Abstract

This paper presents a description of the psychodynamic approach to a patient with psychosis of the paranoid type. The clinical picture of the patient indicated the presence of two parts to their personality: a psychotic and non-psychotic part, which were not integrated. Due to the fragmented presentation, the therapist was in a state of uncertainty for a long time regarding the patient’s bizarre story and its definition in the psychodynamic sense. In time it became clear that the dissociated fragmentation of the psychotic story was hiding a potentially undreamt wealth of fantasy. Early cessation of the therapy on part of the patient prevented working through his projections and connecting the emotionally empty psychotic construction with the living and painful emotional world with the goal of better integration of two parts of the patient’s self: the psychotic and the non-psychotic.