Psychopathology III: Psychosis: Considerations for Diagnosis and Treatment in Psychoanalytic Practice

Fourth Year Adult Psychoanalytic Training (APT)
2022-23, 3rd Trimester — Fridays, 3:30-5:00pm
John De Mott, DO


It is commonly understood in the psychoanalytic view of psychopathology that experiences of undifferentiation (psychotic processes) are a normal condition of the first year of life.  Psychotic  experiences persist under conditions of stress, hallucinogenic drug experiences and reactions, and not infrequently erupt into the full blown and chronic psychotic illnesses.  Psychosis and the pain that accompanies it plague many of our nation’s unhoused, who are by far the most marginalized individuals in our society.  Psychosis means not being able to trust reality itself.  It means being unsure about self and other, often filling in this uncertainty with terror.   Psychoanalysts, as mental healers are well advised to understand psychotic processes to be able to work with them in outpatient, inpatient, or outreach treatment contexts.

Learning Objectives

At the end of the course participants will be able to:

  1. empathize with the loneliness and terror of psychotic experience in themselves and their patients, for the purpose of providing comprehensive and humane psychoanalytic treatment.
  2. differentiate psychotic from borderline and neurotic personality functioning in clinical practice for the purpose of effective diagnostic evaluation and treatment.
  3. work effectively with psychotic presentations as “here and now” challenges to interpersonal trust, reality-testing and the therapeutic re-integration of projected self-states.

March 24, 2023 — Course and Psychopathology Overview

[32 pages]

Stone, L. (1954). The Widening Scope of Indications for Psychoanalysis. JAPA, 2:567-594.

Arieti, S. (1957). What is Effective in the Therapeutic Process? Am. J. Psychoanal., 17(1):30-33.

Bullard, C.M. (2023) Psychoanalytic Psychopathology and Direction of Anxiety Development.

March 31, 2023

[43 pages]

Marcus, E.R. (1996), Psychic reality in psychotic states, Int. J. Psycho-Anal., 77:565-574.

Dwaihy, J.R. (2016) Encounters with Psychosis, Psychoanalytic Quarterly, 85:661-693.

April 7, 2023

[26 pages]

Stone, M.H. (1999) The History of the Psychoanalytic Treatment of Schizophrenia, Journal of the American Academy of Psychoanalysis, 27:583-601.

Weiden, P; Havens, L. (1994) Psychotherapeutic Management Techniques in the Treatment of Outpatients With Schizophrenia, Hospital and Community Psychiatry. 45:6, 549-555

April 14, 2023

[89 pages]

McWilliams, N.; Grenyer, B.F.; Shedler, J. (2018) Personality in PDM-2: Controversial Issues, Psychoanalytic Psychology, 35:299-305.

Freud, S. (1911) Psycho-Analytic Notes on an Autobiographical Account of a Case of Paranoia (Dementia Paranoides). The Standard Edition of the Complete Psychological Works of Sigmund Freud 12:1-82

April 21, 2023

[36 pages]

Mid Course Evaluation

Skehan, D.; Larkin, W.; Read, J. (2012) Childhood adversity and psychosis: A literature review with clinical and societal implications, Psychoanalysis Culture and Society, 17:373-391.

Kris, E. (1950) On preconscious mental processes. Psychoanalytic Quarterly, 19:540-556.

April 28, 2023

[57 pages]

Klein, M. (1940). Mourning and its relation to manic-depressive states.  Int. J. Psychoanal., 21, 125-153.

Solano, P.; Quagelli, L. (2019) On Delusional Thinking in Schizophrenia: Investigating the Communicative Potential of Delusional Emergences During Sessions. Psychoanalytic Quarterly, 88:785-812.

May 5, 2023

[39 pages]

Frosch, J. (1988) Psychotic character versus borderline, Parts I and II. Int. J. Psycho-Anal., 69:347-357.

Kubie, L.S. (1953) The distortion of the symbolic process in neurosis and psychosis. J. Amer. Psychoanal. Assn., 1:59-86.

May 12, 2023

[42 pages]

Kernberg, O. (1986) Identification and its vicissitudes as observed in psychosis. Int. J. Psycho-Anal., 67:147-160.

Marcus, E.R. (1996), Psychic reality in psychotic states, Int. J. Psycho-Anal., 77:565-574.

Waelder, R. (2007) The Principle of Multiple Function: Observations on Over-Determination. Psychoanalytic Quarterly, 76:75-92.

May 19, 2023

[26 pages]

Willick, M. (1983) On the concept of primitive defenses. J. Amer. Psychoanal. Assn., 31:175-200.

May 26, 2023

[23 pages]

Yahalom, I. (1967) Sense, affect and image in development of the symbolic process. Int. J. Psycho-Anal., 48:373-383.

Charles, M.; O’Loughlin, M. (2012) The Complex Subject of Psychosis.  Psychoanalysis Culture and Society, 17(4):410-421.