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.
Reading this book brought to my mind two incidents that happened during the course of my residency in psychiatry some three decades ago. A young woman, diagnosed as having schizophrenia, the onset occurring shortly post-partum, was refused a weekend pass to see her baby. Because she was upset about the refusal, I was called to see her. I was surprised at the depth and intensity of her feelings about the separation. It simply didn't seem to follow any of the textbook descriptions of schizophrenia. I was laboring under the delusion that to be psychotic meant to be out of touch with anything real. If I had had access to this book at the time, I would have had a better idea of the human dilemma of someone in the grip of psychosis.
I would also have understood more clearly another central feature of psychotic distress, namely, the need to legitimize and socialize the psychotic dimension of the patient's personality before genuine growth can occur. For some the psychotic experience is a necessary anticipatory drama occurring at a level of consciousness different from either waking or sleeping but preparatory to engagement with the world at the level of waking consciousness. Psychosis is thus characterized by an intermediate level of arousal incorporating elements from both the dreaming and the waking state but not identifiable with either one.
The second incident occurred in the course of our weekly staff conference