The Transference in Symbolic Realization1

Although for a long time it was suspected that schizophrenics were incapable of transference, to-day analysts who treat these patients are unanimous in recognizing the possibility of a transference relationship in them. Federn was one of the first to show this.

Does this mean that the transference in the schizophrenic is identical with that in the neurotic? That it should be so is difficult to accept when we know the difficulty schizophrenics experience in maintaining real object relationships, relationships indispensable to the analytical situation. But before investigating what it is that differentiates these transferences, I should like to stress that in the treatment of schizophrenics, as in classical analysis, the transference is the analyst's most important instrument. And this remains the case no matter what the category of the patient being treated. There is no doubt, however, that there are individuals diagnosed as schizophrenics who, as Nacht has shown, are better regarded as schizoids with neurotic disturbances and in whom a transference similar to that in neurotics is found.

The patients to whom I shall refer in this paper are on the contrary individuals who are extremely severely regressed and whose ego has much deteriorated. Not only are interpersonal relationships in these patients non-existent, but intrapersonal relationships are deeply disturbed, that is to say they have lost the feeling of their existence, of their identity, and of their situation in the world. In their infancy repeated frustrations are almost always found; an early and severe maternal neglect. Important works of English and American writers on this subject, from Anna Freud to Greenacre, Fromm-Reichmann, Rosen and Spitz, to mention only a few, have been unanimous in underlining the connections which exist between these first experiences and the serious disturbances observed in the personality of schizophrenics: experiences which leave an almost indelible impr