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After some five years of my work at Chestnut Lodge, developments in the therapy of various of my patients brought home to me the realization that even the most deep and chronic symptoms of schizophrenia are to be looked upon not simply as the tragic human debris left behind by the awesome glacial holocaust which this illness surely is, but that these very symptoms can be found to have—or, perhaps more accurately, in the course of therapy can come to reveal—an aspect which is both rich in meaning and alive, one now sees, with unquenched and unquenchable energy. That is, these very symptoms now emerge to the therapist's view as being by no means inert debris but as, rather, the manifestations of an intensely alive, though unconscious, effort on the part of the patient to recapture, to maintain, and to become free from, modes of relatedness which held sway between himself and other persons in his childhood and which he is now fostering unconsciously in current life in, most importantly, his relationship with his therapist. When the therapist sees and feels this aspect of the therapeutic situation, not only does much which has been bewildering, in his previous months or years of work with the patient, become coherently meaningful; but he senses, even more hearteningly, how great are the patient's potential capacities for growth, capacities which are, it is now evident, far from dead, but, rather, congealed in the perpetuation of these unconscious transference-patterns of relatedness.
This realization came to me most memorably in two treatment-situations in particular, in my work with a middle-aged hebephrenic man in whom severe apathy was for years a prominent symptom, and a hebephrenic woman of about 30 who manifested, likewise for years in our work together, a degree of confusion which I often found overwhelming and deeply discouraging. I did not find it strange that a man who had been hospitalized constantly, whether on a back ward of a veterans' hospital or on a l