A 33-year-old man presented with a 10-year history of psychosis and an
imaginary companion; he carried a past diagnosis of chronic schizophrenia.
He responded quickly to neuroleptic and was noted to be an easily
engageable person. It is argued that despite his first-rank Schneiderian
symptoms, the patient may not best be conceptualized as having
schizophrenia. Specific treatment recommendations are made, predicated on
this man's developmental history, his attachment and separation behavior,
and his response to a structured social milieu.