ABSTRACT
This chapter argues that a psychoanalytic assessment can offer a dynamic picture of the deeper psychic structures in the patient’s internal world, which underlie the presenting signs and symptoms of mental illness. The developmental perspective inherent in the psychoanalytic view can help clinicians to focus on repetitive patterns of behaviour. The unstructured nature of the clinical approach and the emphasis on free association is designed to allow different elements of the patient’s mind to emerge during the course of a psychoanalytic session. Patients in psychotic states of mind are continually drawn away from the emotional demands of external reality and into the world of their psychosis. Mental health professionals have to be able to withstand these attacks and hold on to their long-term clinical view. The patient needs a team of clinicians who are working together in the interests of their treatment and care.
