A contemporary appraisal of schizophrenia and its puzzling traits and treatments through the lens of a physician’s esteemed 40-year practice.
Building on his previous book, Catch Them Before They Fall: The Psychoanalysis of Breakdown (2013), which provided alternative methods of observing and treating psychotic breaks, veteran psychoanalyst Bollas presents a companion volume that skirts the causes and differing diagnoses of schizophrenia in favor of analyzing varying aspects of the condition itself. In an erudite, well-structured, three-part narrative, the author chronicles his early, intensive clinical experience with schizophrenic children and adults in the 1970s, accessible theoretical analysis of a typical patient’s behavior, and the methodology of popular psychotherapeutic practice and how it can be tweaked for maximum effectiveness. In a set of vividly harrowing chapters, the author describes the “apocalyptic moments” leading up to a schizophrenic breakdown, clearly showing how frightful the illness can be to the patient, their loved ones, and even their caregivers. Also insightful are Bollas’ explorations into schizophrenic speech, habitual behavior, and thought and personification patterning. He logically argues against assertions by associated mental health professionals that the illness is genetically determined and against the rampant prescribing of antipsychotic medications, which dull patients into what he calls a zombielike state. Too often, notes the author, patients are left at the mercy of a “throw the key away finality,” with the human element of the afflicted wholly disregarded. Instead, Bollas advocates for more fundamental curative measures employing compassionate, natural body therapies like daily massages and methodical interpersonal communication between psychotherapist and patient, approaches that have been proven efficacious within the scope of his own clinical practice. Precisely when the psychotic break occurs becomes a key component as well: “Timing is everything in analytic work.”
A vastly informative, coherent, and valuable assessment; useful and accessible for both mental health professionals and laypeople—even those who don’t share the author’s unique perspectives and treatment alternatives.