When the Sun Bursts: The Enigma of Schizophrenia

In this stunning new work Christopher Bollas has published a beautiful and welcome book on describing and treating psychosis ("the schizophrenias"). In its pages Bollas advocates for psychoanalytic treatment for these patients; he is not the first psychoanalyst to do so, but to my knowledge as both a clinician and the father of a deceased son with schizophrenia, it is the most lucid, by far the most useful, accessible, insightful and humane treatment of the subject.Dr. Bollas has spent a great deal of his working life treating psychotic people beginning as a part time counselor at treatment center for schizophrenic and autistic children at Berkeley. In this book he continues to demonstrate his love for treating this sector of humanity as it evolves through the various stages in his most interesting career.Bollas has described elsewhere that when an analyst meets a new patient he, of necessity, sets aside a search for for an immediate premature knowledge of the patient. Rather he approaches the patient much like when a cultural anthropologist approaches a new people;that with a quiet observation and curiosity, he will learn much without interpreting on the quick. I think Bollas has done something similar in his study of the schizophrenic. He meets these patients before he is a trained clinician and seems to have a natural and uncanny ability to "get" them. It is fascinating to read how this ability is expanded through the mileposts of his career. Bollas, of course, is a stout advocate of the need in the treatment situation of the Freudian notion of unconconcious communication. He brings this communication to light as he gives many clinical examples of his work; one can see how he has FOUND the essence of being psychotic and in doing so has provided a gift by bringing us this knowledge.Bollas informs us that through the extensive overuse of psychotropic medications, the cultural and social whisking away of these people to radical incarceration in locked wards and ghettos of impovrishment, as well as as the use of ill informed and watered down " supportive therapy", that this population has been portrayed as other than human, and, therefore, profoundly lost. Bollas has found these people and offers his portrayal of them.Along the way Bollas illustrates the seemingly un-understandable bizarre behaviors and verbalizations of schizophrenic patients that, when understood, have a brilliant logic... we see a world where disguised meaning becomes clear. We also learn how schizophrenia developes in adolescence as a failed adaptation to adulthood as well as of the psychosexual development of the patient that he refers to as metasexuality. We also discover so importantly that, if a patient is fortunate enough to find herself very soon after her first break to be In a psychoanalytic talk therapy, that is possible for her to be CURED. To quote the author on this matter," There is one thing at the beginning of schizophrenia- one crucial thing- that is vital if a person has a chance to survive and reverse the process. It is crucial there is someone for the person to talk to, perhaps several times a day times a day and possibly for weeks". Through fascinating and beautifully and humanely described clinical examples, this author shows us this way of work with both the newly diagnosed and those further along into the process of illness who can and do make tremendous progress in the "free talk" of psychoanalytic therapy.This book could not be more timely. As psychotherapy for those suffering ANY malady of mental illness is being marginalized, and yes, devastated by by the underlying greed and dehumanizations of the pharhmicutical and insurance industries with thier so called " evidence based" therapies, Bollas elucidates in clear and plain language what actual treatment can look like.In the mind of this reviewer this book is part of a continuing project the author has been working on throughout his luminous career. This project can be referred to as one to describe to ALL of us the nature of mental pain and how it can be addressed through the unconscious work between the patient and therapist. In light of this project this book is one to read by clinicians, patients, and family members as it offers all us real and radical hope in treatment.

Christopher Bollas has given us all a rich gift at a crucial time in our history. As the dominant mental health treatment world has allowed itself to be co-opted by the changing market demands of neoliberalism over the last few decades, psychoanalysts have continued to do their work. And some of us, like Bollas, have worked deeply with psychotic patients throughout this period.Always writing eloquently and evocatively, always further elucidating the capacities of a psychoanalytic lens and experience, Bollas now turns that form and insight toward the farthest reaches of the mind’s struggles. Here he accomplishes a meticulous, extensive, and penetrating interpretation of psychotic logic and mind, while simultaneously carrying the courageous reader to glimpses of our own potential madness, and the creativity that stands alongside it, if only we can listen.The book provides original and exhaustive interpretation of the psychotic and his mind, with numerous case vignettes that breathe life and meaning. The seemingly nonsensical worldviews of the psychotic patient are shown, over and over again and in considerable diversity of types, to have a stunning logic of their own, a logic that requires painstaking time and effort, deep respect and humility, and profound interpersonal courage to come to understand. Many core axioms of the schizophrenic mind are presented; metasexuality, animism, projective identification, sensorial proprioceptive perception, somatoform expressions, and others are identified and animated, opening numerous paths to understanding and appreciating the minds of these patients, as opposed to the dominant interpretation of them as suffering brain difficulties which they must simply come to accept and “manage.”Here is Bollas from the book: “Whereas in the past, patients were simply locked away in hospitals where many would remain for a lifetime, today they are more likely to suffer psychotropic incarceration. The necessity is to find some way to get rid of their symptoms. That the symptom and the person are in many respects one and the same, and that medication can threaten to eradicate the human dimension, is too often disregarded.” Clarifying that while he is not in a position to argue that working with schizophrenics without medications is always possible, “…the more crucial issue is to distinguish between a treatment approach that is ‘generative’ and one that is not.” For Bollas, “generative” indicates a treatment and a way of living that opens up the creative elaboration of the self, such that inherent in the term is a respect for any symptom or set of symptoms as expressing vital aspects of the self in encoded, though “terminal,” or dead-ended, ways. Thus, it is the responsibility of the psychotherapist not to suppress the symptom, inherently thereby suppressing the person, but to treat the symptom by the patient’s and therapist’s coming to understand it together in ways which simultaneously dissolve it and liberate crucial and heretofore incarcerated parts of the individual.This book will surely be vehemently attacked by the dominant mental health-insurance-pharmaceutical corporate complex. It will be the responsibility of psychoanalysts and depth-psychological psychotherapists everywhere to speak up on behalf of the psychotic, on the behalf of the human.

I bought this as part of self-education about schizophrenia now that a close family member has been diagnosed, and also because it was recommended by Martha Nussbaum, a brilliant philosopher. It is a great book for anyone interested in the way the mind works, regardless of the case studies of those adjusting from the difficulties of psychosis and schizophrenia. It explores the nature of the self and how we as individuals seek to navigate any difficult passage in our lives. Fascinating and illuminating.

Worth a read, he’s engaging on the page as he is in the flesh. It’s a scary area, no wonder we’d rather find an answer in a lab.

Reasonably interesting but over intellectualized in its language.Personal theory dominates and only serves to highlight the failings of psychology when compared to neural science.

Great read. Helped me to reflect on different ways of understanding human behaviour.

interesting reading