Schizogenesis

Dear Sir

I read the article by Robin Royston in the British Journal of Psychotherapy, Vol. 6(1) with interest and excitement.

The author reviews some of the relevant research in the field of the genetics of schizophrenia but did not mention one fact that plagues exponents of a strictly biological causation of this illness. This fact is that the psychotic illnesses do not ‘breed true’. That is to say, schizophrenic patients have an increased chance that their children (and other first degree relatives) will also have schizophrenia; but there is also an increased risk of other psychotic illnesses such as psychotic depression and manicdepressive psychosis as well. Thus it seems as if it is the capacity to be psychotic rather than the particular form of the illness that seems to be inherited.

The author reviews Jung's theories of psychosis: that psychotic material forces itself into consciousness, either because of its own particular power, or because consciousness is too weak to hold it back. Another hypothesis, which has advantages that I shall go on to discuss, is that there exists in normal people a ‘filtering mechanism’, not activated whilst dreaming, or deactivated in toxic organic states, that is weakened or absent in those people who develop psychotic illness. This filter would roughly correspond to the horizontal dotted line in Robin Royston's diagram. It would not matter whether the filter had its origin in the biochemical or structural nature of the brain for the validity of this idea.

The author then turns his attention to the work of Melanie Klein. If it was a defective filtering mechanism that was responsible for the development of psychotic illness, then the actual form taken in an individual patient might depend upon the stage that patient reached in early development before the disruption to the normal process of progression from the paranoid-schizoid to the depressive position occurred. Early disruption might lead to schizophrenia, and at a later stage to