IJSP Number 4, 2022

78 But the main difficulty is that, most often, the psychotherapist does not identify the terror behind the schizophrenic’s “mask” and pressures the patient to feel in an inadequate manner. 2.6. Difficulties at the psychodynamic level Schizophrenic individuals must be helped in constructing a more coherent life story about who they are, articulating and integrating dreams, wishes, loss and success in a richer life narrative. If she has a more coherent story about the self and the illness, the individual can critically examine and articulate beliefs and emotions, maintain connection with others and have a more realistic view on causes [23]. The patient’s narrative shall be therefore altered, so it is populated by more known individuals and less abstract persons. It is also necessary to integrate traumatic material in own story, because recovery after trauma only occurs after the traumatic material has been integrated [17]. Psychosis often is the result of trauma (over 70% of the patients with auditory hallucinations have experienced a traumatic event before the onset, the voices being a part of the coping process). Many times there is a connection between the contents of the traumatic event and the contents of the auditory hallucinations and the delusions [2]. By listening to the patient and inviting her to talk about the symptoms and their onset, we may find out about trauma, the triggering event and the patient’s life story, being therefore able to create a connection between the contents of the hallucinations and delusions and her life narrative. Practically, we identify important people from the patient’s life, her relationship with these people, the moment of hallucination onset and what happened prior to that [17] One of the characteristics of schizophrenia is the fragmentation of the self, the individual being vulnerable to the experiences, wishes and impulses that threaten the existence of the self [24]. The schizophrenic can no longer form integrated ideas about the self that can be understood by others. At a theoretical level at least, psychotherapy should have the potential of helping the schizophrenic individual connect thoughts in a coherent manner, find meaning in emotions, become aware of own needs and wishes, and ultimately live a fuller life [24]. As a consequence, the psychotherapist must move away from the patient’s story contents and focus on the way the patient put together information about self and others. In order to do this, the therapist must be aware of the existence of fragmentation and be able to reflect upon fragmentation as a means for reaching a goal [24]. Patients do not tell the psychotherapist directly that they have a fragmented experience, or that their thoughts and emotions are not integrated. The psychotherapist must reach these conclusions, as the life story of the patient progresses and imagine how it would be if she herself could not integrate information from the environment [25]. 3. Interventions in supervision Taking into account that most psychotherapists find it difficult to create a therapeutic alliance and maintain a therapeutic relationship with the schizophrenic patient, due to countertransferential feelings (frustration, fear, anger) and the feeling of failure due to the patient’s lack of p rogress, one of the first interventions in