Sanity and madness within the therapeutic setting: A case study

Abstract

This article analyses a particular case of sanity and madness within the therapeutic setting as an expression of psychosis. It describes the story of a boy named Pedro who, between the ages of 12 and 16 years, struggled with mental balance – oscillating between lucidity, within a broken mind, and the madness required to stay healthy. The psychotherapeutic path was marked by a set of characters – real and fictional – that revealed his split functioning. In the plots Pedro created, he used the evil characters of any given movie saga in order to express himself. Like a dream, these narratives functioned as metaphors and metonyms, where the condensed forces of evil took over the symptom – which brings us to psychosis – while the good side, represented by an isolated and unprotected figure with which Pedro identified, revealed the displaced material of his unconscious desire. Although the psychotic parts of Pedro’s personality had been rehabilitated and integrated, his mental functioning remained marked by dissociation with reality, linked to the psychotic dysfunctionality. Therefore, even if his psychotic parts were contained and masked by clever humor, they were an indelible trace of his mental life.

Keywords:

• psychosis
• psychoanalysis

Notes

1 This and all other translations of quotes are my own.

Additional information

Notes on contributors

Alexandra Medeiros

Alexandra Medeiros is a clinical and health psychologist and has worked since 2002 as a clinical psychologist at the Santa Maria Hospital in Lisbon, Portugal. She is a psychoanalyst in the Portuguese Association for Psychoanalysis and Psychoanalytic Psychotherapy, an Effective Member Specialist in Psychotherapy and Neuropsychology at the Order of Portuguese Psychologists and a member of the Portuguese Group of Neuropsychoanalysis (afiliated to the International Neuropsychoanalysis Association).