Dynamic Structurization and Goldstein's Concept of the Organism

After Having Worked for many years with psychotic patients, I tried to make genuine contact with psychotic experience. Moreover, by entering the world of psychotic communication, I attempted to bring this experience to its appropriate verbal expression. The psychotic world looks like a universe parcelled out in many bits and pieces, each piece being at a closer or greater distance from the others. The distances between these fragments may change suddenly by the appearance of an unexpected gap. How does this happen? We don't really know how or why. We only can observe the fact. We can fill up these gaps and achieve some basis on which to operate. Perhaps the whole secret of the psychotherapy of psychosis is this: one should be very eager to observe the filling up of even the smallest gap. However, very often we do not know whether this new basis is going to be stable, or whether another gap will appear.

There is an important fact which I must point out. Sometimes one notices in what, to use a metaphor, I shall call a part of the “psychotic ground,” a stratum which resembles another stratum seen in another fragment of this ground. We try to approach identical strata in different fragments of the psychotic ground. This process of reconstructing psychical strata which have lost their unity is what I have called “dynamic structurization.” By means of “dynamic structurization” we can achieve a basis for operation.

The following psychotic experience, described in a phenomenological way, will demonstrate the convergence with Kurt Goldstein's conception of the organism as a structure. It is interesting to note that I did not know of Kurt Goldstein's work1 when I treated this patient years ago. I was profoundly struck when I saw the following important methodological requirement—namely, to describe each phenomenon in reference to the organism and in the situation in which it had been observed. This same demand had been my ow