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THE ACADEMIC LECTURE

PSYCHOTHERAPY OF SCHIZOPHRENIA
Published Online:https://doi.org/10.1176/ajp.111.6.410

1. The goal of dynamic psychotherapy with schizophrenics is the same as that of intensive psychotherapy with other mental disturbances, i. e. to help both ambulatory and hospitalized patients gain awareness of and curative insight into the history and unknown dynamic causes which are responsible for their disorder.

2. The same type of psychotherapeutic approach to schizophrenic patients during all phases and manifestations of the disorder and discussions of illness and treatment after their recovery are recommended for the purpose of helping such patients to integrate their recovery with their psychotic past.

3. An attempt is made to understand schizophrenic symptomatology and to approach it therapeutically as an expression of and as a defense against anxiety. The hypothesis is offered that the universal human experience of tension between dependency, fear of relinquishing it, recoil from it, and interpersonal hostility becomes, in the case of schizophrenic persons, so highly magnified and so overwhelming that it leads to unbearable degrees of anxiety and then to discharge in symptom-formation.

4. The multiple meaning of many schizophrenic symptoms, communications, and other manifestations has been discussed. The need for understanding and translating them descriptively for therapeutic reasons has been questioned, and the significance of nonverbal communications with schizophrenic patients has been stressed.

5. Psychodynamic investigation and clarification of schizophrenic anxiety and symptomatology in its conscious and unconscious manifestations in the patient-psychiatrist relationship is presented to be equally as crucial for the psychotherapy with schizophrenics as for other mental patients.

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