Bion was one of the first analysts to treat psychotic patients without changes in psychoanalytic technique. Bion states that thoughts arise from the overlap of expectation and reality, that the mother mediates the emergence of these thoughts, and that the thought is respectively “pre-conception-conception-thinking”. Bion saw Klein’s concept of projective identification as one of the basic building blocks of the analysis of psychotics, saying that preverbal communication is experienced through projective identification. He talks about the importance of countertransference in the psychoanalysis of schizophrenia. The psychotic establishes his own unique psychotic thought universe. This is how he tries to survive. Explains 3 causes of regression in psychotics:
1-) “Staying away from the increase in ability” resulting from psychological development. 2-) Being away from the “phenomena” provided by the skill increase. 3-) To stay away from “physiological” development related to psychological development.
Where the normal person prefers thought, he prefers psychotic action. The opposite is also true. He is omnipotent in thinking. It inserts words into the analyst. He is identified with the analyst’s inner persecutor. His intention is to want to divide the analyst and stay away from miscommunication. Excessive use of the partition in the paranoid-schizoid period; makes it difficult to use symbols and access the noun verb. (Development of verbal thought is interrupted.) Depressive position in infancy: It is the increase of verbal thought elements. But the person in psychosis reacts against the verbal thinking ability and divides them.
There are 2 reasons for psychosis: 1-) Environment 2-) Interpersonal interaction.
2a-) Destructive impulses outweigh. 2b-) Hatred of reality 2c-) “Fear of destruction at any moment” in connection with the first two 2c-) Establishing untimely object relations. Sadism is directed not only at the breast, but also at the “perception apparatus”. Projective identification is used instead of suppression.
The hallucination can have a constructive meaning for the psychotic: spraying the object out. The partition is; Used to release emotions. Psychotic Dream; is the discharge of ingested material while awake. In the psychotic patient; Attributions of arrogance, curiosity, and stupidity (which are discretely present) can be interpreted as an effort to cope with psychological disaster. Psychotic person ties; interprets it as a primitive breast or penis.
The patient finds himself surrounded as much as the object he has divided. The psychoanalytic process is continued by incorporating them in a tightened state. (by reversing the spray). The person has already experienced a split in the paranoid-schizoid stage once. In the treatment, experiencing a severe split again in the depressive stage can put the person’s ego in a situation where it can never recover.
