Inside Psychosis: A clinical and therapeutic exploration of working on male and female acute psychiatric wards

by Helen L Holmes

Overview

This book offers an introductory overview of treatment of psychosis in inpatient acute ward settings, looking at both male and female wards.

Taking a broadly psychoanalytic perspective, the book explores the organizational dynamics on male and female acute wards, exploring both patient and staff dynamics. Containing detailed case studies from across male and female psychiatric wards in London, the author sets out how psychoanalytic concepts, such as transference, questions of trauma, and issues of gender can shape both the presentation of psychosis and our understanding and treatment of it. The book then explores the part played by religion in psychosis and equips readers with ideas for future practice and training on psychosis.

With clear guidance on how to understand and work with psychosis in an inpatient setting, and how many unconscious factors can affect patients and staff, this is key reading for psychiatrists, psychoanalysts and therapists, clinical psychologists, and other mental health professionals working in inpatient acute care and community settings.

Product Details

ISBN-13:	9781040380932
Publisher:	Taylor & Francis
Publication date:	06/27/2025
Sold by:	Barnes & Noble
Format:	eBook
Pages:	214
File size:	3 MB

About the Author

Helen L. Holmes is trained in counselling psychology, and is a forensic psychotherapist, family and couples practitioner, therapeutic counsellor, accredited Autism assessor, accredited mediator and clinical supervisor, working in a Chelsea clinic and private practice in London. Helen has written and taught psychology-related courses at LSE, and innovated a clinical project about adolescent self-harm cessation at IOPPN, Kings College London.

Table of Contents

1. Clinical approaches to therapy on acute psychiatric wards 2. Defining the psychoses and schizophrenias 3. Religious and spiritual considerations in relation to schizophrenia and psychosis 4. Organisational dynamics in acute male and female psychiatric wards 5. Case study 1 – ‘MJ’ - A further case of dissociation 6. Case study 2 – ‘Jennie’ 7. Assessment Case study 3 – ‘Sandra’ 8. Case study 4 – ‘Carlos - Kaleidoscope’ 9. Case study 5 ‘Luma’ 10. Case study 6 ‘Melanie’ 11. Case study 7 ‘Sam’

Editorial Reviews

‘In this book, Helen Holmes has addressed an issue which has been ignored for many years – the nature of psychological support and treatment on psychiatric wards. While it is easy to highlight the deficits we can all see in our increasingly stressed system, Holmes has tried to show positive ways of interacting with (often) detained people in such wards. This can enable the establishment of therapeutic relationship, even when a person is in the throes of quite profound psychological distress and disturbance. Using a psychodynamic perspective she describes ways in which psychological skills and supervision can help more positive relationships to be established, creating a more humane approach and a more therapeutic environment. And makes a powerful argument for embedding psychological support as an integral part of any inpatient service.’ 

Dr Philip Timms FRCPsych, Consultant Psychiatrist, National Psychosis Unit, Honorary Senior Lecturer, King's College London

‘Inside Psychosis is based on Helen Holmes’ work over a period of 15 years with deeply disturbed patients. She recognises the profound need of these individuals to be listened to in a safe relationship of genuine professional trust and care.  Though her primary lens is psychoanalytic she does not hesitate to use a variety of therapeutic perspectives such as cognitive behavior therapy or the person-centered approach. Given the importance of religion and spirituality for many patients, the author advocates a bio psychosocial model of schizophrenia, that should encompass the spiritual needs of patients. Holmes succeeds wonderfully to demystify schizophrenia and psychosis and thus lessen fear and myths about these terrifying conditions. This book will be of great assistance to both, health professionals dealing with people suffering of schizophrenia and the patients so diagnosed, their families and friends. Highly recommended.’

 Thomas R. Verny MD, DHL (Hon), DPsych, FRCPC, FAPA, Founding President APPPAH, Author of The Secret Life of the Unborn Child with John Kelly, Pre-Parenting with Pamela Weintraub, and The Embodied Mind.

“One of the delights of having been involved in Higher Education is seeing former students make their mark in their chosen areas, developing expertise and scholarship that go far beyond anything one might have been able to teach them. That is certainly my response, as a retired teacher of psychology of religion in the University of London, to reading Helen Holmes’ new book, Inside Psychosis.

In the course of many years of mainly one-to-one work with a great variety of people living with and dealing with the experience of psychosis, Helen has come to a near-unique understanding of the different factors involved, and of the range of explanatory models that have been formulated in the attempt to comprehend, and to work with and for, such individuals.

Inside Psychosis takes the reader into this complex world, managing to convey something of the experience of individuals experiencing schizophrenia and psychosis, as well as surveying the theoretical and professional discussions that are slowly shedding light on what has all too easily been seen as requiring treatment only with medication.Religious and spiritual elements are frequently present in psychotic and other schizophrenic experiences, and Inside Psychosis explores the multiple differences involved. These include how some cultures regard as “normal” and indeed significant what others regard as pathological, and how western medicine has found it almost impossible to include religion and spirituality in any attempted whole-person approaches to patient care.

Helen Holmes’ book, in its combination of theoretical discussion and case studies, brings together lived experience and disciplined reflection: it is educative not just of the understanding, but of the heart. “

Revd Brendan Callaghan SJ, MA, MPhil, MTh, Hon FCP, Formerly University of London, Senior Lecturer in the Psychology of Religion, Principal of Heythrop College, University of Oxford: Master of Campion Hall, Institute of Medical Ethics: General Secretary

‘Helen Holmes' Inside Psychosis is a brave and engagingly written mosaic of many of the extraordinary complexities that arise within the interrelations between serious talking and profound listening both in the therapeutic situation and in supervision. Holmes' lengthy and wide-ranging experience in a variety of clinical settings, and with diverse treatment modalities, make this book an important read for anyone wishing to learn about the intimate detail of the internal worlds of psychotic patients, and the psychotic elements in us all. Despite the horrors it details, it is a strangely uplifting book. At the end of the day, as Holmes' work illustrates, the talking/listening 'cures' are treatments of love.’

Richard Ekins, retired member of the British Psychoanalytical Society and Emeritus Professor of Sociology and Cultural Studies, Ulster University, UK

From the Publisher