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Essential Papers on Psychosis

Peter Buckley Editor
Nathaniel J. London
Victor Tausk
Thomas Freeman
Harold F. Searles
Robert C. Bak
Edith Jacobson
Herbert Rosenfeld
Norman Cameron
Copyright Date: 1988
Published by: NYU Press
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  • Book Info
    Essential Papers on Psychosis
    Book Description:

    Since Freud's first mention of object relations in his seminal paper Three Essays on the Theory of Sexuality, analysts have been arguing about its role in the psychological development and mental life of individuals. Essential Papers on Object Relations gathers together the critical papers by major figures in the field. Reflecting the changes and conflicts over the past hundred years, the volume includes the work of key scholars as they attempt to define, delineate, and describe object relations theory. It includes work by: Sigmund Freud, Melanie Klein, Arnold H. Modell, W. R. D. Fairbairn, Jacob A. Arlow, Annie Reich, John Bowlby, Margaret S. Mahler, Harry Guntrip, D. W. Winnicott, Joseph Sandler and Anne-Marie Sandler, Otto Kernberg, T. F. Main, Edith Jacobson, and Hans W. Loewald.The book, which includes explanatory introductions to each part, is an invaluable resource for those seeking a thorough examination of object relations theory and the classical and contemporary work of major analytic thinkers. y.

    eISBN: 978-0-8147-2330-2
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-x)
  4. Introduction
    (pp. xi-xxx)

    In his autobiographical account of his psychosis, Daniel Schreber (1, pp. 83–5) wrote the following:

    In consequence of my every increasing nervousness and the resulting increasing power of attraction, an ever growing number of departed souls felt attracted to me—primarily those who may have retained some special interest in me because of personal contacts with me during their life—and then dissolved on my head or in my body. This process frequently ended with the souls concerned finally leading a short existence on my head in the form of “little men”—tiny figures in human form, perhaps only...

  5. Part I. The Phenomenology of Psychosis

    • [Part I. Introduction]
      (pp. 1-4)

      The fantastic and bizarre symptoms often experienced by psychotic patients have begged for psychological explanation especially in light of what appears to be the naked appearance of primary-process thinking and the breakdown of normal defence mechanisms such as repression. A psychoanalytic theory of the phenomenology of the psychoses can be constructed without simultaneously advancing a general theory of aetiology and given the paucity of confirmed scientific data concerning the latter such a position would appear to be prudent. Even within the psychoanalytic theory of psychotic phenomenology, however, considerable controversy reigns and two opposing viewpoints have been asserted.

      Freud (1) postulated...

    • 1. An Essay on Psychoanalytic Theory: Two Theories of Schizophrenia. Part I: Review and Critical Assessment of the Development of the Two Theories
      (pp. 5-22)
      Nathaniel J. London

      Sound theory remains well rooted in the observations it serves to organize and the investigative goals it serves to define. One of the obstacles to any sound theory is the dilemma as to whether it has been over-extended or underextended. The usual tendency is toward a dialectic of unitary and multiple theories: first one and then the other in ascendancy in the advance of science. The trend in this dialectic usually favours multiple theories in the progression toward increasing specialization. Such advances are also dependent on the creative capacities of those scientists, like Sigmund Freud, who can bring together a...

    • 2. An Essay on Psychoanalytic Theory: Two Theories of Schizophrenia. Part II: Discussion and Restatement of the Specific Theory of Schizophrenia
      (pp. 23-48)
      Nathaniel J. London

      In Part I, I surveyed Freud’s Classical Theory of schizophrenia to show that it may be separated into two theories. These two theories have been developed as the main psychoanalytic theories of schizophrenia today. The Unitary Theory, as I have termed it, emphasizes a continuity between schizophrenia and neuroses, both viewed as intrapsychically motivated or purposive behaviours determined by instinctual drives and defences. Within the Unitary Theory, ‘decathexis’ refers to the defensive process, disturbances in ‘reality’ are considered defensively motivated by means of the mechanism ‘disavowal’, and transference in schizophrenia is considered fundamentally the same as in neuroses. Freud developed...

    • 3. On the Origin of the “Influencing Machine” in Schizophrenia
      (pp. 49-77)
      Victor Tausk

      The following considerations are based upon a single example of the “influencing machine” complained of by a certain type of schizophrenic patient. Although in this particular case the structure of the machine differs materially, to the best of my knowledge, from all other varieties of apparatus of this sort, it is hoped that the present example will nevertheless facilitate psychoanalytic insight into the genesis and purpose of this delusional instrument.

      My example is a variant—a very rare variant—of the typical influencing machine. The objection can of course be made that it is rash to draw general conclusions from...

    • 4. Narcissism and Defensive Processes in Schizophrenic States
      (pp. 78-97)
      Thomas Freeman

      The purpose of this paper is to examine once again the processes of defence in schizophrenic states and their relationship to the various forms of mental activity which underlie the clinical phenomena. The concept of defence was introduced by Freud (4) as a result of his study of dreams and psychoneurotic symptoms. In both groups of phenomena he described the unconscious mental conflict which occurs between instinctual wishes on the one hand and ethical and moral standards on the other. As long as the defensive forces maintain the upper hand dreams adequately protect sleep and anxiety does not become a...

