A Contribution to the Theory of Schizophrenia

If psycho-analysis and psychiatry find themselves at variance owing to the difference of outlook with which they approach identical material, it is none the less a fact that opportunities for mutual understanding occur in plenty precisely in the field of schizophrenic theory, where they are in a position to bring about or at any rate to stimulate an advance in both these sciences. It is obvious that the psychiatrist concentrates his attention more on the ego aspect of schizophrenic phenomena, whereas the psycho-analyst lays greater stress on their id aspect. As Freud has pointed out, it is precisely by investigating paranoia and dementia præcox that we are bound to increase our insight into the psychology of the ego. I propose on this occasion to consider schizophrenic phenomena in one of their ego aspects: I refer to psycho-motor manifestations, which occupy a specially prominent position in the catatonic forms of dementia præcox.

The path to an understanding between psycho-analysis and psychiatry has perhaps been made smoother by the presence of a tendency in psycho-analytic research to do away with the antithesis which seemed once so firmly established between the 'psychical' and the 'somatic', a point which has been elaborated by Felix Deutsch.1 Schilder requires us to apply in the investigation of schizophrenia the 'principle of a double approach', the treatment upon equal terms of psyche and soma. The schizophrenic process is so complex a phenomenon that it is open to us to consider it alike from a psychological and from a physico-chemical standpoint, from the angle of the endocrinal and vegetative processes and from that of neural regulation. But if the very profusion of these possibilities is not to be allowed to obscure the fact that the entire personality falls a victim to the pathological process, the psycho-analyst must deem it a prime necessity to orientate himself with regard to the schizophrenic's libidinal economy, related as it is to both psyc