Berne drew on many sources for the conceptual layout of his theoretical model, and on this basis transactional analysis may be defined as “transtheoretical.” Understanding ego states as systems and structures provides an exciting, original view of personality and psychopathology. Interpreting ego states as stages (Romanini, 1996) makes it possible to reduce the distance between normality and pathology. By being located in a structural and time-related dynamism, psychosis manifests itself when the states/stages become disorganized and dislocated. It is assumed that in psychotic structures there is a lack of equilibrium in complementary adaptation processes, with a prevalence of assimilation over accommodation (Piaget, 1975). This imbalance produces a structural weakness in A2, and on the basis of external stimuli, it reactivates the simultaneous reappearance of states belonging to other developmental stages. Psychotic language reflects this internal disorganization and has its own affective logic and narrative structure. The proposed interpretation of the structural mechanisms may facilitate targeted and efficacious therapeutic actions, illustrated in this article by means of a case example.

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Article
Acute Psychotic States: A Clinical Interpretation
Pages 246-253
Published online: 28 Dec 2017