In an increasingly polarized world, more are noticing how difficult it can be to talk to someone whose beliefs are quite different from our own. It can be even more difficult when trust is broken, and paranoia is strong.

In this training, the focus will be on establishing helpful conversations with people whose paranoia and extremely different beliefs have led to a diagnosis of psychosis. Rather than a “one size fits all” approach, the emphasis will be on finding a method that works for individuals as that person is in specific session. While “reviewing the evidence” and helping the person challenge the belief may sometimes be effective, at other times it may work better to simply accept the belief and to find ways to live successfully while holding it.  And at other times, the best approach might be understanding the belief as an indicator of underlying conflicts or vulnerabilities that need to be addressed before the belief can change.

We depend on our senses for accurate information about the world, but for many people, a significant portion of what they experience as sensory information has no apparent basis in our shared world. This sounds like a definite problem, yet, research in the last quarter century shows that only some of the people who hear voices and see visions have significant problems from these experiences; others seem to get on with their lives successfully.

What makes the difference? One huge factor is how people interpret and relate to these experiences. This training will explore CBT methods of shifting from often unproductive or even counterproductive attempts to eliminate “hallucinations,” to constructive ways of coping. With this change in relationship, experiences like voices may fade, become less troublesome, or even shift into something the person experiences as an overall positive in their lives.

A special area of focus will be the problem of compliance with command voices.  Patterns of compliance with command voices dramatically increase the risk of self harm and other destructive behavior; we will review and practice CBT approaches which have been shown to be effective in significantly reducing such compliance.

A large number of studies now provide strong evidence that psychosis is often an understandable reaction to trauma, abuse, and other difficult life experiences. This training will introduce you to a science based yet humanistic conceptualization of extreme human experiences that can be related to trauma, and will demonstrate how to help people change their relationship with these experiences, for example, by collaborating with them in building coherent and compassionate self narratives that can set the stage for a strong recovery.

Dissociation can be a normal response to traumatic stress and can, in its more extreme forms and when misinterpreted, easily lead to psychosis. Drawing on this understanding, the possibility of addressing dissociation and misinterpretations of dissociation using methods drawn from diverse sources such as CBT, the Hearing Voices Movement, mindfulness, and psychodynamic approaches will be presented. These approaches can help people to regain perspective and personal power and create an opportunity to resolve internal conflicts rather than remaining stuck in endless efforts to suppress whatever is disturbing them.

There is not just one way of making sense of reality; instead, each culture or even each subculture goes about it differently. Further, many or even most people affirm beliefs in various “spiritual” aspects of reality that transcend everyday experiences. But this leads to the question: how are we to distinguish healthy diversity in culture and spirituality, from that which is pathological or “psychotic?”

One approach to this question is to assert that if a way of making sense is common in a culture, then it is sane and acceptable, while if it is unique, then it is pathological. While this approach makes room for diversity that is well established in large social groups, it continues to risk pathologizing possibly healthy innovations made by individuals.

This training will explore how CBT for psychosis can be practiced in a flexible way to adopt to cultural and spiritual differences, allowing for collaborative and respectful explorations of both the possible value as well as dangers of various ways of approaching reality. Based on such explorations, people can discover their own paths to a healthy integration and a path forward in their lives.