The Keys to the Prison: Michael Garrett's Integrative Approach to the Treatment of Psychosis


  • Paul L. Wachtel



psychotherapy integration, psychodynamic therapy, cognitive behavior therapy, CBT, cyclical psychodynamics, Oedipal and preoedipal, psychosis, case study, clinical case study


This discussion of Michael Garrett's (2020) case study, "Portrait of a Man Imprisoned in an Altered State of Consciousness: The Case of 'Sean,'" examines the integrative conceptualization and practice that is evident in the presentation.  Among the themes explored are the particular way that Garrett approaches issues often conceived in the psychoanalytic literature as 'Oedipal' and 'preoedipal;' the role of corrective emotional experiences; the boundaries of self and other in subjective experience; the cyclical nature of the dynamics that maintain Sean’s guilt and his problematic life patterns; and the creative tactics through which Garrett integrates psychodynamic and cognitive-behavioral perspectives in his efforts to help Sean escape from the repetitive pattern in which he is caught.

Author Biography

Paul L. Wachtel

Paul L. Wachtel




How to Cite

Wachtel, P. L. (2020). The Keys to the Prison: Michael Garrett’s Integrative Approach to the Treatment of Psychosis. Pragmatic Case Studies in Psychotherapy, 16(2), 206–214.