Negotiations of peace. Communicating with psychotic patients in outpatientanalytic psychotherapy

The basic psychotic conflict between self-related and object-related tenden cies makes psychotic patients always fear being mentally overwhelmed when b eing in conversation with others. This fear forces them to restrict or to g ive up their symbolic function, which is an attack on linking and meaning. Therefore meaningful psychotherapeutic communication is made impossible. If in psychotherapy the patient is given the opportunity to experience himsel f as being the author of essential messages which can modify the distance b etween himself and the therapist, his conflicting tendencies can be reconci led. This reconciliation prepares him to accept his private metaphers becom ing symbols in the therapeutic situation. This leads to meaningful communic ation and unterstanding of the psychotic dilemma in the therapeutic dialogu e.