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Marcus, E.R. (1998). The Seed of Madness: Constitution, Environment, and Fantasy in the Organization of the Psychotic Core. By Vamik D. Volkan and Salman Akhtar. Madison, CT: International Universities Press, 1997, 213 pp., $35.00. J. Amer. Psychoanal. Assn., 46(4):1320-1321.

(1998). Journal of the American Psychoanalytic Association, 46(4):1320-1321

The Seed of Madness: Constitution, Environment, and Fantasy in the Organization of the Psychotic Core. By Vamik D. Volkan and Salman Akhtar. Madison, CT: International Universities Press, 1997, 213 pp., $35.00

Review by:
Eric R. Marcus

This book is a delightful series of papers explicating and summarizing the traditional psychoanalytic view of psychosis. The writers have spent a large part of their careers treating psychotic patients and are well known. The book includes chapters by the editors and by L. Bryce Boyer, Maurice Apprey, Gabriel Ast, and Yohannes Lehtonen. Their view of psychosis includes the following ideas: (1) All psychosis is schizophrenia. (2) All psychosis involves fusion of inner and outer and self-representation and object representation. (3) Psychotic etiology is nature plus nurture. The nature part is unknown but involves cathexes and drive development. The nurture part involves relationships within the family, especially with the mother. (4) The loss of reality testing, and other ego problems, are dynamically based. (5) Reconstruction is the only valid psychoanalytic view of development. (6) Dynamics equals etiology equals object relations. Drive and cathexes equal structure. (7) All psychosis is the same, with the same development, object relations, dynamics, psychopathology, diagnosis, and Kleinian mechanisms, and these are the same as perversion or psychosomatic illness.

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