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

By Paul Williams

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We also need to be able to create the means to stand up to them, without denying their existence, being overwhelmed by them or pushing them back on to the patients in whom they are already visibly rife. How are we to achieve this? History can come to our aid. We need to create organizational structures that will resist attempts to circumvent this hard-won knowledge about the inherent nature of mental disturbance; structures that will operate efficiently and in optimal conditions be mutually Psychoses and their organizational fate 29 supporting across local, regional and national levels.

Discussion of case In the course of treating this patient I had to pay close attention at the beginning to a certain elliptical nature to her free associations, which at Psychotherapy of schizophrenia and other psychoses 23 times appeared to be loose (because of overinclusion and poor gating capacity for feelings and thoughts). I found that asking her to explain and to supply connections or links between the associations was very helpful, not only in my understanding but also in hers. The patient has made considerable progress in her treatment, but every step along the way is seemingly challenged by her psychotic organization, which might be thought of in terms of endopsychic structure (Fairbairn, 1952) or as a pathological organization or psychic retreat (Steiner, 1993).

The little round, brown men are faeces-men, reminding you of how, ever since you were a little child, you used anal masturbation to soothe yourself, and in so doing, believed that you entered into the other world, the world of psychosis. Patient: What am I to do? Craziness has been discredited. I’m back where I started as a child and have lost all that time. I don’t feel safe. Discussion of case In the course of treating this patient I had to pay close attention at the beginning to a certain elliptical nature to her free associations, which at Psychotherapy of schizophrenia and other psychoses 23 times appeared to be loose (because of overinclusion and poor gating capacity for feelings and thoughts).

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