ABSTRACT
This chapter presents a wide range of examples of the thinking and behaviour typical of severe psychotic illness and offers commentaries based on the application of Kleinian concepts. It demonstrates the value of these concepts as guidelines, or navigational aids, to learning and treatment by psychotherapists, psychiatrists, and others working in the field that have different perspectives and different but related special skills. Klein believed that the most profound unconscious anxiety of the girl from very early in life is of having her body invaded in a destructive manner. Many of the patients have been profoundly helped by their psychotherapists, and most had been so severely and chronically disturbed that they could not have been taken on outside a containing hospital setting. Psychotherapy, with or without associated medication, can often help resolve an acute psychotic episode relatively quickly, but when this has been achieved the therapist is left with the task of considering the character of the patient’s underlying personality.
