Psychosis and Extreme States: An Ethic for Treatment Bret Fimiani,  Palgrave Macmillan, 2021,  228 pp., £99.99, hardback, ISBN: 978-3-030-75439-6

Published online: 13 February 2023

© The Author(s) under exclusive licence to Springer Nature Limited 2023

Freud was skeptical about psychoanalytic treatment for psychosis, at least “for the method as it has been practiced up to the present.” However, he seasoned this skepticism with some hopefulness that it was not “impossible that by suitable changes in the method we may succeed in overcoming this contra indication – and so be able to initiate a psychotherapy of the psychoses” (Freud, 1905/1953). Only a smallish subset of psychoanalysts have taken up that challenge.

Jacques Lacan was asked directly by a journalist about such treatment in a 1968 interview: “Can psychoanalysis be used to treat psychosis?”. Lacan surprisingly replied with one word: “Yes.” For those who know Lacan’s oblique style, the shear bluntness of his response might put one aback. And in psychoanalytically informed settings, where most practitioners are still restrained by Freud’s initial skepticism about such a treatment, this question would be met with cautious hedging. But no such hesitation from Lacan. Having thought long and hard about this topic for his entire teaching and clinical career, he was finally prepared to be quite definitive.

Bret Fimiani joins the expanding number of those who have worked on developing “suitable changes in method” by using ideas inspired, inter alia, by Lacan. He presents them in his new book Psychosis and Extreme States, a worthy addition to the Palgrave Lacan Series. Readers of this journal are probably no stranger to the series which aims to “give voice to the leading writers of a new generation of Lacanian thought” and has already provided a number of brilliant examples of just that.

Fimiani draws not only on the theoretical work of Lacan, but also on the pioneering extension of Lacanian practice in the clinical work of Willy Apollon, Danielle Bergeron, and Lucie Cantin, the inspirational convocations of Françoise