
We present a case study of a drug‐dependent psychotic woman in an assertive outreach program in Norway, and explore how certain therapeutic factors may be operating from a psychoanalytical and cognitive neuroscience point of view. The therapeutic factors and interventions considered are; holding environment, referential triangle, use of metaphor and transference, and the problem of meta‐representation by the patient. The intent is to attempt to integrate perspectives of psychoanalysis, character analysis and neuroscience in the service of seriously mentally ill patients.