Self-regulation of distance in supportive psychotherapy

The authors present the case of a schizophrenic man treated in the setting of a supportive care clinic. The course of treatment from beginning to termination is illustrated by treatment vignettes and by excerpts from the patient's letters to the therapists. Case discussion centers around the handling of the classic schizophrenic conflict over intimacy versus isolation. The authors stress that the therapists must be acutely sensitive to the patient's need and ability to regulate his or her own emotional and therapeutic distance over the course of treatment. They make a case for utilizing this conceptual framework in the treatment of chronic psychiatric patients in supportive clinic settings.