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Not long ago I attended a meeting during which experiences of working with schizophrenic patients were presented. Two discussants objected to the use of the term “schozophrenic” because the patients did not manifest any of the overt symptoms generally associated with schizophrenia. They defended their stand as being more scientifically rigorous in the use of the diagnostic category, and felt that the mere use of the term has certain implications for far too many psychotherapists which lead, consciously or unconsciously, to restrictions in therapeutic technique and feelings of hopelessness in conjunction with an almost automatic assumption of a poor prognosis.
If there still are that many therapists with such attitudes, then it is time to clear the air rather than to completely abandon the terms we use in communicating with one another. In addition, observing my own experiences working with these patients and listening to my colleagues talk about theirs, has led me to believe that we must be much clearer about the factors involved in our becoming hopeless, anxious or excessively passive in our working with these very sick people. What is involved in our fears of a patient becoming overtly psychotic? What are our specialized goals in working with them that are different from working with other patients? What are our specific standards of progress or regression here as we are engaged in the therapeutic process?
As to the subject of our Symposium, “Dynamic Possibilities in the Therapy of Psychosis,” these aforementioned questions become the primary issues and underlie our working with such patients in our offices. But, before we get to these questions, we must dispose of the problem of which categorical name we are going to apply to these patients; admittedly, this is of more importance to the beginning student, the academic teacher, the hospital/legal/insurance authorities and the research scientist than to the working therapist.
It is not my intention to denigrate or min