Hospitality in the Psychotherapy for Psychosis

Hospitality is a key concept in contemporary continental philosophy that emphasizes the importance of welcoming the stranger. Despite its relevance to psychotherapy, little has been written about how it could be a framework for the psychotherapeutic encounter, especially for people experiencing psychosis. In the world of psychiatry, the person with psychosis is often viewed as “other,” a stranger whose presence can unsettle clinicians who do not how to engage or have a conversation with a person experiencing psychotic symptoms. Leaning on writings on the philosophical writings of Ricoeur and Kearney, we apply the concept of hospitality to the clinical setting to guide how to form a relationship and facilitate a dialogue with a person suffering from psychosis. The role of guest and host will be examined, and the ways both patients and therapists inhabit these roles. There is also attention to the importance of being hospitable to the patient’s idiosyncratic use of speech and narrative, and the ways that therapists also need to represent their own interpretations to enable genuine exchange of ideas. Brief clinical vignettes are presented throughout to flesh out these conceptual points.