Defensive Skin Research Articles

Psychic skin: psychotic defences, borderline process and delusions

In this paper, I apply the concept of psychic skin to analytic work with people suffering from personality disorders and psychoses. When psychoses emerge, the defensive skin which protects the ego is breached and violent unconscious forces rip through the personality. Some of the patients diagnosed as schizophrenic with whom I work have identified with archetypal characters such as Christ, Satan, John Lennon and the Queen. I attempt to show how the adoption of these inflated personas can serve as secondary psychic skins. Such delusional identifications can provide a protective shield to hide the denuded self and prevent intrusion from the external world. Through clinical example, I try to demonstrate how these archetypal 'second skins' can preserve life until internal and external conditions make it possible for the self to emerge. I contrast such psychotic identifications with 'thin-skinned' and 'thick-skinned' narcissism as well as 'defences of the self' in borderline states where the psychic skin may be damaged but does not disintegrate. I also look at the ways in which Jung's own personal experience was different from this and how he managed to avert psychotic breakdown.

Between the basic fault and second skin

The ideas that are commonly associated with Esther Bick, such as primal skin function, defensive second skin phenomena and adhesive identity, are traditionally seen as affiliated to the larger body of work that constitutes the Kleinian school. I shall argue, however, that Bick's thinking owes a largely communally unrecognised debt to the work of her training analyst, Michael Balint. Beginning with a discussion of Bick's early psychoanalytic formation within the British Psychoanalytic Society, her ideas will be reapproached in the light of her contemporary psychoanalytic milieu, with particular reference to Balint's notions concerning primary object‐love, the basic fault and space. A brief history of the Manchester Training Centre, a short‐lived but pioneering British attempt to extend psychoanalytic training beyond London, is included incidentally. Bick's early intellectual openness to diverse psychoanalytic streams will then be discussed in relation to the formation of psychoanalytic groups and their relative capacity to tolerate difference.