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Romm, M.E. (1957). Transient Psychotic Episodes During Psychoanalysis. J. Amer. Psychoanal. Assn., 5:325-341.

(1957). Journal of the American Psychoanalytic Association, 5:325-341

Transient Psychotic Episodes During Psychoanalysis

May E. Romm, M.D.

In evaluating the suitability of a patient for psychoanalytic therapy, certain factors have to be taken into consideration. They are, among others, the age of the patient, his intelligence, his reaction to life situations, the potential strength of his ego, the secondary gains from his illness, and his sincerity in seeking treatment. The three patients to be presented who developed transient psychotic episodes during psychoanalytic therapy, all met the prerequisites mentioned above and could be classified as suitable analysands. In their past, there was no history of psychotic behavior. The psychotic episode in each patient during therapy was a reactive formation to facing the problems which dealt with homosexual material. We can, therefore, assume that the psychotic episode was a defense mechanism against an ego-alien concept which came to the surface through the therapeutic process and which clashed with the ego and superego in a sensitized individual. These patients must have developed some specific personality deficiencies and characterological impairments during their formative years which, on fusing with the trigger mechanism during analysis, created the temporary psychoses.

CASE A

Seven years ago an attractive and bright woman was in therapy with me for about a year and a half. At that time she was married to a man who was homosexually inclined and was totally dependent financially on her.

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