The function of communication via email in the treatment as usual of patients with schizophrenia. Evacuation talk, remedial talk, or a creative search for understanding?
More details
Hide details
Katedra Psychiatrii Akademii Krakowskiej im. Andrzeja Frycza Modrzewskiego
Szpital Kliniczny im. dr J. Babińskiego
Krzysztof Wojciech Walczewski   

Szpital im. dr J. Babińskiego
Submission date: 2019-09-11
Final revision date: 2019-10-31
Acceptance date: 2019-11-05
Publication date: 2019-12-27
Psychoter 2019;190(3):41–52
Conversation, understood as the communication process between the patient and the physician, is the basic tool of a psychiatrist’s work and the primary tool to diagnose the way in which the patient’s thought process occurs. As yet, there is no other method to conduct psychiatric diagnoses. This work presents the process of treating a patient with schizophrenic disorder, with persistent drug-resistance symptoms and with an acquired criticism towards their symptoms. In the treatment process, the patient spontaneously maintained contact via emails, which contained descriptions of his psychotic experiences. His emails were sent to a closed inpatient ward where they were read and subjected to colleague supervision with a senior psychiatrist – the supervisor. The discussion concerns the functions of non-factual communication, based on unprocessed mental content: the so-called “mental babbling”. A thesis about the therapeutic function of this type of communication has been put forward, provided that certain conditions are met and the treatment is carried out in a fixed framework based on: (1) the continuity of contact, (2) the regularity of visits and, most importantly, (3) the receptivity of the object at which the patient’s communication is directed. In the presented case, this object was peculiar, consisting of the listening capacity of the physician and the supervisor, the hospital and the “virtual space” between two email boxes: the patient’s outbox and the physician’s inbox.