ABSTRACT
In this chapter, the author explores the experience of psychic deadness in the long-term treatment of a middle-aged man with significant psychotic features. She discusses predominantly clinical and some theoretical concepts that have proved invaluable in her understanding of, and work with, this patient. Along with the other psychic deficits it creates, lack of containment during infancy renders the infant, and later the adult, unable to mourn. W. R. Bion’s way of differentiating between the psychotic and non-psychotic parts of the personality is also pertinent. The author believes that a widening of the gap between the psychotic and the non-psychotic parts of her patient’s personality began during infancy, were exposed for the first time after Carrie’s suicide, and then again after his weight loss. Betty Joseph describes patients whose struggle to maintain their psychic equilibrium comes at the cost of denying the psychic realities of time and loss.
