‘Re-embodiment of the disembodied eye’: The constitution of a psychoanalytic space for a schizophrenic patient

The first modern move towards a psychotherapeutic approach to psychosis was made by Freud. The essential psychotic mechanisms — splitting of the ego, repression, projection, and the primary psychic processes — were already identified in Freud's profound knowledge of the dream-work. His insights permitted some encouraging openings towards a psychoanalytic approach to psychosis: for example, literary openings with ‘Gradiva’ (1907) and ‘The Case of Schreber’ (1911) and clinical ones (1937) elaborated at the end of his life in which he expressed the hope that his method would eventually be applied to psychotics. In 1937 he noted that an insufficiently investigated yet apparently general characteristic of hallucinations was the return to consciousness in distorted form of that which had been experienced very early by the child and forgotten. He observed that‘… there is not only method in madness, as the poet has already perceived, but also a fragment of historical truth; and it is plausible to suppose that the compulsive belief attaching to delusions derives its strength precisely from infantile sources of this kind’ (Freud, 1937, p. 267). This Freudian formulation could then be considered as the cornerstone of a possible therapeutic method. In short, work with psychotics would be almost the same as interpreting a dream.