When the Sun Bursts

September 28, 2015
Psychoanalyst Bollas (Catch Them Before They Fall) explores schizophrenia in a fascinating mix of memoir, case studies, and research. He presumes basic familiarity with psychological and psychoanalytic theory; nevertheless, the text will be accessible to the curious lay reader. Part One details the author’s journey into the field of psychoanalysis, starting when he worked as a counselor with severely autistic and psychotic children in Berkeley, Calif., in the 1960s and ’70s, and moving through his professional training and practice. The bulk of the book is dedicated to describing what it is like (in Bollas’s view) to be schizophrenic and to treat a schizophrenic person. Individual chapters are devoted to different manifestations of schizophrenia, such as hearing voices and experiencing somatoform disorders (mental illnesses with physical symptoms). These are results, according to Bollas, of the patient’s attempts to cope with altered perception by shutting out the world. He also discusses how to provide treatment through talk therapy. While Bollas acknowledges that his own experiences cannot furnish definitive proof, his belief is that intensive, one-on-one therapy can cure schizophrenia. This book is a remarkable look at a confounding illness and the practices of one seasoned, passionate analyst.

September 15, 2015
A contemporary appraisal of schizophrenia and its puzzling traits and treatments through the lens of a physician's esteemed 40-year practice. Building on his previous book, Catch Them Before They Fall: The Psychoanalysis of Breakdown (2013), which provided alternative methods of observing and treating psychotic breaks, veteran psychoanalyst Bollas presents a companion volume that skirts the causes and differing diagnoses of schizophrenia in favor of analyzing varying aspects of the condition itself. In an erudite, well-structured, three-part narrative, the author chronicles his early, intensive clinical experience with schizophrenic children and adults in the 1970s, accessible theoretical analysis of a typical patient's behavior, and the methodology of popular psychotherapeutic practice and how it can be tweaked for maximum effectiveness. In a set of vividly harrowing chapters, the author describes the "apocalyptic moments" leading up to a schizophrenic breakdown, clearly showing how frightful the illness can be to the patient, their loved ones, and even their caregivers. Also insightful are Bollas' explorations into schizophrenic speech, habitual behavior, and thought and personification patterning. He logically argues against assertions by associated mental health professionals that the illness is genetically determined and against the rampant prescribing of antipsychotic medications, which dull patients into what he calls a zombielike state. Too often, notes the author, patients are left at the mercy of a "throw the key away finality," with the human element of the afflicted wholly disregarded. Instead, Bollas advocates for more fundamental curative measures employing compassionate, natural body therapies like daily massages and methodical interpersonal communication between psychotherapist and patient, approaches that have been proven efficacious within the scope of his own clinical practice. Precisely when the psychotic break occurs becomes a key component as well: "Timing is everything in analytic work." A vastly informative, coherent, and valuable assessment; useful and accessible for both mental health professionals and laypeople-even those who don't share the author's unique perspectives and treatment alternatives.

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Starred review from November 1, 2015

A psychoanalyst for 40 years, Bollas (China on the Mind) reports in detail on an uncommon but potentially important practice of psychotherapy with schizophrenics, a group most often treated with drugs. He reports positive outcomes for psychotic adults and children treated intensively--often daily, for years--in the United States and England. Among the author's mentors were Wilfred Bion, R.D. Laing, and Hanna Segal, and he benefitted from therapy himself after a breakdown in college. Bollas notes that routine medication treatment to hasten discharge from the hospital doesn't cure but numbs the mind. Intensive psychotherapy is most effective at the onset of psychosis. An expert on things human that lie beyond comprehension for most people, Bollas applies his insights to social issues such as political paranoia that fosters dehumanization, weapons, and war. VERDICT The author's perspective embraces personal, social, and political life on a vulnerable planet. His expertise extends to civilization generally, making an esoteric specialty relevant to human improvement in general. The book is suited for a general audience interested in psychology applied to the most challenging dilemmas.--E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC

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