Discussion of 'The Psychopathology of the Psychoses: A Proposed Revision'

Our paper has already been published. We believe it conveys our ideas concerning the psychopathology of the psychoses clearly enough to provide a satisfactory basis for a discussion that we hope will be a useful and interesting one.

Essentially our contribution is an attempt to extend to the psychoses Freud's ideas which dealt with anxiety and mental conflict. In our opinion these later ideas of Freud's, which have proved to be so illuminating when applied to the neuroses, can be profitably applied to the psychoses as well. They provide a more useful frame of reference, we believe, than the earlier concept of decathexis, hypercathexis and re-cathexis.

Our approach derives from Freud's basic attitude, which was that there is a fundamental unity which encompasses the psychopathology of the psychoses and the neuroses.

From the point of view of clinical observation, this approach brings psychoanalytic theory into closer agreement with the data of clinical experience.

We have observed that many authors other than ourselves, in reporting their practical work with psychotic patients, have, in fact, conceptualized their data in terms of conflict, anxiety and defence, rather than in terms of shifts of cathexis.

We want to emphasize once again that we are not advancing a theory of the aetiology of psychoses. We have confined ourselves to a discussion of their psychopathology, i.e. the disturbances within the mind which underlie those severe abnormalities of thought and behaviour which together constitute the symptomatology of the psychoses. In our view the psychopathology of the psychoses differs from that of the neuroses in degree rather than in kind: (1) instinctual regression tends to be more severe and more pronounced in the psychoses than in the neuroses; (2) conflicts over aggressive impulses are more intense and more frequent; (3) regressive disturbances of ego and of sperego functioning are more