This book centres on the problem of psychosis, understood from a psychoanalytic perspective, as it manifests itself in different contexts and different levels of organisation: from the individual psychoanalytic session, through work with couples, groups and institutions and wider levels of social organisation. Beginning with a discussion of the psychoanalytic approach to psychosis centring on the work of Freud, Klein and the Post-Kleinians, it goes on to cover individual, couple and group therapy with psychotic patients. It draws on clinical material and theoretical discussion to explore the links between psychotic processes on different levels. This work is aimed at different professionals working within the psychodynamic frame of reference: individual psychotherapists, couple and family and group psychotherapists; organisational consultants and trainees in different therapies. As well as this it will be a useful resource to nurses, doctors and social workers who work with very disturbed patients and wish to learn about psychotic processes.
Contributors: David Bell, Elizabeth Bott Spillius, Tim Dartington, James Fisher, Caroline Garland, Francis Grier, R.D. Hinshelwood, David Kennard, Julian Lousada, Mary Morgan, Aleksandra Novakovic, Salomon Resnik, Margaret Rustin, Hanna Segal, Wilhelm Skogstad, Margot Waddell
Table of Contents
1 The psychoanalytic approach to the treatment of psychotic patients Hanna Segal 1
2 Reflections on "meaning" and "meaninglessness" in post-Kleinian thought Margot Waddell 11
3 Rigidity and stability in a psychotic patient: some thoughts about obstacles to facing reality in psychotherapy Margaret Rustin 28
4 Forms of "folie-à-deux" in the couple relationship James Fisher 45
5 Psychotic and depressive processes in couple functioning Francis Grier 71
6 The Frozen Man: further reflections on glacial times Salomon Resnik 89
7 Psychotic processes: a group perspective Aleksandra Novakovic 108
8 Psychotic processes in large groups Caroline Garland 132
9 A community meeting on an acute psychiatric ward: observation and commentaries 147
Commentary I David Kennard 152
Commentary II Julian Lousada 156
Commentary III Mary Morgan 162
Commentary IV Wilhelm Skogstad 167
10 Asylum and society Elizabeth Bott Spillius 171
11 Schizophrenia, meaninglessness, and professional stress R. D. Hinshelwood 194
12 Brilliant stupidity: madness in organizational life— a perspective from organizational consultancy Tim Dartington 208
13 The dynamics of containment David Bell 226
David Bell is a Consultant Psychiatrist at the Tavistock Clinic, where he directs the Fitzjohn’s Unit, a specialist service for seri- ous/complex psychological disorders. He is visiting Professorial Fellow, Birkbeck College, London and past President of the British Psychoanalytical Society. Throughout his career he has been deeply involved in the relation between psychoanalysis and literature, philosophy, and politics, and he has made numerous contributions in these areas. He is the UK’s leading psychiatric expert in asylum/ human rights. He is contributing editor of Reason and Passion (1997) and Psychoanalysis and Culture: A Kleinian Perspective (1999, revised edition 2004) and the author of Paranoia (2002).
Aleksandra Novakovic is a group analyst and psychoanalyst and is a member of the London Institute of Group Analysis and the British Psychoanalytic Association. She was Joint Head of the Inpatient & Community Psychology Service, Barnet, Enfield & Haringey Mental Health Trust. She worked with patients with severe and complex mental health problems and facilitated staff groups for inpatient and community mental health staff teams. She is currently working in the Complex Care Services, St Ann’s Hospital, and is a Visiting Clinical Lecturer at the Tavistock Centre for Couple Relationships.