ABSTRACT
Psychosis is the result of severe pathology and resultant insecurity of primary attachment, leading to inability to separate psychologically and individuate from the undifferentiated primordial conscious relationship with mother. As a consequence primordial conscious mentation persists in social situations where it is maladaptive and destructive. The separation–individuation process occurs in in maturational stages throughout the life cycle. The severity of the psychosis and the consequent maladaptation, ranging from childhood psychosis, to schizophrenia, and to the vicissitudes of psychotic personality organization, relates to the developmental stage the person is able to reach and resolve without manifesting overt psychotic symptoms. Psychotic personality disorder, the least severe illness on the psychotic spectrum, is characterized by the presence of a socially adaptive false self. Clinical examples of the false self are provided.
The normal attachment phase supports development and use of primordial conscious mentation as substrate for further development. When the attachment phase is sufficiently disturbed the insecure infant is unable to develop reflective representational thought, and primordial conscious mentation persists in social situations where reflective thought is required for purposes of adaptation. Psychosis is the maladaptive persistence of primordial conscious mentation in such situations. Extensive clinical illustrations from essays written by the author’s patients are included.
