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The Regressed Patient deals principally with the psychoanalytic treatment of patients suffering from psychotic and borderline conditions, written by an author who believes that the “treatment of choice” for many of these patients is “psychoanalysis in as near classical form as can be applied.” The heart of the book is a series of papers published by the author from 1955 through 1979, detailing his 35 years of experience in treating patients with these disorders.
The book hinges on the author's concept that regression in therapy is no barrier to therapeutic progress; in fact it is often a means of mastering early traumata. In contrast, conventional psychoanalytic thinking would view the appearance of a psychosis and severe regression within the transference as an indication to discontinue the analysis. The author admits that therapy with these patients “always involves the risk of a suicidal event,” which is heightened during the analyst's absence. What is the magnitude of this risk of suicide, by the author's own data? Of seven patients beginning treatment floridly psychotic or immediately following shock therapy, “two patients committed suicide when I was away from my office.” The book details six extensive case histories of patients with schizophrenic and borderline conditions. In two of these, serious suicide attempts are reported which the author states “failed by chance.” Both of these attempts (Mrs. B. and Robert) occurred in the context of the analyst taking his vacation.
The author's attitude toward this risk is exemplified by an extensive case history of Robert who made a “bizarre suicide attempt,” hydraulically lowering an automobile on his head. The young man survived fortuitously and was hospitalized for a depressed skull fracture, ultimately returning to the couch four times a week (but now with medication prescribed by the hospital's psychiatrist “administrator”). The case history concludes with an elaborate discussion regarding the symbolic meaning of t