Living on the Border

This book centres on the problem of psychosis, understood from a psychoanalytic perspective, as it manifests itself in different contexts and different levels of organisation: from the individual psychoanalytic session, through work with couples, groups and institutions and wider levels of social organisation. Beginning with a discussion of the psychoanalytic approach to psychosis centring on the work of Freud, Klein and the Post-Kleinians, it goes on to cover individual, couple and group therapy with psychotic patients. It draws on clinical material and theoretical discussion to explore the links between psychotic processes on different levels. This work is aimed at different professionals working within the psychodynamic frame of reference: individual psychotherapists, couple and family and group psychotherapists; organisational consultants and trainees in different therapies. As well as this it will be a useful resource to nurses, doctors and social workers who work with very disturbed patients and wish to learn about psychotic processes.

Contributors: David Bell, Elizabeth Bott Spillius, Tim Dartington, James Fisher, Caroline Garland, Francis Grier, R. D. Hinshelwood, David Kennard, Julian Lousada, Mary Morgan, Aleksandra Novakovic, Salomon Resnik, Margaret Rustin, Hanna Segal, Wilhelm Skogstad, Margot Waddell

1 The psychoanalytic approach to the treatment of psychotic patients Hanna Segal 1

2 Reflections on "meaning" and "meaninglessness" in post-Kleinian thought Margot Waddell 11

3 Rigidity and stability in a psychotic patient: some thoughts about obstacles to facing reality in psychotherapy Margaret Rustin 28

4 Forms of "folie-à-deux" in the couple relationship James Fisher 45

5 Psychotic and depressive processes in couple functioning Francis Grier 71

6 The Frozen Man: further reflections on glacial times Salomon Resnik 89

7 Psychotic processes: a group perspective Aleksandra Novakovic 108

8 Psychotic processes in large groups Caroline Garland 132

9 A community meeting on an acute psychiatric ward: observation and commentaries 147

Commentary I David Kennard 152

Commentary II Julian Lousada 156

Commentary III Mary Morgan 162

Commentary IV Wilhelm Skogstad 167

10 Asylum and society Elizabeth Bott Spillius 171

11 Schizophrenia, meaninglessness, and professional stress R. D. Hinshelwood 194

12 Brilliant stupidity: madness in organizational life- a perspective from organizational consultancy Tim Dartington 208

13 The dynamics of containment David Bell 226