Wanneer het onbewuste spreekt — Psychose tussen vervreemding en oorspronkelijke waarheid

Abstract

In this article, psychosis is approached as an epistemological boundary phenomenon that should not be understood merely as a biological disorder or cognitive deficiency, but as an original experience of reality in which the distinction between self and world, between symbolic and real, is temporarily dissolved. Starting from a critical reflection on the materialist paradigm and its limitations in mental health care, insights from psychoanalysis (Bion, Lacan, Jung), metaphysical idealism (Kastrup), rhizomic thinking (Deleuze & Guattari) and clinical practice experiences are woven into an alternative approach to psychosis. The hypothesis is developed that psychosis results not from an excess of dissociation, but from a deficit of it — which allows contents from broader (personal, collective and transpersonal) layers of experience to enter consciousness unfiltered. Clinical vignettes illustrate how these experiences often carry a mythical or existential character and how they can touch not only the patient, but also the clinician, in their own emotional world. This requires an attitude of ‹not-knowing› and resonance, in which the clinician is receptive to the unspeakable in the psychotic experience. The article argues for a humane psychiatry in which psychotic experiences are recognized as meaningful and can be made bearable through proximity, co-creative processes, symbolization and dialogic contact. Psychosis thus appears not as a defect, but as an experience of a boundary that confronts man with the foundations of subjectivity, reality and connectedness.