ABSTRACT
The effects of the psychoses on the lives of many sufferers are devastating. The results of treatments of the psychoses in sophisticated centres around the world are disappointing. Although the consulting room would rarely see the patient with a severe or a recurring schizophrenic illness, subtle shades of psychosis are frequently present. One needs a full psychodynamic assessment done by a psychotherapist experienced in working with psychosis. Early symptoms of psychosis may be rather mild and nonspecific, such as peculiar behaviour, loss of expression of feelings, speech that is difficult to follow and so on. The models of psychosis developed by Bion, Grotstein, M. Robbins and others, assume the existence of a psychotic and a nonpsychotic personality. All psychoanalytical models of psychosis have derived at least in part from Freud's theories, although he was even pessimistic about the treatment of narcissistic disorders. The interplay between ontogenetic and phylogenetic factors forms part of the more recent psychoanalytical models.
