The Psychotic Core

“The Psychotic Core is like a dream image, tightly condensed and packed full of multiple threads, visions and feeling tones… yet unlike a dream it remains durable, tangible and accessible to the interested reader, evoking our attempts to dip into new experiential moments, try things on for size, as we read with less fear of what breakdown and recovery might mean, and feel less anxiety about probing our own minds. What the jacket cover promotes feels accurate: we become less afraid of ourselves by taking time to sympathetically understand, if not taste, the various aspects of madness laid out… and relatedly, experiential richness grows from making this effort. Madness becomes something no longer defensively hidden away in the dark corners of locked wards or reflected in faces of homeless, but instead something more common as part of our everyday lives… as events on the world stage and in our night dreams attest.“This book contains much about madness that remains under-represented and overlooked in our current therapy milieu and society at large. But it does not search for causes and solutions. Instead of explaining psychosis as a problem of brain wiring and chemistry, or due to the unfortunate position of planets and stars, Eigen leads us to a 21st century awareness of complexity from the inside… delineating kernels of experiential and emotional moments that link to positive and creative capacities seen as cousins to madness. Eigen offers us subjective slices and samples we can all relate to. For instance, when we idealize anything we are touching a capacity for infinity that can go very wrong in many ways (heaven and hell), can reverse direction (love-hate) or even disappear altogether; and when we fantasize, wish or desire, we touch hallucinatory operations that can take on extremes of positive and negative qualities (bliss and horror).“The Psychotic Core connects many wheels containing many spokes, yet the centers hold. In its own way, the book can be seen as a wide and loving embrace of the full range of what madness can mean, both from the inside-out (emotionally, from the bottom-up) as well as from the outside-in (conceptually, from top-down)… and not just because of Eigen’s depth and breadth of field and history, but also the colorful cast of characters painted with a literary and sometimes poetic brush, much as Freud did with his case histories. Eigen depicts both overt and subtle madnesses of patients and doctors alike, his own cases along with Freud’s Schreber, and even famous artists and writers—all of whom are given a context and presented in ways that put emotional and experiential flesh on the bones of concept and theory.“In addition to its compelling historical overviews, psychoanalytic lineages, and links to our current state of affairs, (in particular our many societal challenges and dilemmas), Eigen brings to bear and proceeds to dissect an important set of categories that constitute mad operations—those ingredients by which to understand the warp and woof of what psychosis means, and with which he weaves compelling case histories. We visit the craziness of Sylvia Plath, Vincent Van Gogh and Ernest Hemingway, along with the madness of increasingly lethal armaments in the hands of powerful nations. Links between these destructive forces and what goes on in our minds are no longer sidelined and split off from one another, as Eigen rhythmically and empathically alternates between our unseen insides and their outward consequences. The reader comes away wondering if war might be viewed as the outward manifestation of what goes on in our own minds, writ large. Does war physicalize the psyche? Is our excessive destruction trying to tell us something dramatic and costly about what is wrong with us on the inside? Can we ask and reflect and keep asking?“Having assimilated many fearless hunters of our all too human, and more than human psyche, Eigen honors and expands what is possible to live through and live with, looking madness in the eye without flinching, while also not neglecting the creative sources and potentials within breakdown, for repair and growth. Rebirth experiences have a long and varied history, and provide one example of how madness, when supported and guided well, can potentially lead to fuller living. Can we bear the worst and even grow from it? Can a broader understanding of madness open us to more aliveness and even creative vistas, while softening defensiveness? Eigen’s answers are unique and much needed in our troubled times, but you’ll have to read the book to discover them (:“The Psychotic Core should be a required textbook for every medical intern, social worker and psychology student, as well as for advanced clinicians who find themselves shying away from therapy with psychotic patients. Even better if this book should become very widely read by the general public, as the madness we fear in ourselves and others has historically been one of humanity’s most difficult and opaque areas, and continues to be our worst nightmare. The daily news tells us so, but need it be so? Eigen teaches us that by traveling deeply into the core of psychosis, its origins and operations, its chaos and beauty, its multivalent reversals… that we often come through feeling more confident and less fearful of our own madnesses and those of others. From the depths of destructive annihilation to commonplace desire to the ideal of creative potential, madness is given a compassionate hearing in this book, a well-ventilated playground with more room to breathe safely. Robin Bagai, Psy.D.

There are probably other fine books on the Psychosis but this one by Eigen is one of my favorites on the subject. The clarity and breadth as well as clinical examples illuminate what is otherwise an inherently dark and mysterious subject. "She never was comfortable with her body, but neither was she alienated from it" (p166). Another example, from Eigen, "The self may respond to pain by trying to bury itself in areas of blankness" (p.167). Another on the relationship between hate, envy, and fear. "Some mixture of fear and hate is almost always involved in the distortions and deformations that characterize psychotic experience and behavior. The work of hidden fear-hate can often be read in the person's body, which may be twisted and bent over with the rage he is out of touch with" (p.169). There are many examples of the fluid boundary problems co-existing with states Eigen describes as "mindlessness" that signify the patient is seriously out of touch with reality. Don't read this book unless you are clinically disposed and have some background in mental diseases or the like. The book contains it's typical share of psychoanalytic terminology and is dominated by the insights the author has gleaned from his clinical experience. What I liked best was the breakdown of each attribute of psychosis, one chapter at a time. For example, hallucination, mindlessness, boundaries, and hate. If you would like to understand distinctions between fragmented attitudes and disturbances in body image, Eigen will explain this for you. The role guilt plays in many of our lives, is manifested tenfold in disturbed personalities. The numerous manifestations and symptom clusters described in this book provide so much information that you start to experience the panic and confusion inherent in the client being depicted. Once you close this book you can and should call a friend just to reestablish you are really here and being recognized as vital.

Should be part of the CEU/MEUs for behavioral health providers whom serve and treat patients with psychosis, or psychotic features with their primary diagnosis.

One of my favorites.