Jahrbuch der Psychoanalyse. Bd 48. Psychotische Mechanismen bei neurotischen Erkrankungen

Psychotic mechanisms in neurotic patients make them lose their connection to reality: to internal and external reality and to the functions of the ego which aid the perception of internal and external reality. Thus for example consciousness, attentiveness, memory, curiosity or judgemental competence are actively changed and limited. The function of these active limitations is to reverse the strain of this depressive disorder if this becomes too heavy and is experienced as a “new danger” (Freud) and causes too much fear. These psychotic mechanisms lead to particular clinical phenomena such as for example the projection of interest in the analysis on to the analyst, forgetting thought associations, latent aroused-dazed states of consciousness etc. Neurotic patients do not receive fundamental existential psychoanalytic support until there is sufficient theoretical and clinical courage to examine the psychotic elements in their ego functions in their relationship to the analyst