vol. 1, num. 1, 2003

Dissociative Phenomena. Questions and Answers.

Editors: Mario Di Fiorino and Maria Luisa Figueira

Dissociations and “derealistic” associations of the mind in psychosis

Salomon Resnik

Dissociations and “derealistic” associations of the mind in psychosis

Summary. The author discusses the concept of “splitting” (Spaltung) as it is described in classical psychiatric writings such as those of Bleuler, as well as by psychoanalysts from Freud and Jung onwards. Drawing on clinical illustrations from three psychotic patients, he shows how splitting affects not only the ego and the object but also the transference itself. Dissocia-tion as between different realities, ordinary and delusional, is a defence against unbearable anxiety, persecutory feelings, and catastrophic experiences; the self breaks down into bits and pieces, often with bizarre associations that give rise to a delusional construction of the universe. This demands both a phenomenological and a psychoanalytic understanding. Ideally, different approaches psychotherapeutic, pharmacological and institutional can be undertaken in a complementary fashion as long as staff members work truly together.

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