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Badaracco, M.R. (1975). Retreat From Sanity by Malcolm B. Bowers, Jr., Human Sciences Press, New York, 1974, 238 pages, $7.95. Am. J. Psychoanal., 35(2):189-191.

(1975). American Journal of Psychoanalysis, 35(2):189-191

Retreat From Sanity by Malcolm B. Bowers, Jr., Human Sciences Press, New York, 1974, 238 pages, $7.95

Review by:
Marie R. Badaracco, M.D.

Malcolm Bowers makes an orderly and precise contribution to understanding the nature of the psychotic event and places the acute psychotic episode in dynamic relevance to the evolving life of the individual who experiences it.

Bowers distinguishes the acute psychotic episode from chronic psychosis. In this volume he addresses himself only to the former. He presents autobiographical accounts of individuals who experienced such events related to significant life experiences such as adolescent psychosexual development, heterosexual rejection, marital crisis, childbirth, and drug use. In his commentary on these and in his formulations he views the psychotic episode as a form of growth struggle in the evolving psychosocial development of the individual. When an individual, with certain antecedent vulnerabilities and conflicts, is confronted by a life event that is specifically and relevantly challenging, that individual may enter a state of altered consciousness, called psychotic, which has certain characteristics. Bowers indicates that the psychotic episode can be viewed tripartitely. One part is the form: that is, patterned, repeatedly demonstrated characteristics of the psychotic altered consciousness itself. The second part is the idiosyncratic person-related antecedents. The third is determined by the life event that precipitated the psychosis. These latter two determine the specific content of the episode, as well as its timing in the life of the individual.

The main body of this volume is devoted to a description and analysis of the nature of the psychotic state. First of all, Bowers views it as an altered state of consciousness in which the individual experiences the self and the outer world as changing in structure. Changes do actually take place in perception, cognition, and affect. Bowers, referring to these as “destructuring” from what formerly existed, traces the experiential progression of the individual's sense of conflictual impasse and intense dread onward to the destructuring or changes in perception and affect. With the intense anxiety or dread provoked by the conflictual impasse, comes a hypervigilance, leading to expanding awareness of inner and outer stimuli and a heightened sense of self. These perceptions influence ideation, and ideas of reference or influence result.

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