A Revised Psychopathology of the Psychoses and Psychoneuroses

Within recent years I have become increasingly interested in the problems presented by schizophrenic and schizoid patients and have devoted special attention to these problems. The result has been the emergence of a point of view which, if it proves to be well-founded, must necessarily have far-reaching implications both for psychiatry in general and for psycho-analysis in particular. My various findings and the conclusions to which they lead involve not only a considerable revision of prevailing ideas regarding the nature and ætiology of schizoid conditions, but also a considerable revision of ideas regarding the prevalence of schizoid processes and a corresponding change in current clinical conceptions of the various psychoneuroses and psychoses. My findings and conclusions also involve a recasting and re-orientation of the libido theory together with a modification of various classical psycho-analytical concepts.

For various reasons the present paper will be for the most part restricted to a consideration of the more general aspects of the point of view to which I have been led by the study of schizoid conditions. Special consideration of the psychopathology of these schizoid conditions themselves must unfortunately be deferred until a subsequent occasion. It is necessary to make clear, however, that much of the argument which follows depends upon a conclusion to which I have been driven by the analysis of schizoid cases, but which, for lack of space to expand the theme, I must reluctantly treat as axiomatic—the conclusion, namely, that the schizoid group is much more comprehensive than has hitherto been recognized, and that a high percentage of anxiety states and of paranoid, phobic, hysterical and obsessional symptoms have a definitely schizoid background. The comprehensive meaning which I have come to attach to the concept of 'Schizoid' may perhaps best be indicated by the statement that, according to my findings, the schizoid group comprises