How the Sense of Self Breaks Down and Recovers in Neurosis and Psychosis

Presenter: Andrew Lotterman, MD

• November 4, 2025

• 8:00pm-9:30pm ET

• Location: Virtual

• Source Link: The Association for Psychoanalytic Medicine

“In this presentation Dr. Lotterman documents the extensive overlap between the symptoms and psychology of neurotic and psychotic patients. He portrays the way the sense of self falls apart, and its possible recovery in psychological therapy. Areas of convergence between neurosis and psychosis include: the fragmenting of the sense of self, the sense of aloneness in the world, the loss of identity, the presence of an internal and often hostile inner figure and the creation of a camouflaged surrogate self to draw the fire of attackers. Dr. Lotterman also highlights the essential supports of the self’s resilience: the acceptance by caregivers of what is genuine about the self, and the appreciation of the value of the love given by the self. He discusses Winnicott’s and Fairbairn’s contributions to these ideas. He also describes paranoid psychology in terms of a fear of being seduced into the experience of annihilation. Finally, he emphasizes that understanding the areas of common psychology shared by both neurosis and psychosis can lead to better informed treatments of each.”