4 Study of the Psychotic Part of the Personality

Study of the problem of dependence-independence has guided me to the problem of those cases of extreme dependence that we recognize as symbiosis. I found that the characteristics of the transference relation appearing in the symbioses were equivalent to those of psychotic transference that I had already encountered, both in my own experience with the psychoanalysis of psychotics and in basic writings on this theme, especially those by F. Fromm-Reichmann, E. Pichon Rivière, H. Rosenfeld and W. Bion. On the other hand, I found I was dealing not only with a large quantity of clinical facts closely related to the subject of symbiosis (psychopathy, hypochondria, epilepsy, confusional states, psychosomatic affections, etc.) but also with the complex theme of narcissism and development of the ego (identity, body schema, hetero-homosexual differentiation, etc.).

Guided at first by the work of M. Mahler, I recognized the clinical existence of symbiosis in adults, as well as that of the symbiotic psychoses. Later, I studied symbiotic organization in the transference relation, particularly in connection with autism, in terms of both the dynamics and the vicissitudes of symbiosis. Preserving the clinical autonomy of this phenomenon offered certain advantages and some disadvantages. One of the advantages was that it enabled me to elaborate some hypotheses that I think clarify to some extent the problem of symbiosis and other related problems. Another advantage was that it allowed me to discover the symbiotic nuclei in the analyses of patients who did not present a clinical picture of symbiosis, at least not superficially. An equally valuable advantage was that it enabled me to understand in a unified way a number of clinical phenomena that crop up either as organisation, immobilisation and control of symbiosis (affect blockage, autism, body-mind dissociation, negative therapeutic reaction), or as defences against the rupture of symbiosis (hypochondria, phobias, psycho