Psychoanalysis of the Psychoses brings together a distinguished international set of contributors, offering a range of views and approaches, to explore the latest thinking in the psychoanalytic treatment of psychosis and related disorders. Drawing on findings from neuroscience, theory and clinical material from many schools of psychoanalytic thought, this book offers a comprehensive guide to understanding how psychosis is conceptualised from a psychoanalytic perspective. It looks at how to work with psychotic patients, typical problems in treating psychosis and the role of pharmacology. It demonstrates the relational dimension, capable of strengthening the patient’s observing Ego and facilitating the integration of the different areas of the personality. This process can identify and work through the main psychological stress factors involved in psychotic disturbances, transforming chaotic thoughts into springboards for important insights, and offering patients the precious chance to construct for the first time a creative relationship with their own existence. Psychoanalysis of the Psychoses will be of great interest to psychoanalysts and psychoanalytic psychotherapists as well as psychiatrists wishing to draw upon psychoanalytic ideas in their work.

Psychoanalysis Meets Psychosis proposes a major revision of the psychoanalytic theory of the most severe mental illnesses including schizophrenia. Freud believed that psychosis is the consequence of a biologically determined inability to attain and sustain a normal or neurotic mental organization. Michael Robbins proposes instead that psychosis is the outcome of a different developmental pathway. Conscious mind functions in two qualitatively different ways, primordial conscious mentation and reflective representational thought, and psychosis is the result of persistence of a primordial mental process, which is adaptive in infancy, in later situations in which it is neither appropriate nor adaptive. In Part I Robbins describes how the medical model of psychosis underlies the current approach of both psychiatry and psychoanalysis, despite the fact that neuroscience has failed to confirm the model’s basic organic assumption. In Part II Robbins examines two of Freud’s models of psychosis that are based on the assumption of a constitutional inability to develop a normal or neurotic mind. The theories of succeeding generations of analysts have for the most part reiterated the biases of Freud’s two models, so that psychoanalysis considers the psychoses beyond its scope. In Part III Robbins proposes that the psychoses are the result of disturbances in the attachment-separation phase of development, leading to maladaptive persistence of a primordial form of mental activity related to Freud’s primary process. Finally, in Part IV Robbins describes a psychoanalytic approach to treatment based on his model. The book is richly illustrated with material from Robbins’ clinical practice. Psychoanalysis Meets Psychosis has the potential to undo centuries of alienation between society and psychotic persons. The book offers an understanding of severe mental illness that will be novel and inspiring not only to psychoanalysts but to all mental health professionals.

Do psychotic disorders make sense? Are psychotic symptoms amenable to interpretation? Understanding Psychosis: A Psychoanalytic Approach takes the various pathways to psychotic illness outlined by psychoanalytic clinicians and scholars and integrates them into a model that allows a systematic assessment of relevant psychodynamic dimensions in the diagnosis of psychotic disorders, and which serves as a guide to psychotherapy with psychotically ill patients. Joachim Küchenhoff reviews and integrates various psychoanalytic concepts and theories about psychosis into a multi-dimensional psychodynamic model that allows an assessment and understanding of the patient’s subjective experience, objective psychological capabilities, and interpersonal resources. Küchenhoff helps the therapist to establish a basic attitude in working psychodynamically with patients and to understand the dynamics of the therapeutic relationship. Understanding Psychosis also addresses specific issues that can arise in work with clients experiencing psychosis, including understanding imminent crises or precursor states, elucidating semiotic qualities in seemingly negative symptoms, differentiating the psychotic and a non-psychotic part of the personality and providing a dynamic approach to the psychopharmacological treatment. Clinical vignettes and three detailed case reports are included in the book. Understanding Psychosis will be an essential guide for psychiatrists, psychotherapists and psychoanalysts working with patients experiencing psychosis. It will also be of use to psychologists, and academics and students of psychotherapy, psychiatry and psychoanalysis for psychosis.

