The Psychotic Core

This book examines the key ordering—disordering processes of the psychotic self. It draws on Sigmund Freud, Jung, object relation and selfpsychologies, and, particularly, the work of Winnicott, Bion, and Elkin.

More and more individuals with ego defects, severe object relations conflicts, affective turbulence, and unassimilated contradictions are seeking help from psychoanalysts and psychotherapists. Contributors to this book explore hereditary and constitutional factors, environmental influences and unconscious fantasies in the development of the psychotic core in such patients and provide guidance for psychoanalysts and psychotherapists to hear and therapeutically respond to these patients' uncanny ways of describing their internal worlds. This volume includes contributions by experienced clinicians from Europe and the United States, as well as case histories illustrating the transformation of the psychotic core and how these patients can develop healthier internal structures. The editors' introductory and closing summaries integrate knowledge dealing with especially difficult patients. By reading this book, psychoanalysts and therapists will be prepared to gain insights as newer neurobiological and psychological research findings become available and, hopefully, enthusiasm about working with individuals with "the seed of madness."

This comprehensive and tightly argued book deals with the process through which a coherent self evolves, the various ways such development fails to occur, and the therapeutic measures to put things back together. Beginning with the child's early relationships and their internalization as the substrate of the self, the text moves on to psychodynamically sophisticated and developmentally anchored descriptions of certain psychopathological syndromes that are widespread and yet inoptimally discussed. Going from the most severe to the least severe conditions in this realm, the book deals with the psychotic core, the schizoid wish to die and be reborn, the fantasies related to unresolved separation-individuation, the sociopathic tendency to lie, and the impact of excessive narcissism on love relations. The book also provides a unique perspective on the treatment of these conditions in so far as it not only elucidates the ways that a therapist listens and talks to his patients but also the subtle but deep impact of his ongoing attitude toward psychotherapeutic work. Even the role the therapist's office silently plays in the conduct of his work is discussed in detail. The book is theoretically sound and contemporary. More importantly, it is clinically generous and provides a number of vignettes to illustrate the ideas proposed. The writing style is a refreshing admixture of scientific scrupulosity, literary elegance, and humane relatedness.

"Ecstasy is a force to be reckoned with--sometimes creative, sometimes destructive. Eigen argues that there is an ecstasy that comes through the ever-necessary confrontation of our psychic cores with suffering and degradation and he shows that when we can learn to be present with these feelings, they add to the tone and texture of our lives, and help us to feel real."--Page 4 of cover.

An essential handbook providing practical guidance and medication advice on the effective management and treatment of psychotic disorders.

“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.

This important new book offers techniques for carers to help their family member with schizophrenia on to a recovery trajectory.