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Franco De Masi's Vulnerability to Psychosis is a successful attempt to illustrate by clinical examples a theoretical psychoanalytic model of psychosis which, while personal, belongs firmly within a tradition whose
principal forebears are Bion, Meltzer, Rosenfeld, and the post-Kleinians in general—a tradition that is further enriched by the contributions of other authors, among whom Winnicott, Fonagy, and Aulagnier stand out.
The book presents the experience of De Masi as an analyst at work with his patients or in supervisions, revealing not only a personal style but also a range of theoretical and technical instruments of his own. An atmosphere of great sincerity emerges from his descriptions of difficult phases of analyses, with their moments of incomprehension, feelings of inadequacy, and therapeutic disappointment.
The image conveyed is that of an expert analyst supported by a solid theoretical and technical frame of reference, who is, however, also cautious and imbued with anything but a sense of therapeutic omnipotence, and who seems to talk a lot to his patients; one's abiding impression is of an analyst who is at all times curious and intent on understanding—an analyst who remains stubbornly convinced that understanding will be the way to reach and help the patient.
I will try to outline some of the salient aspects of De Masi's model, while confining any comments, a large number of which might be suggested by a reading of this book, to a minimum.
In developing his argument, the author considers anew the concept of the unconscious (chapter 4 reproduces what is now surely a celebrated contribution originally published in the International Journal of Psychoanalysis in ). Taking as his starting point the complexity already presented by this concept in Freud, as well as the shifts of meaning to which it has been subject in the various psychoanalytic schools and the work of various authors—the same could, as it happens, be said of many other terms used in psychoanaly