When theory paints a picture: a clinician reflects on Piera Aulagnier's metapsychology

The author discusses a patient who, while not frankly psychotic, was prone to states of disintegration marked by fragmented thinking, retreats into extreme isolation, and an idiosyncratic relation to language that manifested in his speaking without seeming to communicate. The analyst used his own forms of dreaming and reverie, including looking at pictures, to help him understand the patient's unique forms of self-expression. The metapsychology of French analyst Piera Aulagnier was particularly useful to the analyst in conceptualizing the patient's experience an understanding his reactions to interventions.