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.
This is a most important and encouraging book for psychoanalytic psychotherapists working in the Health Service who wish to contribute directly to the treatment of some of those patients suffering from schizophrenic illnesses.
Its importance stems from the following factors:
unlike a number of accounts of psychoanalysts working with psychotic patients, there is no room for doubt that the patients discussed in this book are suffering from long-standing schizophrenic illnesses that have been fully recognised as such by general psychiatrists;
Lotterman is clearly deeply respectful of non-analytic contributions to the management and treatment of schizophrenic disturbances; and
most importantly (and perhaps for the first time in a book written by a psychoanalyst) Lotterman offers psychoanalytic psychotherapists a number of specific recommendations and techniques for particular manifestations of schizophrenic disturbance—such as delusions, hallucinations, boundary disturbances, pressure of speech and looseness of associations, and other disturbances of thought. This contrasts with a number of other publications in which the technique seems not to differ from psychoanalytic work with other types of disturbance.
Though some of these techniques will be controversial, they will surely provoke both intense interest and close observation of the clinical consequences and also debate amongst psychotherapists as the pendulum begins to swing back to a better integration of the biological and psychological approaches.
Lotterman clearly has extensive clinical experience of working with schizophrenic patients. I thought that he was particularly good in describing the patient's disturbances with conceptual and symbolic thinking, and the unconscious motivations that may drive this. I found his practical recommendations and his theoretical exposition convincing and fully cognizant of the various contributors in this field. He emphasises that it must be the primary task in the early phases of t