Dream Analysis and the Psychotic Subject with Bret Fimiani, Psy.D.

Saturday, December 12, 4-6 p.m. 422 Alhambra Blvd, Sacramento and online via Zoom*

The dream ruptures the ego's narrative to present an unconscious wish. This is Freud's fundamental thesis in The Interpretation of Dreams. If the ego, for the neurotic subject, is built upon the fantasy of satisfaction, for the psychotic it is built upon delusion. As the psychotic subject's solution to a terrifying real, the delusion shores up the fragile ego by presenting itself as a truth upon which the subject can rely. While this truth may be disconnected from the social link, the psychotic will cling to and follow it, even to their own ruin. Any attempt by the clinician to refute this narrative finds the clinician grouped in with those who comprise a persecutory Other. "The dream," writes Dr. Fimiani, "functions to pierce a hole in delusion, thus creating the possibility for the psychotic to reverse their position and question the certainty of the delusion." This premise has profound implications for the treatment of the psychotic, and for the analyst's act in helping to sustain a new ethic for the psychotic in the wake of the dream's rupture.

Please join us for another conversation with Dr. Bret Fimiani on the ethics of psychoanalytic treatment with patients who are hearing voices and/or experiencing extreme states. While the focus of this conversation is on treating psychosis, it should be edifying for clinicians working with patients from across the diagnostic spectrum as well as for anyone interested in understanding the human experience, as we find the psychotic has much to teach us.

Bret Fimiani, Psy.D. is the author of Psychosis and Extreme States: An Ethic for Treatment (2022) He is a clinical psychologist and a psychoanalyst of the Lacanian School of Psychoanalysis. He works with people experiencing psychosis and extreme states in his private practice in Oakland, CA, and at the Haight-Ashbury Integrated Care Center in San Francisco. He is the chairperson for the Northern California Chapter of the International Society for the Psychological and Social approaches to Psychosis and he is on the board of directors for the Bay Area Hearing Voices Network. His research interests include adapting the Lacanian analytic framework for the treatment of psychosis and extreme states, and the integration of peer and clinical models. He has presented his work on the treatment of psychosis nationally and internationally.

*This is a hybrid event. If you plan to attend via Zoom, please email sacpsysoc@gmail.com upon registration and we will send you a link.