ISPS-US Annual Conference 2026

Name: The Uninvited Guest: Psychosis, Pedagogical Failure, and the Analyst who is Unprepared (Hybrid)
Start: 2026-11-08T13:30:00-0500
End: 2026-11-08T14:30:00-0500

The Uninvited Guest: Psychosis, Pedagogical Failure, and the Analyst who is Unprepared (Hybrid)

Sunday November 8, 2026 1:30pm - 2:30pm EST

Student Dining Hall, John Jay College of Criminal Justice

When a patient presents with psychotic symptoms, most clinically trained therapists are at a loss—they refer out, pursue hospitalization, refuse treatment, or misapply techniques meant for other patients—not because of individual failure but because doctoral programs and psychoanalytic institutes have progressively ceded psychosis to psychiatry, leaving a generation equipped with theoretical sophistication but without the foundational clinical experience this work uniquely provides. Drawing on my concept of unconscious literacy, I argue that psychosis renders the unconscious not latent but transparent: primary process becomes directly visible, projective identification operates at primitive intensity, and the failure of Bion's alpha function makes its ordinary workings suddenly legible. The analyst trained in this encounter develops capacities—tolerance for non-symbolic communication, containment, attunement to pre-verbal distress—that are difficult to acquire any other way and that constitute core rather than specialized analytic competencies. I further argue that relational and intersubjective frameworks, which position the patient as co-equal subject in a mutually constructed field, may be not merely insufficient but actively disorienting in psychotic process, since the patient does not yet have stable access to the subjectivity these approaches presuppose: what psychosis requires first is containment, not encounter—holding before meeting. The paper concludes with a call for structural reform: supervised clinical exposure to psychosis, theoretical grounding in its psychoanalytic understanding, and the integration of existing resources into standard curricula.

Speakers

Danielle Knafo, PhD

professor, psychologist/psychoanalyst, NYU Postdoctoral program in psychotherapy and psychoanalysis, private practice

Danielle Knafo, PhD is a professor, clinical psychologist, psychoanalyst, and author. She chaired a concentration on the treatment of serious mental illness at LIU-Post's doctoral program for 22 years. She has treated persons with SMI for 40 years. Her most recent book (with Michael... Read More →

Sunday November 8, 2026 1:30pm - 2:30pm EST
Student Dining Hall, John Jay College of Criminal Justice 524 West 59th Street, New York, NY 10019

Breakout Session, Hybrid

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ISPS-US Annual Conference 2026

Danielle Knafo, PhD

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ISPS-US Annual Conference 2026

Danielle Knafo, PhD

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