You mentioned you would get back to Pre-Axial dynamics. How about now?

Pre-Axial patterns are different from the other Primary Energetics in that, with rare exceptions, we do not see them in modern times as the central dynamic in the personality structures of healthy individuals. They are primarily of interest to people in the helping professions.

In Pre-Axial patterns, we see a special affinity with the most unformed part of the creative cycle. It is extremely difficult to carry the major part of one’s primary energetic in the earliest parts of cycle and function effectively in the context of the highly form-defined reality of contemporary culture. Because of this, we see Pre-Axial dynamics primary most often in situations where there has been some kind of major disturbance, either an extremely unhealthy childhood environment or a significant biochemical defect. These disturbances act at the most germinal sub-stages to inhibit the person’s capacity to move toward form.

This observation offers a useful vantage from which to think about psychotic processes. It addresses only certain aspects, but it helps link what may seem like very different dynamics. We see what appear to be Pre-Axial mechanisms with all the different things we call psychoses. The effect appears to happen earliest in the creative cycle in “organic” psychoses, where the symptoms are a result of direct tissue damage, internal toxicity, or an external pharmacologic agent. In “schizophrenic” patterns, the effect seems to be somewhat later, and in the “affective” psychoses—severe manias and depressions—somewhat later still. There is some beginning establishment of structure, but not yet of sufficient substance to handle major engagements with reality. The response to meeting significant Aliveness is severe polarization. The fact that schizophrenic and affective patterns often blend and overlap is easily understandable within this framework. (There is the additional difference that certain kinds of affective patterns happen periodically in people with otherwise quite diverse personality styles. Something happens to override what is otherwise one’s primary energetic. One sees this sometimes in schizophrenic patterns, though here chronic symptoms are also common.)

This framing of psychosis can help us better understand the symptomology we see in these patterns. For example, schizophrenic symptoms can be thought of in terms of two counterbalancing dynamics. First, they express the Pre-Axial unformedness of the system. We commonly see such things as hallucinations (the taking of inner reality for external fact), loose associations (a lack of organization in thought), delusions (commonly reflecting a loss of boundary distinction, for example the belief that the person on T.V. is talking directly to you), and withdrawal (from the world of things). At the same time, they express a particular kind of structure, a making of form from what is available within that particular reality. In an important sense, psychosis is not so much a disintegration of the psyche, as an attempt to salvage it. Those loose associations make very effective boundaries. Delusions function to create unique identity and, along with hallucinations, provide a safe sense of connection and communication with other than oneself. The common bodily disorganization in chronic patterns—in which the different body parts seem fragmented—reflects each of these complementary mechanisms, being a kind of disruption and, yet, a very effective way to keep the whole from merging into unity.

Besides helping us see relationships and understand symptoms, this conceptual vantage helps with common controversies regarding etiology. It doesn’t reconcile disagreements in psychiatry regarding whether various psychotic patterns result from biochemical defects or are a product of aberrant childhood experiences. But the CSPT’s framework lets us approach such question as more than an either/or. (At present, the biological or “nature” side of the argument tends to be winning most of the battles. With the advent of brain imaging techniques, we are seeing clear anatomical changes in many cases. But these kinds of things tend to go in cycles. The more “nurture” side of the argument may again flex its muscles.)

Many things can serve to disrupt the germinal sub-stages of the creative cycle. Environmentally, the cause could be a family matrix in which primary bonding is disrupted or, alternatively, where little if any individual identity is tolerated within the system. Biochemically there could be a genetic defect, effecting either the general capacity for rhythmic progression or the child’s specific ability to establish that early bond. I think of the various psychotic patterns as “final common pathways” for a multiplicity of often interwoven etiological processes.

As with any personality style, the symptoms serve creative/protective functions expressive of the unique reality and the unique needs of that part of creative experience.