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.