Weathering Storms: Psychotherapy for Psychosis

396 Pages·2001·10.688 MB·English

by  Murray Jackson

Ifilft
WEATHERING
THE STORMS
PSYCHOTHERAPY
FOR PSYCHOSIS
RRAY

SON
WEATHERING

THE STORMS

WEATHERING

THE STORMS

Psychotherapy for Psychosis
Murray Jackson
Foreword by Preface by
James S. Grotstein Paul Williams
K A R N AC

LONDON NEW YORK
First published in 2001 by
H. Karnac (Books) Ltd,
118 Finchley Road, London NW3 5HT
A subsidiary of Other Press LLC, New York
Reprinted 2002
Copyright ©2001 Murray Jackson
Preface copyright © 2001 Paul Williams
Foreword copyright © 2001 James S. Grotstein
The rights of Murray Jackson to be identified as the author of this work have
been asserted in accordance with §§ 77 and 78 of the Copyright Design and
Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without the prior written
permission of the publisher.
British Library Cataloguing in Publication Data
A CLP. for this book is available from the British Library
ISBN 978 1 85575 267 2
10 9 8 7 6 5 4 32
Edited, designed, and produced by Communication Crafts
www.karnacbooks. com
This book is dedicated to the Scandinavian
psychotherapists who made it possible and who,
for reasons of confidentiality, remain anonymous
"I have gathered a posie of other men's flowers, and nothing but
the thread that binds them is my own."
Montaigne

CONTENTS

ACKNOWLEDGEMENTS ix

ABOUT THE AUTHOR xi

PREFACE by Paul Williams xiii

FOREWORD by James S. Grotstein xv

Introduction 1

1 Psychotic features

in obsessive-compulsive neurosis: "Ada" 11

2 Obsessional symptoms

following adolescent psychosis: "Brenda" 26

3 Obsessions in schizophrenia: "Alec" 40

4 Paranoid schizophrenia—

command hallucinations: "Brian" 61

5 Hysterical psychosis: "Claudia" 76

6 Anorexia, psychosis,

and the question of sexual abuse: "Dorothy" 95

7 Paranoid schizophrenia—

space-time factors: "Conrad" 120

8 Chronic paranoid schizophrenia—

schizoid thinking: "Ellen" 141

vii
Viii CONTENTS
9 Paranoid violence: "Duncan" 150

10 Schizophrenia—psychotherapy,

termination, reparation: "Florence" 162

11 Paranoid psychosis—

delusional body image: "Elmer" 176

12 Paranoid delusions—

sealing-over and working through

a psychotic transference: "Frank" 191

13 Phobia, hysteria, psychosis: "Grace" 208

14 Chronic schizophrenia—

catatonic and spatial features: "George" 219

15 Manic-depressive psychosis: "Harry" 235

16 Vignettes 255

17 Mostly theory 273

18 Mostly practice 294

19 Conclusions 303

APPENDIX A: Characteristics of schizoid thinking 313

APPENDIX B: Infant research and the "right mind" 317

APPENDIX c: Thefuture—winds ofchange 319

GLOSSARY 321

REFERENCES AND BIBLIOGRAPHY 343

INDEX 360
ACKNOWLEDGEMENTS

My indebtedness to my old friend and mentor, the late Henri Rey, is
incalculable.
I am particularly grateful to Jeanne Magagna, who, having col­
lected and edited Rey's work, helped me very much with my own.
As a teacher of trainee psychiatrists and child psychotherapists, she
scrutinized the manuscript in its several draft forms and made many
invaluable contributions and helpful suggestions. Michael Sinason
also gave a great deal of his time in studying the text, and his exper­
tise was particularly helpful.
Since this work is the fruit of many years of teaching about psy­
chotic illness and its treatment in collaboration with a large number of
Scandinavian psychiatrists and psychologists, I can only name some
to whom I am especially indebted.
In Norway, I owe a great debt of gratitude to Anna Leira, to the
late Thoralv Nadland, and to the late Endre Ugelstad; in Finland, to
Yrjo Alanen and Viljo Rakkolainen; in Sweden, to G»ran Andre, Ulla
Arnell, Johan Cullberg, Magnus Elfstadius, Kina Meurle Hallberg,
Rolf Holmqvist, and Tiit Saarman; in Denmark, to Ulla Bartells, Eliza­
beth Blum, Jens Bolvig Hansen, Anne Viskinge Jensen, Margit
Jorgensen, Ulla Just, Ebbe Linnemann, Gert Rasmussen, and Bent
Rosenbaum. They opened doors to teaching /learning opportunities
and offered warm and generous hospitality.
Pearl King told me long ago that I should write about my psy­
choanalytic work in hospital and academic psychiatry, and I was
extremely fortunate in having the opportunity of learning from psy­
choanalysts who knew a great deal about psychosis, in particular
Henri Rey, Hanna Segal, Betty Joseph, Herbert Rosenfeld, and Leslie
Sohn.
Jeremy Holmes, Michael Sinason, and Cesare Sacerdoti encour­
aged me to write about psychosis, and Paul Williams conceived the
ix