DIVISION A QUARTERLY PSYCHOANALYTIC FORUM
NO.23 SPRING 2021
THE WRITING CURE | MALKIN | Lieber
T H E
A N A L Y T I C
F I E L D
PSYCHODYNAMIC TREATMENT FOR PSYCHOSIS | KNAFO and SELZER
R E M I N I S C E N C E DEATH WISHES | KAHR
CHARLES | KARON
PSYCHOSIS AND PSYCHOANALYSIS | BIEN and BROWN
C O M M E N T A R I E S POSTPARTUM PSYCHOSIS | CHO DENNIS MCNULTY
Ars Psychotica
ARCHIVE OF ADJUSTMENTS | HEALEY
P H O T O G R A P H Y Loren DENT
In Civilization and its Discontents, Freud (1930) enumerates a series of “technique[s] in the art of living” (p.81) that individuals employ to mitigate the consequent suffering of the demands made of culture upon the drives. Among these techniques is madness itself, an attempt to delusionally re-construct the world as one wishes in a futile attempt to fend off reality’s misery. Freud’s madman, though, “finds no one to help him in carrying through his delusion” (Freud, 1930, p.81). But while no one is willing to help the madman in his remolding of reality, Freud is quick to note that much of social life is organized around mass delusion to “procure a certainty of happiness.” Despite the phenomenology of psychosis, which often includes isolation through withdrawing from the world, Freud in the above passage points to the inseparability of madness and collectivity, a point he had already alluded to in
his prior Group Psychology, where he refuted the simplistic opposition between individual and social, including for the most extreme of “narcissistic” illnesses (1921, p.69). Several disciplines in the 20th and 21st centuries have addressed the encounters and chiasms between psychosis and the collective, including psychiatry, social work, sociology, and critical theory (e.g., the work of the Frankfurt School). As is often noted, the history of psychoanalysis and its approach to the treatment of psychosis is a thorny one, despite the encouragement of traditions including Kleinian, Bionian, and Lacanian to listen to madness with analytic ears. At the same time, psychoanalysts were integral to the development of a rich history of institutional and community therapies, such as the Chestnut Lodge and Austen Riggs in the U.S., as well as the work of François Tosquelles and Jean Oury in France and
Franz Fanon in Algeria (Mackie, 2006; Robcis, 2016, 2020). More recent analytically-informed undertakings, among several others, have included the Psychosis Therapy Project in London (Gherovici, Steinkoler, and Bonnigal-Katz, 2018; Bonnigal-Katz, 2019) and the 388/GIFRIC in Quebec (Apollon, Bergeron and Cantin, 2002). In the United States over the past 20 years, the fields of psychiatry and public health have developed various psychosocial and rehabilitative models for recovery, often referred to as “coordinated specialty care.” These approaches, typically funded by significant state and federal grants, aim to provide multiple treatments for young people at high risk or experiencing their first episode of frank psychosis. Patients receiving care from these programs are typically offered psychotherapy, medication management, educational or professional coaching, and in some cases,
Official publication of Division of Psychoanalysis (39) of the American Psychological Association
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