Schizophrenia: A Panel

The contribution of psychoanalysis to the understanding of the schizophrenic reaction has many values in therapy. I would like, in this paper, to present aspects of this process as illustrated by some drawings and associations of such a patient during treatment.

Miss A, a 32-year-old, divorced, white woman, entered therapy because of an inability to function in her job and difficulties in her relationships with men. She presented very early in treatment many apparently intuitive expressions of unconscious material though her drawings and verbalizations. However, to her these expressions were removed from the ownership of herself. Here, we see one of the basic concepts of schizophrenia—Alienation. Estrangement from her actual self (as she is now), as well as from her real self, was at the core of this process. The almost full loss of feeling of oneself as an organic whole and a removal from the alive center of the real self were present. This resulted in a distance from her own feelings, wishes, beliefs and energies. Alienation could have explained the frequent feelings of depersonalization, the loss of identity, amnesias, feelings of unreality, and generalized haziness as seen in many schizophrenic patients.

One of the first drawings presented to me by this patient early in therapy depicted a dream. A large robot-like figure, faceless, stood rigidly holding a faceless doll in her arms. Strewn about the feet of the robot were numerous other faceless dolls. In the background a bleak, dark, threatening cloud emerged behind a barren wasteland surrounded by barbed wire. The entire feeling of this drawing was one of horror, desolation, and emptiness. Her associations to the drawing were that it was a mannequin with armor that could be splintered at the first blow. The faceless dolls were her feelings of loss of identity. She said further: “The woman is without identity on a pedestal carrying her new-born self which has also not been permitted to be real. This wooden Madonna