You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
A severely ill but unusually articulate schizophrenic woman once told me, “If you want to bring someone back to reality, you have to enter their world first.” Michael Robbins has devoted a significant portion of his career to the world of schizophrenia, and has brought several patients “back to reality.” He has written a superb integrative book on the psychoanalytically oriented treatment of schizophrenia. He has done a masterful job of synthesizing information from a wealth of sources, from the consulting room to biological and social vantage points. The model he follows is “hierarchical systems theory,” an application of general systems theory, which “asserts that psychopathology does not exist concretely at any single level, therefore … no single science has a monopoly on its comprehension and treatment, but it may be viewed with equal validity from a hierarchy of systems and the sciences which conceptualize them, and the different viewpoints may be mutually enriching” (p. 32).
Sadly, given the radical shifts in prevailing treatment philosophies concerning schizophrenia, there is some risk that this book may constitute a threnody to a dying art. Robbins himself sounds this note on his dedication page, where he refers respectfully but nostalgically to “the McLean Hospital of yesteryear.” Nevertheless, I hope Robbins's impressive book will rekindle interest in the psychoanalytic understanding and treatment of some of our most severely ill patients. Psychoanalysts still have much to contribute in this area.
Robbins's preface offers a lucid account of his motives for writing this book. He notes that his career as a psychoanalyst has been atypical, in that he has devoted much of it to hospital psychiatry. He realized that the work he was doing with schizophrenics “had become a sort of endangered species” (p. ix).
Robbins introduces the provocative thesis that our efforts to reach a scientific understanding of schizophrenia contain “reflections of the very elements of pri