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DR. FROMM-REICHMANN: I feel sure that all psycho-analysts who work with schizophrenics are very grateful to Dr. Eissler for one of the central theses of his stimulating paper. I refer to his suggestion that when analysing a schizophrenic we differentiate sharply, for the purpose of evaluation of therapeutic results, between states of acute psychotic disturbance and 'mute' states, as he calls them. I agree with Dr. Eissler that almost every approach in which a psychiatrist makes use of his own 'primary processes' in order to address himself to the psychotic in terms of the patient's 'primary processes' may help the psychotic. This approach can be utilized by the psychotic to emerge, if and when the psychiatrist is able to convey to the patient that the doctor's complete concentration and intentness of purpose is directed toward helping him to recover. This may be done in terms of Rosen's method of 'direct interpretation' or of Eissler's own method of applying unconditional love, acceptance and care to his psychotic soldiers. This is also the case with my own former approach of unmitigated understanding and acceptance, which I described ten years ago in my paper on 'Transference Problems with Schizophrenics' (Psychoanal. Quart., 8, 1939), or in any similar way.
Emergence from the acute psychosis, however, has nothing to do with the cure of a schizophrenic. The contrary is true—another more serious problem begins with the patient's treatment in the post-psychotic state. We are particularly indebted to Dr. Eissler for having focused our attention upon this fact and for stating it definitely and clearly in so many words. Up to this point I am in agreement with Dr. Eissler. I have come to different conclusions, however, about the method of treatment that is the best approach to this symptomatological dichotomy. From our experience at Chestnut Lodge, it seems to me that throughout the whole course of his illness the schizophrenic can be treated with the same met