How Can Open Dialogue Change Our Understanding of the Behavior of People Experiencing Psychosis?


  • Jun-ichi Murakami
  • Jun-ichi Murakami
  • Kazusa Yamanaka


Open dialogue, Metaphorical thinking, Psychosis, Meaning-Making, Implementation


The Japanese psychiatric system has had a tendency to
institutionalize attaching too much emphasis on the
medical model and avoiding uncertainty. The authors
have encountered and learned from Open Dialogue
practice. In 2019 a dialogical practice unit was formed.
The authors held a series of meetings to listen to the
voices of those involved and shared the decisionmaking process with clients and network members.
The collaborative process between clients and network
members who had been diagnosed with serious mental
illness resulted in increased understanding as all voices
were shared. In addition, the process increased
tolerance for uncertainty and dissolved social
alienation, and symptoms were significantly reduced.
As a result, 15 out of 35 clients were able to transition
to the community within three years. Building on the
foundation of horizontal relationships with clients and
network members, shared meanings and emotions
contributed to this process.