ABSTRACT
The prevalent belief that psychosis is an adult onset genetically determined biological disease has no scientific foundation. Conscious mind functions in two normal but qualitatively different ways, primordial consciousness and reflective representational thought. The model of primordial conscious mentation is derived from Freud’s concept of primary process and his work on dreaming. Primordial consciousness is the first mind of infancy and early childhood. It commences in utero and is the modality of mother–infant attachment. It continues to manifest itself in normal ways throughout life although it is ordinarily employed selectively and adaptively. When the attachment phase is good enough it is normally supplanted by reflective representational thought in most adult situations. When there are major problems of attachment primordial conscious mentation persists inappropriately and maladaptively and the result is psychosis. Accounts written by the author’s patients illustrate the process.
