Engaging Loneliness in the Psychotherapy for Psychosis

This is one of three presentations given at the Residential and Community Treatment of Psychosis conference, organized by Ellenhorn, Gould Farm, and the Erikson Institute at Austen Riggs Center.
Jeremy M. Ridenour, PsyD, ABPP, is a staff psychologist/psychoanalyst at the Austen Riggs Center where he and also serves as the Director of Psychological Testing.
In this lecture, he discusses how people with psychosis experience loneliness at higher rates than the general population and identify loneliness as one of the most significant barriers to personal recovery. While many researchers have called for psychosocial treatments to specifically target loneliness for people experiencing psychosis, there are limited treatment models that provide direct recommendations for therapists working with people with psychosis. In this paper, the concept of loneliness is explored through a review of psychological and philosophical literature and through first-person accounts of psychosis. Additionally, the correlation between specific psychotic symptoms and loneliness is also reviewed. Following this, four key practice elements are outlined, including addressing barriers to accessing the patient’s longing for connection, the loneliness of psychotic experiences, internalized stigma, and loneliness within the therapeutic relationship, that can serve to reduce loneliness through psychotherapy.