ABSTRACT
Bion’s first psychoanalytic case study in 1950, ‘The Imaginary Twin,’ proved to be an auspicious entry into the experience of understanding psychosis. He struggled long and hard to understand a male schoolteacher’s state of mind, yet his slippery and elusive analysand left him befuddled. The ‘Twin’ lived inside a protective imaginary enclave, one that profoundly disoriented both himself as well as his analyst. He appeased the analyst while keeping him at bay and off balance. The analyst’s eventual contact with this interior enclave revealed someone living in a severe dissociation from reality; yet contact had its emotional costs in terms of persecutory fears of reprisals by the analyst.
At the case’s conclusion, Bion had demonstrated that he had learned his analytic craft as he then sailed directly into the forbidding realm of the psychoanalytic treatment of psychosis. He now explored the idea first broached by Freud in The Interpretation of Dreams: if it is true that there is a ‘psychotic island’ within all of us—after all, we can all self-depict as insane, usually in our sleep when we are dreaming—what relationship did this profound irrationality bear on otherwise more dominant neurotic and normal functioning with which it coexisted?
