingdon

My introduction to cognitive behaviour therapy came from reading Aaron Beck's work as a trainee psychiatrist in the late 1970s. Previously I had read about a range of psychotherapies from non-directive therapy (Rogers, 1977), brief psychodynamic psychotherapy (Malan, 1979) and transactional analysis (Berne, 1968) and found them very illuminating. However, Beck's explanations of emotional disorders and way of working with them seemed to draw these together in a coherent and intuitively very satisfying way. I worked on a project led by Dr Peter Tyrer investigating treatment strategies, including CBT, in neurotic disorder (Tyrer et al., 1988) and adapted these techniques for use in psychosis (Kingdon & Turkington, 1991). The importance of understanding how problems developed and how they could be understood was central to this and Laing (Laing & Esterson, 1970) and Foudraine (1971), among others, were influential exponents of this. When I met Nicky, I had been using these techniques for many years but nevertheless her individual presentation was unique and, over the past two years, very challenging. Managing the risks inherent in her symptoms and the distress she experienced was difficult but eventually seems to have been productive.


NICKY

Nicky and I first met when she was an inpatient of a psychiatric colleague. As part of a reorganisation of services, her care was now to be my responsibility. My colleague expressed his concern for Nicky's very distressing and persistent symptoms, i.e. very unpleasant voices and depression. She had also been physically very ill, which complicated her medication management. This, in any event, had not proved very successful against the symptoms she had.

A Case Study Guide to Cognitive Behaviour Therapy of Psychosis. Edited by
David Kingdon and Douglas Turkington. © 2002 John Wiley & Sons, Ltd.

-85-

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