The Schizophrenic Patient, the Psychotherapist and the Consultant

FEW PSYCHIATRISTS develop or maintain an interest in the intensive psychotherapy of psychotic people. This work may not seem personally rewarding to a therapist, and he may resent the fact that such individualized efforts—often prolonged and tedious—are not available to the populations of our crowded mental hospitals, and even if they were, in many instances would not be demonstrably helpful. Nonetheless, such therapy need not be looked upon as impractical and unjustified. It is enough that some seriously disturbed persons can be benefited significantly by interested and capable physicians; the alleviation of human misery, even for the few, does not require justification, and it is useful that there be repeated demonstrations that psychosis need not be equated with a "living death." Furthermore, the therapy of psychoses is also the study of psychoses, the information derived therefrom being relevant to the understanding of human behavior in general and to the care and prevention of mental disorder in particular. Experience gained in the psychotherapy of psychoses will further the physician's knowledge of psychopathology and improve upon the effective use of technical skills.

In this presentation I shall discuss matters that are of special significance to me both as therapist and as consultant to others who work with psychotic patients; that is, the subject has relevance to both education and psychotherapy. My own experience as a consultant has been with the colleague—psychiatric resident, candidate in