Schizophrenia Bulletin
January 1, 1983
Lawrence Fischman
109 citations
Dreams, hallucinogenic drug states, and schizophrenia share fundamental similarities, particularly in the breakdown of ego boundaries—the capacity to synthesize self-representations into a coherent self. This impairment compromises reality-oriented secondary process thinking and allows florid primary process attributes to emerge, explaining many common features of these states. The hallucinogenic drug model of psychosis was initially attractive but has fallen out of favor. Current neurophysiological theories emphasize serotonin neurotransmission in regulating dream and hallucinogenic states, and the analogy suggests serotonin may also play a role in regulating schizophrenic states.
Neuropsychoanalysis
July 3, 2019
Lawrence Fischman
44 citations
Psychedelic-assisted psychotherapy can be transformative by dissolving the ego boundary, which normally acts as a defense mechanism regulating the significance objects hold for the self. This ego dissolution uncouples midline cortical structures and deactivates defenses that mitigate the threat of losing loved objects, allowing dreamlike primary process imagery, regression to earlier object relations, and feelings of love and connectivity. The noetic quality of the psychedelic state arises from recognizing that experiences without character defenses feel more genuine. The process supports Freud's oceanic mode of relating to the world, better suited for finding meaning, alongside the narrower ego feeling suited for survival. An analogy to Fonagy's mentalization model suggests that psychedelic-assisted psychotherapy enables transformative self-acceptance by seeing oneself through another's eyes.
Frontiers in Psychiatry
September 20, 2022
Lawrence Fischman
9 citations
People who undergo MDMA- and psychedelic-assisted psychotherapy often adopt new beliefs about themselves and the world, and these changes are linked to mystical-type experiences during drug sessions. This paper argues that the sense of authenticity accompanying these belief changes arises from a simultaneous feeling of knowing and being known. The medications reduce defensive barriers, enabling the subject to share powerful feelings intersubjectively with the therapist or internalized others. The author draws on concepts such as existential feeling, ipseity, the True Self, transitional phenomena, implicit relational knowing, and predictive processing to propose a transitional space model for working through dissociated experience.
Frontiers in Psychology
January 1, 2025
Lawrence Fischman
4 citations
MDMA-assisted therapy for trauma is unusually effective, partly because the therapist's full trust in the participant's inner healing intelligence—analogous to the body's self-healing—helps trauma survivors who struggle with trust to engage the therapist as a witness. The medication enhances trust subjectively. This therapeutic attitude parallels how a relational psychoanalyst acts as witness in resolving dissociative enactment. Trusting one's inner healing intelligence is dynamically equivalent to trusting the relational process, making it a process of feeling witnessed. The therapist's willingness to acknowledge limitations, coupled with conviction that the participant's primary need is to feel witnessed, facilitates integration of dissociated experience.
Front Psychol
June 20, 2024
Lawrence Fischman
4 citations
The human drive to find meaning and the need for connection are rooted in early attachment relationships. According to the free energy principle, self-organizing systems must create models to predict experience, leading to the development of a narrative self. This self-model biases interpretation toward the predictable, causing us to take things personally. Meaning is felt more intensely when defenses are down and the narrative self is offline, allowing less egocentric meaning-making. Dreams, psychosis, and psychedelic states reveal how sense-making occurs without a coherent self, highlighting attachment's role in shaping meaningful experience.
Frontiers in Psychology
January 1, 2023
Lawrence Fischman
2 citations
Self-touch, particularly the form observed in infant engagement with transitional objects, provides a pre-reflective sense of mine-ness that grounds experience during states of self-loss. These transitional states include absorption in art, empathic immersion, drug-induced ego dissolution, and depersonalization. Drawing on examples from Rodin, Dante, and the Beatles, along with neurophysiological research, predictive processing models, and phenomenological perspectives on touch, the author argues that self-touch serves as a template for experiencing oneself as both subject and object, thereby maintaining a sense of reality and grounding in experiences where the self is diminished or dissolved.
Psychoanalytic Dialogues
November 2, 2025
Lawrence Fischman
The author clarifies their own relational perspective on unitive feelings, such as the oceanic feeling, and applies it to a case vignette from Peoples and Rundel's paper. They highlight convergences and contrasts between this relational perspective and Peoples and Rundel's model of levels of consciousness, which argues that oceanic feelings can have transformative value rather than indicating pathological fusion or unhealthy regression.