Back in the day (I am talking about 30+ years, here) analytic training at CMPS began with a two year “field placement” in the “back ward” of a psychiatric institution. Although those back wards, for the most part, no longer exist, the basic modern psychoanalytic tenet that observing psychosis is a singularly illuminating way to understand all forms of human behavior holds true today as much as ever.

A naive and newly minted social worker fresh out of graduate school, I was eager, if trepidatious, about beginning my placement at The Manhattan State Psychiatric Center, on Wards Island; a bus ride and a world away.

Field placement students there were assigned patients to follow in the following manner: We were told to “mingle” in the day room and see which patients might gravitate to us or which ones we might take an interest in: a fairly terrifying prospect. The television blared and patients in various stages of decompensation paced relentlessly, sat listlessly, or generally appeared to be acting “crazy.”