chapter  8
Psychoanalytic Psychotherapy and Psychoanalysis of Near Psychosis
ByEric R. Marcus
Pages 26

Near psychotic structure involves a specific alteration of reality testing. The psychotherapeutic approach to observing ego in near psychosis is to confront it together with reality testing, at the same time trying to make near psychotic condensations conscious. The treatment of the behavioral borderline near psychotic is exactly the same as the treatment of the pseudodelusional type, but with one prior step and one complication. The complication is that behavioral defense structures may be based on splitting mechanisms which separate positively valenced from negatively valenced self and object relations. In analyzing the relationship between character and psychosis or near psychosis, one observes the recapitulation of theme in the psychotic or near psychotic material and also in reality, behavior, fantasy, the past and the present, and character derivatives. Some near psychotic patients find relief from transference intensity on the couch, where without the observing gaze of the therapist, transference intensity actually decreases.