Working with Psychosis (1): Against social adjustment

A close reading of Chapter 12 ('Working with Psychosis') of Darian Leader's book What is Madness? helps us think through a variety of treatment options when it comes to clinical psychoanalytic work with psychosis. Leader begins by noting that there is "no such thing as a psychoanalysis of psychosis" an assertion which highlights how various historical techniques developed in the clinic of neurosis (free association, enigmatic interpretations, etc.) are decidely not recommended with psychosis. The implication of Leader's assertion is that in each individual case of psychosis "a treatment needs to be invented". As opposed to attempts at social adjustment, Leader recommends attention to what has been stabilizing in an individual patient's history, inclusive of careful attention to points of identification, idealization, activities or projects.