People with psychosis experience intense emotions before, during, and after psychotic episodes, including distress, transformed perception, self-blame, guilt, confusion, despair, and hope. Interviews with eight individuals in an early intervention service revealed four emotional phases: struggling with life distress before psychosis, a transformed world with intense emotion during psychosis, blame and guilt after the breakdown, and a mix of confusion, despair, and hope in the post-onset phase. The findings suggest that normalizing these emotional experiences can improve engagement with services and that assessing self-criticism, despair, and hope after psychosis is important for therapy.
The first cohort of cognitive behaviour therapists to complete a UK government-funded mindfulness-based cognitive therapy (MBCT) teacher-training reported high levels of satisfaction. The embodiment of trainers and supervisors was considered particularly significant, and the retreat was experienced as a core component that deepened mindfulness practice. Challenges included difficulties with the retreat, technical issues, and completion challenges for a minority of trainees. The training followed a new curriculum approved by NHS England and commissioned by Health Education England, enabling trainees to teach MBCT in Improving Access to Psychological Therapies services and to meet British Association of Mindfulness-Based Approaches registration criteria.
Imagery rehearsal therapy, a nightmare treatment, was acceptable and feasible for people who also have psychotic symptoms. In a small sample of six participants with frequent distressing nightmares and psychosis, five completed four to six sessions of imagery rehearsal. Nightmare-related distress, vividness, and intensity showed descriptive improvements, and participants gave positive feedback. Nightmare frequency did not decrease, but participants reported a change in their emotional response to nightmares. A larger controlled trial is needed to test the therapy's efficacy for this population.