Cognitive Therapy for Delusions, Voices and Paranoia

by Paul Chadwick, Max Birchwood, Peter Trower

Internationally respected authors, actively working in this area, establish theoretical reasons for extending cognitive therapy to these symptoms. This includes a justification for looking at symptoms rather than syndromes, first-person accounts of delusions and hallucinations along with an analysis of why the cognitive approach is ideally suited to the study and treatment of these disabling disorders. Describes how to make a cognitive assessment of both hallucinations and delusions and which measures to use. Contains new research and methods of managing these severe psychoses.

Genres: Mental Health

232 pages, Paperback

First published June 4, 1996

About the author

Paul Chadwick (b.1957) has worked widely as an artist and writer for comic books, with collaborators like Ron Randall, Doug Wheatley, Alan Moore, John Bolton, Harlan Ellison, Jan Strnad, Randy Stradley, Archie Goodwin, Brian K. Vaughan, and others.

He's most noted for his award-winning series Concrete, about a thoughtful man stuck in a brutish, rock-coated body. Born in Seattle, he grew up in its lakeside suburb Medina, then a haven for Boeing engineers and their families, now the site of palaces for Bill Gates and his ilk. His father Stephen F. Chadwick was City Attorney for the small hamlet.

As a teen, he joined Apa-5, the amateur press alliance of comics fans which also provided a creative outlet for future comics luminaries like Frank Miller, Mike Richardson, Randy Stradley, Chris Warner, Randy Emberlin, and others.

He attended Art Center College of Design, majoring in illustration. Around this time Chadwick lived in a courtyard apartment building, The Golden Palm, which teemed with talent. Bryn Barnard, Ron Harris, David Mattingly, James Gurney, Thomas Kinkade, Kurt Cyrus, Mark Verheiden, Andy Su, Terry Robinson all lived there, five of them as Chadwick's roommate (at different times).

Chadwick graduated in 1979, and began storyboarding movies for Disney, Warner Brothers, Lucasfilm and others. Credits include Pee Wee's Big Adventure, Strange Brew, The Big Easy and Ewoks: The Battle for Endor. Chadwick says the auteurs behind two small films he worked on, Lies (Jim & Ken Wheat) and Miracle Mile (Steve DeJarnatt) were the greatest personal influences on his writing.

Chadwick also freelanced illustration, mainly for movie advertising (Streamers and Galaxy of Terror were the only finished posters among the dozens of preliminary paintings he did) and for SF and Fantasy paperbacks.

Chadwick decided to devote himself to comics, but Concrete didn't sell at first. Chadwick's first comic in print was The Life of St. Norbert, published by an order of Norbertine monks. Going from the sacred to the (mildly) profane, he next drew Steve Perry's strange and silly Salimba, about a jungle girl fighting "wormboys" and a giant three-headed were-dog.

A year on Marvel's Dazzler completed Chadwick's apprentice years, and he sold Concrete in 1985 to Dark Horse comics. It has appeared intermittently ever since.

A Concrete movie has been in development for years. Chadwick has written several screenplays for it, first in collaboration with Larry Wilson, then solo. Peter Jackson and Fran Walsh wrote one, as well, which briefly won a green light for the film.

The decision was reversed upon the release of the surprise hit The Blair Witch Project, which caused the sudden mass delusion that Hollywood could dispense with costly visual effects and stars. The fever passed, but Concrete's window had closed, at least until somebody with the clout or energy decides to brave the thousand demons that lay waiting to kill every movie.

Chadwick wrote and drew (inks by Ron Randall) eight issues of The World Below, about a network of vast, mysteriously lit caverns beneath northern Washington State, and the strange beings and technology to be found there. Dark Horse plans to reissue the series as a collection.

The Human Dilemma, the newest Concrete series, won an Eisner Award (best cartoonist) and a Reuben Award (best in comic books division) from the National Cartoonist Society.

Chadwick is currently drawing a miniseries for DC, Seven Against Chaos, written by Harlan Ellison.

He's also working on a (non-Concrete, TBA) graphic novel for Dark Horse, as well as a new Concrete miniseries.

Biography updated 2010

Reviews

[Alastair Kemp · Rating 4 out of 5]

Covers Paul Chadwick and other's ABC model of CBT for delusions, voices and paranoia.
Reasonably practical variation of Beck's model, with more emphasis on listening understanding and working with the meaning that voice hearer's and other symptoms that people with psychotic diagnoses often struggle with. Along with the models similar to those developed by groups like Intervoice and the Hearing Voices Network.
It focuses on the relation of belief to the processing of ideation based on the meaning that people give to the cause and effect of their emotions and feelings in relation to their experience in the world.

However it is still CBT and whilst giving more pragmatic ways of dealing with the trauma of sufferers, it is still CBT and is subject to the question of longitudinal studies.

There may be reasons why even though it addresses the 'beliefs' that are formed as a defence mechanism with regards long term trauma and distressing emotions, I wonder if both a more psychotherapeutic approach is needed to tackle the more underlying distal issues, rather than 'fix' what the result of this distal issue with regards more 'proximate' issues.

In only doing so it only deals with the dopamine rewards system, given the tendency to rely on this to deal with unpleasant feelings when life is 'difficult', no matter the positives in this method, I can't see this working without addressing social and economic issues at a social support level (social work, finances, etc), if this shifts people into a better life circumstance, then there is may be the possibility to tip the client, along with self-compassion methods, into more serotonin/ oxytocin maintaining systems (although by know means guaranteed), but otherwise, there is reason to suspect that in 3 or more year follow ups there may be a return to earlier behaviour, or new but by no means better, defence mechanisms.

[Jaimini Mehta · Rating 3 out of 5]

Some very good ideas and learning but also a bit dated as practice and theory has moved on but definitely would recommend if working with psychosis.