Disturbances in Self-Experience in Schizophrenia: Metacognition and the Development of an Integrative Recovery-Oriented Individual Psychotherapy.
Psychopathology January 1, 2019 Paul H Lysaker, Giancarlo Dimaggio, Jay A Hamm et al.
Disturbances in first-person experience are a broadly noted feature of schizophrenia that cannot be reduced to the expression of psychopathology, yet they are often ignored by most contemporary treatment models. This paper presents a model suggesting that deficits in metacognition and their later resolution parsimoniously explain the development of self-disturbance and clarify how persons can later recover. Metacognition is defined as processes integral to the availability of a sense of self and others within the flow of life. The paper describes Metacognitive Reflection and Insight Therapy (MERIT), an integrative form of psychotherapy designed to target metacognition and enhance recovery of healthy self-experience, with eight measurable core elements. Research provides evidence of MERIT's feasibility, acceptability, and effectiveness across a broad range of patients.