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Most therapists of psychotic patients develop a “psychotic feel”; it can be a sense of mental pressure, confusion, or dullness. The psychotic feel is quite personal, but is consistent within each therapist. Piera Aulagnier, who first published this book in French in 1975, when confronted with psychotic discourse, went beyond the feeling and tried to understand the meaning of the psychotic communication. She reports that she
often felt that she was receiving it “as the wild interpretation made to the analyst of the non-evidence of the evident” (p. xxv). She found that the theory bequeathed us by Freud did not address all of what she experienced when trying to analyze psychotic patients. She hoped that by expanding the theory to account for what is elaborated in psychosis, her analytic work with psychotic patients would become more productive. She observed how these patients confidently oppose their delusion to the reality of the analyst. As there is no doubt about reality for either analyst or patient, she asks if there might not have been a time for each when the psyche encountered a discourse that could not be doubted, a discourse in which the communication of the object formed the representation of the self and the understanding of the world.
Aulagnier sees psychic development as balanced between drives, the need for satisfaction, and thought, the need to “make sense.” In working with psychotic patients, she found that communications from the mother (or the parents), both in words and in action, had led either to painful answers to essential questions concerning how the child came to have life or to secrets that could not be spoken or thought. The problematic questions in psychosis are questions of origin: Did you desire me? How did I come to be? She describes a pattern in which the mothers of future psychotic patients did not want a child, or did not want this child. The mother imposes on the child, to an excessive degree, her own idea of how the child is to beh