Encounters with Psychosis

Abstract

This essay offers a personal account of one physician's attempt to engage with psychotic patients in an inner-city hospital. It considers some of the obstacles to psychoanalytic work with psychotic patients, including anxiety in the psychotherapist, anxiety in the patient, institutional resistances, and paradigmatic errors. A discussion of paradigmatic errors in Western mental health care is expanded upon. Rorty's () critique of objectivity and Kuhn's () work on scientific paradigm shifts are discussed in an attempt to demonstrate how we might better understand psychosis as an illness and connect with patients across the entire diagnostic spectrum.

Atypical Discourses

“…Elsewhere I discussed Austin's () performative utterances (also called performatives or speech acts ) as an example of atypical (then called abnormal ) discourse (Dwaihy ). Performatives are communications that do something.…”

“…I previously advocated the exploration and use of abnormal discourse (Dwaihy ), a term offered by Rorty and based on Kuhn's notion of revolutionary science. Abnormal discourse, roughly speaking, is language used by someone who is ignorant or defiant of the established conventions of a conversation.…”

“…I previously suggested that Rorty's notion of edifying philosophy and psychoanalysis are natural bedfellows (Dwaihy ). I now feel confident enough to overtly extend the comparison to pragmatism and psychoanalysis.…”