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Psychoanalysis remains split concerning its place in both the theoretical understanding and treatment of the psychoses. This contemporary split was exemplified in the fascinating exchanges in this Journal in the series on ‘Psychoanalytic Controversies’ which took the form of a debate between Richard Lucas and Robert Michels in 2003 (Lucas, 2003; Michels, 2003). Lucas is the author of this book entitled The Psychotic Wavelength. Michels and presumably many colleagues seem convinced that schizophrenic psychoses are essentially organic disorders and that psychoanalytic approaches have no more a place than with any other central nervous system organic affliction such as multiple sclerosis. Lucas does not take quite the opposite view, but in this outstanding book he does a great deal to encourage psychoanalysts, especially those with psychiatric responsibilities, that they can have a most useful role at the very heart of psychosis services and not at its periphery.
This book is very timely because it addresses this question of the place of psychoanalytic thinking in psychosis services, a matter of great urgency for psychoanalysis in some countries. Urgent because the matter could easily become only an academic discourse unless psychoanalysts can find a solid way of finding their way back into mainstream psychiatry. We live in an era of national guidelines for purchasers and providers of services (Gaebel et al., 2005). These guidelines make their recommendations mainly on the basis of random controlled trials and have as great an influence in the mental health field as in physical health in supporting or discouraging the investment and utilization of therapies, medications and other interventions.