Reflections on the Psychoanalysis of Psychosis

Abstract

Some metapsychological ideas of psychoses are discussed from a geneticstructural point of view, with special stress on the ego’s organization-disorganizationreorganization - Two features within the structure of the mental apparatus in psychoses are differentiated: one in latency stage, the other, in the manifest psychotic crises or in chronic psychoses. In the first case we find am ego which has been able to continue its development in a precarious way with a parallel growth of the superego. This fragile and poorly structured ego works with different kinds of splitting. One of them, the most important of all, is the one which keeps the destructive amalgamatic nucleus separate. This is a conglomerate of partial objects with traits of “no-relationships” and archaic or primitive anxieties which remain active. The conglomerate means a constant internal menace for the ego (as a split it), but there are other  sis) and they either have a preconscious quality in the Freudian sense, or other changeable and dynamic splits take place.
This is the case of certain narcissistic configurations which are built by parts of the self and of archaic objects without a clear distinction between each other. These narcissistic configurations, in spite of being pathological in their structure and in their ties (frequently sadomasochistic), have —like every narcissistic set up— am effect of cleaving together the ego in its unity and identity when faced with the danger of disorganization. Frequently the ego uses pathological projective identification mechanisms, finding subjects with the adequate traits within the external world who will take care of the projection of theses configurations, and thus a pathological symbiosis with the external object takes place. In psychotic crises, the narcissistic wound acting on am ego which cannot be handled due to the weakness of its functional integration, creates the propietious situation for the irruption of the destructive amalgamatic nucleus which attacks the ego functions and the ego, splitting it. This ego “throws off” into the external world parts of itself and of destroyed and malignant partial objects, projecting them on animate and inanimate objects in a confused and changing manner. Under such conditions narcissistic configurations are dissolved and any approach to the tripartite structure of the psychic apparatus dissappears. Delirium in such situation may be considered the last effort of the ego to survive, the last attempt to adjust in this asphyxiation between unbearable external reality and overwhelming internal danger. The interaction of projective and introjective identifications determines a pathological recomposition which is structured in a moremovable manner in psychotic outbreaks and in a more steady way in chronic psychoses.