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Until now, results of psychoanalytic treatment of the schizophrenias have been most variable and inconclusive. Published reports have indicated a therapeutic effectiveness ranging from unqualified success to failure, from excessive optimism to undeserved nihilism. But relatively few analysts have described their therapeutic techniques and kinds of results in much detail. This is particularly true of a small group who have claimed that use of Horney's holistic-dynamic approach, even though modified somewhat for the psychoses, has proven effective in a small number of patients in private practice. Too often there has been vagueness and imprecision in describing the pathological condition, the concepts used to define it, the type of patient, and the therapeutic interactions.
In the present psychiatric and psychoanalytic climate, the usefulness of psychoanalytic therapy for the schizophrenias is being widely questioned. We believe it is now essential to test further its effectiveness by continued clinical investigation. There are a number of reasons why such research is rather urgently needed.
For one, the community mental health movement has been emphasizing therapeutic needs of a hitherto neglected, lower-economic segment of the population. It has thus been demanding treatment for the greatest number of persons in the shortest time, stressing rapid and superficial improvement rather than approaches leading to more profound changes. This newer trend has directed attention toward such forms of intervention as drug therapy, behavior therapy, group and encounter therapy, or direct environmental manipulation. There is no doubt that manifest psychotic symptoms can generally be ameliorated by these forms of treatment. With these and the various newer “psycho-social” therapies, including communal-living facilities, foster-home arrangements, day-care centers, and graded work-rehabilitation programs, many patients can become better able to “adjust” socially. Unfortunately, howeve