Dynamic Possibilities in the Therapy of Psychosis: A Symposium

Welcome ato our symposium on “Dynamic Possibilities in the Therapy of Psychosis.” “In Office Practice” might well have been added to the title because that is where the patients mentioned in all the presentations were treated. This fact identifies the revolutionary changes that have taken place in our attitudes toward the severely mentally ill and the psychoses.

In less than half a century we have moved from the hospitalization of the severely ill for long periods, at times for life, to their therapy within institutions by a courageous few, like Fromm-Reichmann, and then to the office therapy of the psychoses as an increasingly accepted practice. In this revolution, the contributions of Freud, the advances in psychopharmacology and the new conceptions in community psychiatry have each added momentum and innovation to this heartwarming and humane happening.

Other advances were required to prepare the way and to foster this revolution. The mental hygiene movement initiated through the efforts of Clifford Beers, himself a patient, brought to the community an increasing awareness of the crucial importance of mental health and mental illness. World War II forcibly confronted the nation with the widespread presence of psychiatric problems in our youth and stimulated in many physicians an interest in psychiatric and psychoanalytic training. While the demand for the full course in psychoanalytic training has fallen off, the applications of psychoanalytic principles to theory building, to research investigation, to newer techniques of therapy, are in their earliest phases.

The subjects discussed in this symposium concern themselves with some major new directions in our thinking. We have to re-examine our nosologies and redefine what we mean by severe mental illness and psychosis. Dr. Cantor confronts this issue in his discussion of “Occult Schizophrenia.” Most fruitful have been the studies on “The Communications of Psychotics” to which Dr. Sheiner has