The Abyss of Madness: 1st Edition (Paperback) book cover

The Abyss of Madness

1st Edition

By George E. Atwood


240 pages

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Despite the many ways in which the so-called psychoses can become manifest, they are ultimately human events arising out of human contexts. As such, they can be understood in an intersubjective manner, removing the stigmatizing boundary between madness and sanity. Utilizing the post-Cartesian psychoanalytic approach of phenomenological contextualism, as well as almost 50 years of clinical experience, George Atwood presents detailed case studies depicting individuals in crisis and the successes and failures that occurred in their treatment. Topics range from depression to schizophrenia, bipolar disorder to dreams, dissociative states to suicidality. Throughout is an emphasis on the underlying essence of humanity demonstrated in even the most extreme cases of psychological and emotional disturbance, and both the surprising highs and tragic lows of the search for the inner truth of a life – that of the analyst as well as the patient.


"From the very beginning of his career, George Atwood has immersed himself in the world of madness, doing psychotherapy and psychoanalysis with the most difficult patients – those suffering from psychoses, deep depressions, suicidality, and multiple self-states. He has a unique gift for both understanding and working effectively with such individuals, and this book – primarily a series of case stories – brings them alive as individual personalities, as well as showing his special talents as a therapist. Written in jargon-free, poetic, and highly accessible style, one feels as though one is in a comfortable room, talking with George as psychological difficulties are unraveled, meaning revealed, and terrible and painful histories lived through. There is profound knowledge in this book." - Louis Breger, author of Freud: Darkness in the Midst of Vision

"At the heart of what is healing in psychotherapy lays a kind of humaneness, understanding, and compassion – one that dissolves the centuries-long barrier between madness and sanity and neutralizes the pathologizing effects of traditional diagnosis. In this volume, George Atwood masterfully recasts the workings of the so-called psychoses and the associated emotional suffering into an insightful and humane understanding of how we experience ourselves and the world in the face of trauma, deprivation, and personal annihilation. Grounded in phenomenological contextualism, his lifelong theorizing and moving clinical narratives clearly reflect his humanity, accessibility, and contemporary clinical sensibility. Understanding madness not as an aberration and diagnosable disease, separate and estranged from what is presumed to be "normal," his work underscores how emotional suffering and seemingly intractable delusions result from relational contexts centered on traumatic loss and the absence of understanding, responsiveness, and human connection. This volume is as clinically profound and insightful as it is personally accessible and emotionally engaging. It is a must-read for all contemporary clinicians concerned with deepening their understanding of therapeutic action, regardless of their patient population." - William J. Coburn, Editor of the International Journal of Psychoanalytic Self Psychology

"George Atwood explores with a clarity of vision and impassioned perspective the abiding and thorny arguments regarding the relative merit of medical and psychological perspectives on the etiology and treatment of extreme mental states. The real strength and contribution of [this book]are in Atwood's deep and far-reaching understanding and beautiful explication of the profound destructiveness inherent in the invalidation and discrediting of experience that can lead to the annihilation of a person's felt sense of being. The Abyss of Madness is successful at provoking and summoning the reader to clarify his or her own thinking regarding the use of diagnostic labeling, the use of medications, and the nature of so-called mental illness. Atwood's book is an important contribution in an age of biological psychiatry and waning interest in psychodynamic understanding and treatments. The Abyss of Madness is an engaging and thought-provoking book that will be of interest to advanced students, academics from many disciplines and clinicians." - Jennifer L. Stevens, PsycCRITIQUES

Table of Contents

Psychotherapy Is a Human Science. Exploring the Abyss of Madness. Philosophy and Psychotherapy. Dreams and Delusions. The Unbearable and the Unsayable. The Tragedy of Self-destruction. The Dark Sun of Melancholia. What is a Ghost? Madness and Genius in Post-Cartesian Philosophy: A Distant Mirror.

About the Author

George E. Atwood, Ph.D., is Professor of Clinical Psychology at Rutgers, the State University of New Jersey, USA. He is the author and co-author of numerous books, including Contexts of Being (Analytic Press, 1992), Faces in a Cloud (Jason Aronson, 1993), The Intersubjective Perspective (Jason Aronson, 1994), Working Intersubjectively (Analytic Press, 1997), and Worlds of Experience (Basic Books, 2002).

About the Series

Psychoanalytic Inquiry Book Series

Like its counterpart, Psychoanalytic Inquiry: A Topical Journal for Mental Health Professionals, the Psychoanalytic Inquiry Book Series presents a diversity of subjects within a diversity of approaches to those subjects. Under the editorship of Joseph Lichtenberg, in collaboration with Melvin Bornstein and the editorial board of Psychoanalytic Inquiry, the volumes in this series strike a balance between research, theory, and clinical application. We are honored to have published the works of various innovators in psychoanalysis, such as Lachmann, Fosshage, Stolorow, Orange, Sander, Wurmser, Grotstein, Jones, Brothers, Busch, and Lichtenberg, among others. 

The series includes books and monographs on mainline psychoanalytic topics, such as sexuality, narcissism, trauma, homosexuality, jealousy, envy, and varied aspects of analytic process and technique.  In our efforts to broaden the field of analytic interest, the series has incorporated and embraced innovative discoveries in infant research, self psychology, intersubjectivity, motivational systems, affects as process, responses to cancer, borderline states, contextualism, postmodernism, attachment research and theory, medication, and mentalization. As further investigations in psychoanalysis come to fruition, we seek to present them in readable, easily comprehensible writing.

After 25 years, the core vision of this series remains the investigation, analysis and discussion of developments on the cutting edge of the psychoanalytic field, inspired by a boundless spirit of inquiry.

Learn more…

Subject Categories

BISAC Subject Codes/Headings:
PSYCHOLOGY / Movements / Psychoanalysis
PSYCHOLOGY / Mental Health