This book offers a novel and integrative psychodynamic theory of psychosis, grounded in the concept of an unconscious fantasy of a private world. It explores a new framework that considers multiple explanatory mechanisms to sufficiently address the development of psychosis. Drawing on critical reviews of key theorists including Freud, Bion, and Kernberg, along with contemporary affective neuroscience, this work synthesises seven foundational domains necessary for a comprehensive theory: affect regulation, unconscious thinking, anxiety, internal object relations, motivational conflict, denial of perceptual reality, and fantasy-based world construction. Central to the book is the argument that psychosis arises from the dominance of an aggressive antiaffiliative motivational structure, which shapes an unconscious fantasy of a private world. Special attention is given to Kernberg’s revised theory of drives, Davanloo’s psychophysiological model of anxiety, and the role of affective trauma in psychotic structure formation. This book enables readers to advance their understanding and treatment of psychosis. Understanding the psychotic internal world on its own terms allows for more empathic, targeted, and effective therapeutic engagement, providing a coherent explanatory framework that has immediate clinical relevance. This work benefits academics, clinicians, and anyone interested in improving their understanding and ability to explain the development of psychosis, and will be of interest to psychological practitioners, psychoanalysts, and psychologists more generally.
