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Integration and Sealing Over:  Clinically Distinct Recovery Styles From Schizophrenia

Thomas H. McGlashan, MD; Steven T. Levy, MD; William T. Carpenter Jr., MD
Arch Gen Psychiatry. 1975;32(10):1269-1272. doi:10.1001/archpsyc.1975.01760280067006.
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Concepts of integration and sealing over are common clinical psychiatric parlance. Our experience studying and treating acute schizophrenic patients, primarily with psychosocial techniques, has emphasized the meaningfulness of these concepts. By studying the recovered patient's attitude toward his psychotic experiences, we have obtained material from which to formulate definitions of these concepts.

Integrators tend to be curious about their symptoms, regard them as part of their life's pattern, and gain information from them, resulting in a more flexible and variable attitude toward illness than patients who seal over. The latter have rather fixed, usually negative, views of their illness, and tend not to strive to understand their psychotic symptoms nor to place their psychotic experiences in perspective with their lives before and after psychosis.


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