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A Language for Psychosis: Psychoanalysis of Psychotic States by Paul Williams

By Paul Williams

Booklet through Paul Williams

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Extra info for A Language for Psychosis: Psychoanalysis of Psychotic States

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These unconscious, so-called ‘primitive’ processes, together with their consequences, come into play in particular to deal with human affects that are felt to be too threatening to psychic stability, or are unbearably painful for the person who is vulnerable to psychosis. The social impact of such phenomena has come to be realized from studies of these processes that have examined transference and countertransference activity in individuals, groups, families and organizations. If we accept that such phenomena are an inevitable part of the dynamics of interpersonal processes when psychosis is present then it must be both legitimate and indeed essential for us to keep them in mind constantly, as a primary task.

The strain of integrating both the biological and psychological approaches to the patient’s condition can lead to splitting processes by Psychoses and their organizational fate 31 staff, leading to a polarization of thinking amongst the staff group. Where there is professional insecurity at individual or group level in any one area of knowledge or skill, it is commonplace to find splitting, leading to idealization of the easier form of therapy and denigration of the other. For example, a psychiatrist, Dr Smith, talked about John, a patient with schizophrenia, in a joking and rather dismissive manner.

The Finnish National Board of Health initiated a study in six districts that altered the treatment focus to include a much greater, more active psychotherapeutic approach for new cases of schizophrenia in order to try to prevent new chronicity. Even with staff who, at that time, were poorly trained in psychotherapy, this new active approach had dramatic results – only 9% of 219 new patients treated needed hospitalization, although many patients were nevertheless still incapable of work and were given disability pensions.

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