Language and the Schizophrenic

In this paper I shall discuss the schizophrenic patient's use of language and the bearing of this on the theory and practice of his analysis.1 I must make it clear, for the better understanding of what I say, that even where I do not make specific acknowledgment of the fact, Melanie Klein's work occupies a central position in my view of the psychoanalytic theory of schizophrenia. I assume that the explanation of terms such as ‘projective identification’ and the ‘paranoid’ and ‘depressive positions’ is known through her work.

Freud made numerous references to the bearing of psychoanalysis on psychosis, but for the purpose of introducing my paper I shall refer only to one or two of these. In his 1924 paper ‘Neurosis and Psychosis’ he gives a simple formula for expressing perhaps the most important genetic difference between neurosis and psychosis, as follows: “Neurosis is the result of a conflict between the ego and its id, whereas psychosis is the analogous outcome of a similar disturbance in the relation between the ego and its environment (outer world).”2

As it stands this statement would appear to equate an endo-psychic conflict with a conflict between the personality and the environment and to open the way to confusion. I do not think it unjust to his views to assume they are more correctly represented by passages in which the dynamics of neurosis and psychosis are uncompromisingly

based on the concept of endo-psychic conflict. Yet Freud's formula does, by pointing to the psychotic patient's hostility to reality, and conflict with it, help us to grasp one element that determines the nature of the endo-psychic conflict, and I remind you of it for that reason. I would now turn to some passages from his paper, written in 1911, entitled, “Formulati