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233d Regular Meeting, Dec. 17, 1940, A. Stern, M.D., Presiding
Frederic, P. Psychoanalysis of Psychoses. The first treatment is prevention. The dangers of using the conventional analytic method in handling individuals who are or may become psychotic; it is possible to convert a neurosis into a psychosis. In handling schizophrenic individuals the lying position, free association, and other usual analytic means are discarded. Whereas the neurotic may be handled even where his environment is difficult, in the psychosis it is important that there be an ideal situation. The analyst may use helpers and may even utilize members of the family to assist him in the treatment. These cases are very difficult to handle and require unusual patience on the part of the analyst, for the analysand may even resent the analyst taking a vacation. The transference is easily broken. In neurosis one looks for the phantasy behind the reality but in psychosis one looks for the reality behind the phantasy. In manic depressive individuals phantastic demands must be made more objective and conformant with reality. Where husband and wife are both manic depressive types they may have difficulties only at certain times. Understanding may help them through such trying periods. The time will come when there will be no difference between psychiatrist and analyst.[Foxe.]