On the Therapy of Schizophrenia

I Believe Schizophrenia to be a complicated form of human existence, beginning in childhood and evolving out of basic needs to maintain life and growth under unnatural conditions. The consequences and patterns of this kind of growing arc such that a person's premises become almost entirely irrational, his feelings terrifying, his behavior bizarre and his style of living strikingly different from that of others in his society. The styles of life vary from person to person, but fall into broad general groupings. Varying, also, are the degrees of apparent disorder.

A schizophrenic person has lived, for nearly all of his lifetime, in chronic anxiety and terror. His sense of self is compounded of contradictions and unrealities. He feels empty; while yearning to be open, he feels closed off from others. Psychic pain pervades him and appears to him as concrete external reality. Living in a subjective nightmare he experiences the threat of becoming separated from the outer world. He cannot reach it and yearns to have it reach him across his barriers. He has a sense of being permanently defective and of having been irreparably damaged, to which belief he responds with feelings of being abused. He hates, envies and distrusts others. Whatever spontaneity he has, is buried. To say that he hates himself implies a “he” that hates and a “himself” that is hated, but this is not the case. Rather, feeling loathsome, he believes he is inhuman.

Seemingly strange goals bring him to a psychoanalyst. They are not so very strange as that he must state them indirectly. He may say, “I have no friends, I want you to tell me what to do”; or “I smell bad”; or “The F.B.I. has microphones in my house and I have heard that you have influence.”

One man telephoned, asking for a single consultation. Half an hour after the appointed time he rushed in, saying: “Here I am.” A woman, at our first meeting, glared furiously for forty minutes and then exploded with: “I hate them all.” Another patient excoriate