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This book is a meditation on madness—its nature, description, place in life, and responses to it. Eigen examines his therapeutic experience, psychoanalytic thought (especially Freud, Jung, Winnicott, and Bion), and the contributions of literature, cinema, theology, and history. The wide range of his investigations testifies to the importance and complexity of the subject.
For Eigen, psychosis represents not merely a group of extreme
defensive operations or the splintered fragments of a destroyed personality, but also a group of creative and inherently interesting attempts to deal with universal problems. Eigen tries to understand the meanings and ways of psychosis in their own right. From this viewpoint, psychotic content is inherently significant. In this, he differs from many therapists who use the presence of manifestly psychotic material primarily as an indication of severe distress and dysfunction.
Eigen examines the "core of psychosis" in regard to six dimensions: hallucinations, mindlessness, boundaries, hate, epistemology (by which he seems to mean the basic structuring of experience), and reversal. He reviews what selected thinkers have said, and he illustrates their ideas with his own case material. He applies these categories to the Schreber case and then illustrates their use in an extended case study of his own.
Eigen values the creative confusion, the Winnicottian "muddle," as opposed to simplified pseudosolutions that deny complexity, difficulty, and particularly, evil and hatred. I suspect he would view the reader's frustration at his failure to draw clear conclusions, his tendency to leave things ambiguous, and his long lists of what psychotic material "may" mean, as a welcome indication that he has communicated the inherent difficulty presented by psychosis. His search outside the bounds of analysis for concepts to explain and explore psychosis is a recognition both that the issues he studies have preoccupied people for ages and that the m