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The Chairman introduced the panel with a statement that reminded us of some of the central psychoanalytic debates about psychosis. He claimed that psychoses seemed to be primarily psychogenic, in spite of the current belief in biological idiopathogenic factors. This is a statement with which not all of us agreed. It is an example of the wide divergences among us. But probably all of us would agree that to make progress it would be helpful if we at least understood each other's language. Ganzarain, therefore, challenged the panel to define the meaning of psychotic states as opposed to psychosis or as opposed to psychotic parts of the personality. In this way, I think, Ganzarain challenged psychoanalysis to sharpen and clarify its diagnostic acumen. Psychoanalysts use the same terms to refer to different mental states and different organisations of mental functioning. This makes learning from each others' research and experiences very difficult.
Ganzarain further challenged the panel to think about the meanings of reality and of psychotic reality. He pointed out that if psychotic reality in psychotic states means delusional beliefs, then our panel title is an oxymoron. He reminded us that real reality is a creative game as long as we respect the borders between fiction and reality.
Ganzarain also challenged the panel to discuss technique. He reminded us that Freud, Klein, Bion and Matte-Blanco all developed useful theories to understand the psychotic mind. A technical issue remains, however, whether we approach psychotics only with words and concepts or mainly non-verbally with intuition and tuning into the emotions between analyst and patient. Should we combine both of these approaches and, if so, how? As an example of this controversy, he cited Matte-Blanco's technique of translating psychotic, symmetric, conglomerate thinking into the Aristotelian, verbal and linear. He relied on intuition of emotion as a technical tool because he believed that psychotic links, like