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Published online: 20 June 2025
© The Author(s) under exclusive licence to Springer Nature Limited 2025
I recently encountered a woman and her young grandson in the waiting room of a psychiatric hospital. They were there to see her daughter, the child’s mother. In the midst of telling me about his Minecraft game, the boy deviated, with no encouragement and in an unaffected manner, to the subject of his mother, casually mentioning that she had been taken to hospital because she talked to ghosts. His calm was in contrast to the agitated state of his grandmother, who complained loudly about the wait. The receptionist tried to raise a sympathetic smile – the usual problems with the room booking system. The woman, overwhelmed with dread and confusion, spoke to me a little. A few weeks previously, without precedent, her daughter had been sectioned with psychosis – a radically altered situation for which the family had no map and no frame of reference.
Psychoanalysts will tell you, that in both its noisy and more discreet forms, psychosis is ubiquitous, all the while remaining little understood as a phenomenon. In timely fashion, Lacanian psychoanalyst Stijn Vanheule’s latest book Why Psychosis is Not So Crazy, a resolutely accessible text, seeks to illuminate the experience of psychosis for families and caregivers. In a moment when the psychological investigation of mental suffering has been marginalised, if not foreclosed, by psychiatric services, this is a vital piece of writing.
In the 1970s, a popular appreciation of Lacanian theory took hold in France. The result? Medics, school counsellors and social workers often had a good understanding of psychoanalytic concepts, including ways to conceptualise psychosis. This is not, and has never been, the case in the UK. In the event of a psychosis in the family, the answers that come from mental health services can be of little help. Medication is prescribed in the hope of quelling the more disturbing symptoms and any explanations