Chapter 5 Concerning Schizophrenia: The Potential for Psychosis and Primary Delusional Thinking

Whatever criticisms one may rightly make of this entomology of human beings and the thoughts about them offered by psychiatry, analysts continue to use the same labels, even while transforming the meaning proper to them. Do we do this out offeree of habit or as homage paid to our predecessors’ gifts of observation? Probably both. But this borrowing is not without its dangers and one may well wonder if it does not conceal an ambiguity in the relation of psychoanalysis to psychosis. I shall leave the question unanswered and simply say that the forms that psychotic discourse assumes for the observer are never the effect of mere chance and may be understood simply by analysing the mode of defence that they privilege. They derive from a time when psychical work came up against an insuperable obstacle, forcing it to abandon well trod paths, and they provide an insight into the particular nature of that obstacle. Nevertheless, psychoanalytic theory generally assumes the right to speak about psychosis (in the singular) or the psychotic structure and to postulate, beyond the diversity of its forms, the presence of a minimum series of features, a common background to the various clinical pictures. The elements that each author will isolate in the series, the interpretation that he will offer of them, define in turn the various psychoanalytic constructions that seek to account for the psychotic phenomenon. The homogeneity that these options often claim is illusory, though each author usually appeals to the same key concepts of fixation, regression, reality loss, foreclosure, to cite only the principal ones. Much more than in the field of neurosis one is struck, as soon as the question of psychosis arises, by the facility with which one assumes the right to

create an amalgam in which will be found a jumble of Freudian, Kleinian, Lacanian concepts, and more recently ones deriving from Bateson, Bion an