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In his Preface, Michael Eigen states that he intends to review various “basic ideas” pertaining to the dynamics of psychosis deriving from the work of Freud, Jung, recent object-relations theory, and self psychology; to critique these ideas; and to contribute “a working orientation that does madness justice” (vi). By doing madness justice, Eigen means doing justice to the pervasiveness of it, the trace of craziness even in everyday life. “The view that a basic madness marks human affairs cannot easily be avoided,” he claims (vi). As Meissner does in The Paranoid Process (1978), Eigen treats what might be called “psychotic orientations” as part of a spectrum of processes ranging from those of essentially normal people to the wildest, most self-destructive behavior of the certifiably insane. Correspondingly, Eigen does not see the analyst as occupying an antiseptic mental space carefully demarked from that of his patients. He rather insists, as Searles (1965) so notably does, on the partly participatory nature of the analyst' role.
What most distinguishes Eigen' volume from other approaches to the subject is the manner in which he insists on defining psychosis not nosologically, or taxonomically, according to more or less received notions about types and categories of pathology, but rather in terms of a particular set of “invariant” he claims characterizes psychotic processes in general. He chooses to concentrate on six of these “principal elements” of psychosis, admitting freely that these are conceptual elements he finds he cannot personally do without in the clinical encounter, and that other practitioners might well wish to consider other factors. There is nothing especially controversial about the principal elements he selects: hallucination, mindlessness, boundary demarcation (of self and other), hate, epistemology (reality testing, self-definition),