The Psychotherapeutic Treatment of Schizophrenia: Psychoanalytical Explorations of the Metacognitive Movement

Metacognition refers to the set of activities which allow persons to have a sense of oneself and of others available to them within the flow of daily experience. These activities range from awareness of discrete aspects of experience to their synthesis into larger, more complex ideas. Following research documenting the existence and influence of metacognitive deficits in schizophrenia, psychotherapeutic frameworks have emerged aiming to improve metacognition in this group. Metacognitive Reflection and Insight Therapy (MERIT) is one such integrative psychotherapy framework. Therapeutic targets and principles of MERIT are intended to be integrative but share common characteristics with psychoanalytical tradition in the treatment of schizophrenia. This paper accordingly explores how psychoanalytic theory can help explain how the effects of MERIT upon metacognition and self-experience in schizophrenia may reflect its effects on repairing the collapse of the boundary/connection between self and the world, mental fragmentation, and the lack of symbolization.