Danielle Knafo, PhD: “Alone in a Crowded Mind: When Psychosis Masks Loneliness



The JC’s fifth meeting, featuring Danielle Knafo PhD, was on Friday, March 8th, 2024, at 4PM London time.

Registration, which is free of charge, is open to IPA members and candidates, other interested mental health professionals, scholars and academics. A copy of the paper will be made available to registrants, also free of charge and with the copyright owner’s permission, in advance of the meeting. Ideally, all registrants will have read the paper beforehand and have an opportunity to ask questions or make comments to the guest author.

This article explores the relationship between loneliness and psychosis, with respect to how psychosis constitutes a longing for connection and reality, how harrowing loneliness both precedes and follows psychosis, even triggering it in some individuals. It also examines some strategies individuals with psychosis use to cope with loneliness and how psychosis and its treatment further isolate a person, increasing loneliness. Finally, it discusses how therapists who treat psychosis experience a particular kind of loneliness in the countertransference. 

The IPA Journal Club would like to thank Psychoanalytic Psychology and APA Publishing for giving permission to share this paper with the Journal Club attendees. The Knafo paper can be downloaded at this link:

Knafo, D. (2019). Alone in a crowded mind: When psychosis masks loneliness. Psychoanalytic Psychology, 37(2), 108–116.

Danielle Knafo, Ph.D,
is a clinical psychologist, psychoanalyst, professor, supervisor, author, and writing coach. She is a professor in the Clinical Psychology Doctoral Program at Long Island University’s C.W. Post campus where she taught for 22 years and served as chair of the Serious Mental Illness concentration. She is currently faculty and supervisor at NYU’s Postdoctoral Program in Psychotherapy and Psychoanalysis and Adelphi University’s Postgraduate Program in Psychoanalysis and Psychotherapy. She is a member of many psychoanalytic organizations and institutes, including the IPA, IPTAR, and the Israel Psychoanalytic Society. 
Dr. Knafo has written ten books and dozens of articles on a variety of subjects, including the psychology of art and creativity, unconscious fantasies, sex and gender, trauma and psychosis. More recently she has turned her focus to the effects of technology and artificial intelligence on the human psyche and relational life. Dr. Knafo has extensive experience treating diverse patient populations in psychiatric institutions, clinics and the court system, and, thus, brings this experience to her private practice, which includes the treatment of psychosis. Her own multicultural background has been an asset in working with ethnically and linguistically diverse populations. She maintains a private practice in Great Neck and Manhattan, New York, specializing in psychodynamic psychotherapy and psychoanalysis. Her most recent book is From Breakdown to Breakthrough: Psychoanalytic Treatment of Psychosis.

The regular moderator of the Journal Club is Jack Drescher, MD

Jack Drescher, MD,
a member of IPA’s Communications Committee, is a psychiatrist and psychoanalyst in New York City. A recipient of the 2022 Mary S. Sigourney Award for his international work on gender and sexuality, Dr. Drescher is on the faculties of the William Alanson White Institute, the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis, the Columbia University Center for Psychoanalytic Training and Research and the Florida Psychoanalytic Center. He is a Clinical Professor of Psychiatry at Columbia as well. He is an elected Director-at-Large of the American Psychoanalytic Association. His publications have been translated into numerous languages. He is author of Psychoanalytic Therapy and the Gay Man (Routledge) and Emeritus Editor of the Journal of Gay and Lesbian Mental Health.