Creating alternative therapeutic spaces in psychiatry: a tribute to Loren R. Mosher

ABSTRACT

Background

For much of the 20th century, psychosocial approaches to psychosis were rejected by conventional psychiatry. However, Loren R. Mosher, an American psychiatrist, drawing on the ideas of R. D. Laing and the tenets of interpersonal phenomenology, set up the Soteria project in California, and in so doing made his mark on the psychosocial treatment of psychosis. This essy revisits Mosher’s life’s work, analysing some of the implications derived from his creation of alternative therapeutic spaces in psychiatry for those stigmatized, medicalized, and objectified within a psychiatric category.

Methods

Using a selection of relevant works from the literature (including many written by Mosher alone or in collaboration with others), this paper is a timely reconsideration of this question, as there is a growing acknowledgment today of the need for alternatives to the current drug-centered approach to the care of people who are going through psychotic episodes.

Results and Discussion

As I will show here, Mosher was a potent precursor of the so-called community-based approach, imbuing his clinical praxis with a strong phenomenological vision of psychosis. He also showed his work to be compatible with robust research, and provided empirical evidence for its efficacy, without rejecting drug prescriptions when necessary.

KEYWORDS:

• Basaglia
• Laing
• Mosher
• community psychiatry
• psychosis

Acknowledgements

I am especially grateful to Luc Ciompi, Prof. Dr. med. Emeritus, Dr. h.c., Swiss Psychiatrist and psychotherapist FMH, for sharing with me his ideas and wise comments on this topic under examination. I would also like to gratefully thank Theodor Itten, a retired psychotherapist, who maintained a close friendship with Mosher, for sharing ideas and sending me articles by Mosher which were not easily available, and which have been of great value in the preparation of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).