Comment on Dr Bychowski's Paper1

In 1950 The Psychoanalytic Quarterly published a paper by William L. Pious under the title 'Obsessive-Compulsive Symptoms in an Incipient Schizophrenic'. Dr Bychowski's enlightening contribution approaches the same problem under a very similar title, 'Obsessive Compulsive Façade in Schizophrenia'. What has intrigued me is the fact that a comparative analysis of the rich observations and formulations of these two authors carries us right to the heart of the central theoretical issue in the problem of schizophrenia.

Both authors begin by calling attention to the clinically established observation that psychoneurotic symptoms may mask an underlying psychosis and may even prevent the development of an overt schizophrenia. Pious documents this finding in detail from the literature, referring to Freud (1918), Federn (1943), Mack Brunswick (1928), Ferenczi (1911), Staveren (1947), Tower (1947), Cohen (1947), Stengel (1945), and Sullivan (1947).

Such consistent relationships present us with an immediate challenge to decipher the meaning and function of obsessive and compulsive forms of thought and behaviour in connexion with latent or overt psychosis. This is what has been undertaken by both Pious and Bychowski. No summary of their papers can do full justice to the extraordinary complexity and depth of observation and inference to be found in both. Nevertheless, a brief and therefore inadequate summary of each will help to point up an issue that has become more and more urgent of solution in psycho-analytic thinking.

On the basis of minute clinical observation Pious felt it necessary to make an extension of the position held by Freud with respect to schizophrenia. Freud (1924) had stated that

in the clinical picture of the psychosis, manifestations of the pathogenic process are often overlaid by manifestations of an attempt at a cure or a reconstruction.

For Pious this statement was too qualified. He asserted that all observable phenomena and symptomatic manifestations i