    • 5. Sources of Anxiety in Paranoid Schizophrenia
      (pp. 98-117)
      Harold F. Searles

      In this description of what I have found to be the major sources of anxiety in individuals suffering from paranoid schizophrenia, I shall endeavour to demonstrate how affective phenomena and structural phenomena are interrelated. Further, although I shall have to assume, during much of this portrayal, the vantage point of the observer, whenever possible I shall discuss these sources of anxiety in terms of the patient’s own subjective experience of them. This latter emphasis helps to explain the apparent paradox that I shall count, among the ‘sources’ of his anxiety, various ego-defensivephenomena. We well know that to any psychiatric...

    • 6. Masochism in Paranoia
      (pp. 118-130)
      Robert C. Bak

      Until the works of Ferenczi (1) and Freud gave us essential insight into paranoia, Kraepelin’s point of view dominated. Kraepelin gave the classic description, delineating the symptom complex, and the bulk of the ensuing research attempted to isolate paranoia as a disease entity. With the separation of the paraphrenias from dementia præcox, the sole two remaining clinical forms of sensitive paranoia were the paranoia of jealousy and litigious paranoia. Most investigators held that the psychosis was characterogenic, originating in a specific paranoid constitution, which manifested itself in certain personality traits. The psychosis was supposed to develop under the influence of...

    • 7. On Psychotic Identifications
      (pp. 131-142)
      Edith Jacobson

      Not only in the manic-depressive but also in the schizophrenic groups of psychoses, pathological mechanisms of identification seem to play a paramount part in the psychotic symptom formation. From Freud’s, Abraham’s, Rado’s, Klein’s papers, we are familiar with the narcissistic identifications underlying the delusional ideas in manic-depressive states. But apart from the paranoid projections, the nature and functions of the identification mechanisms operating in schizophrenic processes have not been so systematically investigated.

      It is a challenging task indeed to study and to compare their nature and their role in symptom formation with the corresponding phenomena in manic-depressive psychosis. The time...

  6. Part II: Psychotherapeutic Encounters with Psychosis

    • [Part II: Introduction]
      (pp. 143-146)

      The psychoanalytic treatment of the psychoses has been fraught with controversy from the beginning and many psychoanalysts have subscribed to Freud’s skepticism concerning the accessibility of such patients to its methods. In an important review of the technical strategies involved in the intensive psychotherapy of schizophrenia, McGlashan (1, p. 911) noted that Freud wrote to a colleague in 1928 (2, p. 21): ‬“Ultimately I had to confess to myself … that I do not care for these patients [psychotics], that they annoy me, and that I find them alien to me and to everything human. A peculiar kind of intolerance...

    • 8. On the Treatment of Psychotic States by Psychoanalysis: An Historical Approach
      (pp. 147-176)
      Herbert Rosenfeld

      During the last 50 years the psychoanalytic approach to psychosis has undergone very considerable change and at the present time there is no unified theory of either the psychopathology or the technique of treating the psychoses. Many analysts working with psychotics have found it necessary to alter to some extent the classical technique of analysis developed by Freud in dealing with neurotic states; a technique which relies predominantly on the development of transference manifestations which can be interpreted to the patients. Freud himself thought, as I shall show later, that this technique was unsuitable for psychotics. The work of many...

    • 9. Transference Psychosis in the Psychotherapy of Chronic Schizophrenia
      (pp. 177-232)
      Harold F. Searles

      After some five years of my work at Chestnut Lodge, developments in the therapy of various of my patients brought home to me the realization that even the most deep and chronic symptoms of schizophrenia are to be looked upon not simply as the tragic human debris left behind by the awesome glacial holocaust which this illness surely is, but that these very symptoms can be found to have—or, perhaps more accurately, in the course of therapy can come to reveal—an aspect which is both rich in meaning and alive, one now sees, with unquenched and unquenchable energy....

    • 10. Introjection, Reprojection, and Hallucination in the Interaction Between Schizophrenic Patient and Therapist
      (pp. 233-255)
      Norman Cameron

      Freud has pointed out that psychotic persons are sometimes able to communicate their experiences with aspects of internal reality that are ordinarily inaccessible to normal and neurotic persons (4). This paper presents material from the intensive, psycho-analytically oriented therapy of a patient, over a period of three and a half years, which describes such experiences with exceptional clarity. These include the regressive reprojection of primitive superego functions in the form of an hallucinated mother image, the hallucination of the therapist under conditions of stress, and the subsequent introjection of a therapist image, followed by its apparent assimilation into a new...

    • 11. Phases of Patient-Therapist Interaction in the Psychotherapy of Chronic Schizophrenia
      (pp. 256-292)
      Harold F. Searles

      At the end of three years of doing intensive psychotherapy with chronically schizophrenic patients, I found myself occupied, for a comparatively brief period, with the question of whether I should go ahead and devote myself, for an indefinite number of further years—perhaps for the whole remainder of my professional career—primarily, to this line of endeavour. I decided in favour of doing this, out of a feeling of having found myself in the course of my personal analysis, in the course of these early years in the crucible of the intensive psychotherapy of schizophrenia, and in the course of...

  7. Index
    (pp. 293-296)