ABSTRACT
Today people are dealing with a promiscuous, aggressive and or self-mutilating borderline patient with a complex traumatic history, who nourishes an addiction in addition to eating disorders. This is the new madness. In practice, this means that people meet in our consulting room, for example, an obese male patient, reeking of stale beer, arriving twenty minutes late who, clearly but non-verbally, gives people to understand that they should not expect him to co-operate easily. The supposedly new character of contemporary madness is highly relative, as it has undoubtedly always been present. The only new thing is that it presents itself more often, or receives more attention than before. If people want to work with the new madness, they have to leave the comfortable armchair. In the instance, it is necessary to understand, in terms of psychoanalytical theory, the distinctions from classic psychoneurosis. Subsequently, people can develop, based on the understanding, a different and more efficacious therapeutic approach.