Covering the last four decades of the 20th century, this book explores the unwritten history of the struggles between psychoanalysis and psychiatry in postwar USA, inaugurated by the neosomatic revolution, which had profound consequences for the treatment of psychotic patients. Analyzing and synthesizing major developments in this critical and clinical field, Orna Ophir discusses how leading theories redefined what schizophrenia is and how to treat it, offering a fresh interpretation of the nature and challenges of the psychoanalytic profession. The book also considers the internal dynamics and conflicts within mental health organizations, their theoretical paradigms and therapeutic practices. Opening a timely debate, considering both the continuing relevance and the inherent limitations of the psychoanalytic approach, the book demonstrates how psychoanalysts reinterpreted their professional identity by formalizing and disseminating knowledge among their fellow practitioners, while negotiating with neighboring professions in the medical fields, such as psychiatry, pharmacology and the burgeoning neurosciences. Chapters explore the ways in which psychoanalysts constructed – and also transgressed upon – the boundaries of their professional identity and practice as they sought to understand schizophrenia and treat its patients. The book argues that among the many relationships psychoanalysis sustained with psychiatry, some weakened their own social role as service providers, while others made the theory and practice of psychoanalysis a viable contender in the jurisdictional struggles between professions. Psychosis, Psychoanalysis and Psychiatry in Postwar USA will appeal to researchers, academics, graduate students and advanced undergraduates who are interested in the history of psychoanalysis, psychiatry, the medical humanities and the history of science and ideas. It will also be of interest to clinicians, health care professionals and other practitioners.

Psychosis and Near Psychosis offers a psychoanalytically-based approach to an integrated treatment of psychosis and near psychosis, achieved by organizing psychotherapy, medication, hospital and milieu interventions into a powerful therapeutic tool. The author navigates confidently between psychiatric and psychoanalytic approaches, between biological evidence and psychological assessments. According to Dr. Eric Marcus, since the past, so-called heroic psychoanalyses with psychotic patients have clearly been shown to fail, the time is now ripe again to discuss psychosis in terms of the broadened psychoanalytic theory, with the support of medication and a better understanding of the neuropsychological factors involved. This book, which maps out mental illness in concrete and innovative ways, will interest all researchers and clinicians eager to find the best means, both practical and theoretical, to initiate satisfying psychiatric therapies.

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This is the first book of its kind that attempts to distill Lacan’s views on psychosis for both a specialized and non-specialized audience. An attempt is made to present Lacan’s unorganized theories to apply to conceptual paradigms in psychoanalysis and the humanities as well as applied clinical practice. This effort is in the spirit of fostering dialogue and educating different theoretical orientations within psychoanalysis on what Lacan and his followers have contributed to emerging contemporary perspectives on psychotic phenomena in both normative and pathological populations. Within Lacanian circles there is debate over what constitutes psychosis, including defining the ordinary from pathological variants that have historically defined the phenomena as a mental illness. Here psychosis is not defined by hegemonic authoritarian psychiatry, but rather as a conceptual framework or philosophical perspective supported by descriptive narrative and symptomatic phenomenology that challenges preconceived notions of what we typically consider psychosis to entail. In this book a variety of perspectives are presented by internationally respected scholars and clinicians who examine what Lacan had to say about psychosis, from his nuanced theories represented in select texts, including omissions, extrapolations, and new applications, as well as how clinical methodology and technique have been adapted and advanced by practitioners treating psychotic individuals. Lacan on Psychosis will be of interest to academics, scholars, researchers, and practitioners in the fields of psychoanalysis, psychotherapy, philosophy, cultural theory, the humanities, and the behavioral sciences.

