title: Working with psychotic patients.
abstract: I have discussed a model of the psyche comprising two different modes of thinking, one non-psychotic and the other psychotic. I have related these modes of thinking to our modern myth of Jekyll and Hyde, the study of which could in my opinion give us some insight into their nature. In my view a non-psychotic state of mind belongs to a person who has a history, with particular parents, a particular development, particular conflicts, and operates in the depressive position. A psychotic state of mind belongs to a person who lives in a still and timeless present, with no origin, no development and no conflict, and operates in the paranoid-schizoid position. On the basis of this model I have subsequently described the life history of a psychotic patient and an analytic session in detail, showing how psychotic and non-psychotic states alternate and interact with each other within the same individual and between patient and therapist. The use of my countertransference, moving from a concrete to a symbolic position, has enabled me to make an interpretation. The result of this interpretation has been double, leading to a negative therapeutic reaction. An upsurge of psychotic fury was followed by increased patient/therapist communication, with a small movement from the paranoid-schizoid to the depressive position.
authors.forename: L
authors.initials: L
authors.lastname: Bacelle
mesh_terms: D000328:Adult; D004532:Ego; D006801:Humans; D007602:Jungian Theory; D008297:Male; D010553:Personality Development; D011575:Psychoanalytic Therapy / Q000379:methods*; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*