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From Ms Joscelyn Richards
I very much enjoyed Richard Lucas's comments about the concept of the internal cohabitee and fully appreciated his hope that ‘some controversy’ would act as a ‘healthy stimulus to further thought and research’. My reply to his comments is within that spirit.
Richard Lucas's comments suggest to me that he and I would probably agree that it is important for both psychotherapist and patient to be able to distinguish psychotic from non-psychotic behaviour. I would also agree with him that at times it is essential to recognise that a murderous attack is taking place, or is about to take place, and for the protection of the patient or others the patient should be got into hospital. However, when the attack is not overwhelming, it is possible to help a patient in psychotherapy to understand why the attack is taking place at this time. Such analytic work can help the patient differentiate himself from his cohabitee and understand why the latter feels murderous towards the patient within the context of the therapeutic work.
Where Richard Lucas and I disagree is over the issue of how to conceptualise the psychic structure that underlies the psychotic and the non-psychotic states. For Richard Lucas there is a part dominated by the death instinct and fuelled by envy