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The Exit from Psychosis

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Length: 30 minutes

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Carla Jensen, PhD The Exit from Psychosis

Clinical material is provided from an 8-week, 5 times a week analysis which included a three month planned break in treatment, and nine months of once a week follow-up integration sessions.  The patient as the teacher determined the sequencing, timing and dosage of treatment.  In the integration phase of the treatment, the analysis leads to the “unthawing of “frozen” affects via the analysis of primitive omnipotence and the resolve of a transference psychosis.

When Mr. Oliver was three months old and being breast fed, his mother went next door to a neighbor’s home, broke a glass window pane with her fist, slit her wrists, and fell to the ground in a puddle of blood, proclaiming the birth of Christ.  Mr. Oliver’s mother was hospitalized in a mental institution for almost three years; Mr. Oliver and his father lived with the maternal grandparents.

Examples of clinical material and dream analysis are provided such as the following passages in the treatment.  Mr. Oliver, forty-four years old, was a tortured soul suffering a split or ‘other’ in his personality, an ‘other’ that lived a completely separate and morally misaligned life from Mr. Oliver the primary.  In a dream he reported that he was battling a man who represented the ‘other’ or the dark side of himself.  He described this ‘other’ as only a head, purely logical, totally alienated from bodily input.  For Mr. Oliver, the dream represented his struggle to let the double, the split in his personality, die.  Doing so would leave Mr. Oliver feeling vulnerable to his wife and to his worst fear—total ‘annihilation’ by me.  Sharing this vulnerability created a deep emotional release.

He was experiencing such deep sadness in the center of his chest that the aching projected into the room with such magnitude that I experienced almost complete immobilization on two occasions.  I tried to lift my arms or move my feet; they felt encased in concrete.   I could hardly breathe from the weight of his projected feelings.   He related his own sensations at the time as the return from an out-of-body experience, probably due to the temporary albeit traumatic loss of his mother as an infant. 

What Mr. Oliver terms as his “escape route’ from me and my office then, results in the patient being able to rupture his symbiotic transference with me and propel himself to healing.  Eventually, Mr. Oliver was able to successfully terminate, because for the first time in his life, he was in charge of the leaving; I was to be left behind, not him.

The magnitude and intensity of this case are indelibly imprinted upon me, along with a deep respect for suffering and the will to heal catastrophic trauma.  During our work together the patient, Mr. Oliver, progressed from denial to realization and grief, to acceptance and freedom.  Seven year in person follow up and summary illustrates the successful clinical outcome of this case. Implications regarding technical stance and theorizing in the analysis of a psychosis are provided.



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