Beyond Symbiosis

Abstract

This article is based on years of clinical experience with adult psychotic patients, including both those who are chronic and those experiencing their first episode of schizophrenia. These patients live in the London borough of Lambeth in South East London, which is recognized as having one of the highest rates of psychosis in the United Kingdom and probably in Europe (Kirkbride et al., 2006). The author first describes Berne's (1957/1969) views on splitting and his later theory of Parent exclusions (Berne, 1961(Berne, /1975 in creating active psychosis and then suggests that schizophrenia is a relational trauma disorder rather than the result soley of symbiosis (Schiff, 1975) or the product of intrapsychic conflicts (Novellino, 1991(Novellino, , 1998(Novellino, , 2004Novellino & Moiso, 1990) and complex contaminations (Goulding & Goulding, 1979). The author proposes that schizophrenia involves profound multiple structural exclusions that are responsible for early Parent lacunae within the Child ego state (P 0 and P 1 ), ultimately resulting in ego/self-fragmentation.