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 that is adaptive in infancy, in later situations in which it is neither appropriate nor adaptive. In Part One 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 Two 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 Three 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 Four 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. Table of Contents
Preface Introduction PART I: NOT FULLY HUMAN: THE UNWITTING COLLUSION BETWEEN MEDICINE AND PSYCHOANALYSIS 1: Not fully human: Psychiatric and psychoanalytic understandings of psychosis 2: the medicalization of madness: Evolution of the equation of psychosis with degeneracy PART II: PSYCHOANALYTIC MODELS OF PSYCHOSIS 3: Freud’s attempt to treat psychosis as though it were neurosis 4: Freud’s three models and their offspring: I: The inability to relate 5: Freud’s three models and their offspring: IIA: The inability to integrate mind and become neurotic: The European Kleinian iteration 6: Freud’s three models and their offspring: IIB: The inability to become neurotic: American ego psychological iteration of the integration model and Kernberg’s trans-Atlantic rapprochement 7: Freud’s three models and their offspring: III: Thought disorder PART III: A NEW BEGINNING: DISTINGUISHING PSYCHOSIS FROM NEUROSIS Clinical preface to chapters 8, 10, & 13 8: Two conscious mental processes: The role of primordial consciousness in psychosis and other human phenomena 9: Revisiting the Rat Man as an example of primordial consciousness. 10: Psychosis as a disorder of attachment and separation-individuation PART IV: TREATMENT OF PSYCHOSIS 11: Psychiatric treatment of psychosis: Transforming psychosis from a socially disruptive to a socially adaptive disease 12: Studies of the efficacy of psychological and psychoanalytic therapies of psychosis 13: Psychoanalytic therapy of psychosis: Transforming primordial conscious mentation to reflective representational thought 14: Qualities of a psychoanalytic therapist of psychosis 15: Patients write about their therapy 16: The 11 year therapy of a chronic paranoid schizophrenic woman 17: Conclusion About the Author Michael Robbins is former Professor of Clinical Psychiatry at Harvard Medical School, USA. He is a member of the American and International Psychoanalytic Associations. His previous books include Experiences of Schizophrenia (1993), Conceiving of Personality (1996), The Primordial Mind in Health and Illness: A Cross-Cultural Perspective (2011), and Consciousness, Language and Self: A Psychoanalytic, Linguistic and Anthropological Exploration of the Dual Nature of Mind (2018).
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