The Psychotic Wavelength provides a psychoanalytical framework for clinicians to use in everyday general psychiatric practice and discusses how psychoanalytic ideas can be of great value when used in the treatment of seriously disturbed and disturbing psychiatric patients with psychoses, including both schizophrenia and the affective disorders. In this book Richard Lucas suggests that when clinicians are faced with psychotic patients, the primary concern should be to make sense of what is happening during their breakdown. He refers to this as tuning into the psychotic wavelength, a process that allows clinicians to distinguish between, and appropriately address, the psychotic and non-psychotic parts of the personality. He argues that if clinicians can find and identify the psychotic wavelength, they can more effectively help the patient to come to terms with the realities of living with a psychotic disorder. Divided into five parts and illustrated throughout with illuminating clinical vignettes, case examples and theoretical and clinical discussions, this book covers: the case for a psychoanalytical perspective on psychosis a historical overview of psychoanalytical theories for psychosis clinical evidence supporting the concept of a psychotic wavelength the psychotic wavelength in affective disorders implications for management and education. The Psychotic Wavelength is an essential resource for anyone working with disturbed psychiatric patients. It will be of particular interest to junior psychiatrists and nursing staff and will be invaluable in helping to maintain treatment aims and staff morale. It will also be useful for more experienced psychiatrists and psychoanalysts.

“This brilliant and beautifully written book invokes a radical reorientation of the treatment of psychosis” Juliet Flower MacCannell, Author of Figuring Lacan and The Hysteric’s Guide to the Future Female Subject. “Bret Fimiani's book offers an illuminating presentation of the Lacanian approach to psychosis thanks to his clear style which presents Lacanian concepts with a wonderful accuracy, illustrated by examples from his psychoanalytic practice. The dynamic of his investigation challenges the fear of psychosis with testimonies of lived experiences, the Hearing Voices Network, and analysts who claim the unclaimed intelligence at work in psychosis." Francoise Davoine, co-author of History Beyond Trauma This book advances a theory of transference-in-psychosis with the aim of provoking a change in the way the experience of psychosis is understood and thus, clinically treated. It examines the function of ‘ethics’ in the ‘installation’ of transference in the treatment of psychosis and contends that the aim of the psychoanalytic experience is the creation of a new ethic for the analysand and for the treatment. Beginning from the premise that the body of the psychotic is a site of social contestation, the author draws upon the work of Freud, Lacan, Deleuze & Guattari and Apollon to reframe the problem of the ‘body’ (as an effect of language) and its relation to transference, and ethics, in treating psychosis. It argues that psychosis still has much to teach psychoanalysis about how psychoanalysis must continue to change in order to create/offer an approach that is effective for psychosis (versus neurosis) and provides a comprehensive psychoanalytic theory of psychosis that derives, at its core, from the experience of psychosis itself. The book’s synthesis of clinical and ‘peer model’ principles will provide readers with a way to understand and navigate potential transference impasses often encountered with purely clinical approaches. In doing so it provides a valuable new framework for practitioners and scholars working in clinical psychology, psychoanalysis, philosophy, critical theory, psychiatry and social work.

When madness is intolerable for sufferers, how do professional carers remain sane? Psychiatric institutions have always been places of fear and awe. Madness impacts on family, friends and relatives, but also those who provide a caring environment, whether in large institutions of the past, or community care in the present. This book explores the effects of the psychotic patient's suffering on carers and the culture of psychiatric services. Suffering Insanity is arranged as three essays. The first concerns staff stress in psychiatric services, exploring how the impact of madness demands a personal resilience as well as careful professional support, which may not be forthcoming. The second essay attempts a systematic review of the nature of psychosis and the intolerable psychotic experience, which the patient attempts to evade, and which the carer must confront in the course of daily work. The third essay returns to the impact of psychosis on the psychiatric services, which frequently configure in ways which can have serious and harmful effects on the provision of care. In particular, service may succumb to an unfortunate schismatic process resulting in sterile conflict, and to an assertively scientific culture, which leads to an unwitting depersonalisation of patients. Suffering Insanity makes a powerful argument for considering care in the psychiatric services as a whole system that includes staff as well as patients; all need attention and understanding in order to deliver care in as humane a way as possible. All those working in the psychiatric services, both in large and small agencies and institutions, will appreciate that closer examination of the actual psychology and interrelations of staff, as well as patients, is essential and urgent.