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In this slim but densely reasoned book, Liliane Abensour weaves an intricate fabric, considering the possibility and necessity for creative transformation of the self, drawing from her clinical experience with psychotic patients at the Kestemberg Center in Paris and her own psychoanalytic practice. Her wide-ranging sources include theories of psychosis from Freud, Winnicott, and many French contributors, as well as literary figures who have attempted to depict the process of subjective creation.
Abensour bases her argument for creative self-fashioning on the notion of a problematic initial inscription of the psychotic subject in the infantile world of the drives, as proposed by Freud. With emphasis on the fate of the sexual and aggressive impulses and their constant remodeling in the après-coup, Freud's theory takes into account the constant to-and-fro of temporal movement between past and present. Abensour makes a frank distinction between the modes of neurotic and psychotic mental functioning in relation to this temporal movement. Her interest is in their different ways of using space and time to anchor the subject, with the psychotic living in a perpetual present that cannot enrich itself from an unconscious or infantile past, while simultaneously facing a frightening external reality.
Because the psychotic lacks attachment to a secure base of primary experiences that have established a functioning self, he is unlikely to benefit from a therapeutic attempt analogous to the treatment of neurotics. The exploration of developmental origins, Abensour argues, can engulf and explode the fragile ego of the psychotic by reviving a traumatic overstimulation or its counterpart, the terrifying void of total absence. In this situation, the “psychotic temptation” of imposing barriers both to the unconscious and to external reality has been the sole recourse for survival for many patients and indicates their extreme fragility. The analyst's role is therefore not to interpret or