You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The main purpose of the case interviews recorded in Dr. Searles's and his co-authors' paper is to initiate therapy, to draw out some reality factors of the case and some of its emotional tone, and to prepare the patient for rapport with the doctor to whom he or she will be assigned. With that understood, there is no need to be critical of the interviews as therapy sessions.
In my novel Savage Sleep , based on the work of Dr. John N. Rosen (and written in close association with him), I showed that the psychotic patient was in many respects in an opposite condition from the neurotic and required an opposite technique of treatment, one in which passivity gave way to active and even aggressive concern, and in which transference was encouraged and there was no fear of interpretation. Dr. Searles partly follows this path by not being afraid to express his own aggression and fear and by gaining the confidence of the patient with his honesty. But the patient in each instance is in complete verbal contact and not at the hallucinatory extreme where he is unaware of the role of the doctor as doctor or where the doctor needs to enter the psychosis to try to lead his patient out.
It may be for this reason that Dr. Searles does not assume a role of omnipotence, of the powerful parent able to bring his child up all over again, this time under loving and beneficent auspices.
Dr. Thomas Szasz and others have made much of democracy,
of equality in the exchanges between patient and doctor. This is acceptable, even admirable, in cases like those presented here, but it breaks down in situations where, for example, the therapist has to take the patient to the bathroom and instruct him in the elements of hygiene.
Psychosis is, in its beginnings and in its depths, an oral problem. The first hint of paranoia usually is fear of poisoning, the danger of eating or drinking. In Case 4, Mrs. Glaser reported that as a child she “wasn't free to stop in for a Coke or something like that” on her way h