The “Transference Psychosis”

Of the 22 patients recommended for and started in psychoanalysis in PRP, the 10 whose treatment courses have been described in detail to this point include 6 of the 8 (4 of those 6, women) who had really good treatment outcomes; 3 of the 5 (2 of those 3, women) who had moderate treatment outcomes; 1 of the 3 (a man, the Devoted Son) who had equivocal outcomes; and none of the 6 with failed outcomes. That is, they represent as a group the better psychoanalytic results (whatever the individual limitations of those results may have been), and they contain among them all those in the cluster of patients with hysterical character formations. Another large grouping that emerged in the PRP population was one of patients with a strongly paranoid character trend. These have been described in Section III (see Chapter 8, pp. 143-144). Fourteen patients (10 men and 4 women), a full third of the total research sample, are there identified as sharing this trend; another 5 are seen as strong externalizers in their attribution of psychological responsibility (though not strictly paranoid).

Of those 14 with paranoid attributes, 9 were recommended for psychoanalysis and 5 for psychotherapy. One of those among this group recommended for psychoanalysis, the English Professor, has already been described among the very good analytic outcomes (see pp. 279-283). As noted, at the time of initial evaluation, he was in an acutely decompensated phobic state marked by an (encapsulated) paranoid trend that emerged most clearly in the psychological projective tests—the disguised men peering at him from the Rorschach cards; the consciousness of being watched and sought out for punishment for unknown misdeeds; and so forth. It was because of this trend that he was initially recommended for an expressive-supportive psychotherapy, in which (over a 2½ year span) he came to a much improved life functioning and a psychological reintegration (confirmed by