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Although it may be true that nothing succeeds like success, research is spurred even more relentlessly by quixotic and incomplete successes. Our behaviourist colleagues would remind us that our behaviour—as researchers and therapists—is much more the captive of aperiodic reinforcement—the occasional success—than it is the rewarding crown of uninterrupted and ordained achievements. Bemused by the less than stunning triumphs of psychotherapy in the Camarillo study (May, 1968) compared with the power and economy of the psychoactive drugs in the treatment of schizophrenia, the members of the Los Angeles group1 (three of whom had also participated in the Camarillo study) turned to what they hoped would be a productive licking of wounds.
At the workshop on 'The Influence of Theoretical Models on Practice in Treating Schizophrenia' (for further details see the end of this paper) we touched briefly on those characteristics of the patient which promote success in therapy and only in slighter greater detail on the characteristics of the successful therapist: sense of mission, rescue fantasies, being desirous of challenge, tolerant of distress within the patient and in himself, strong sense of identity, keen interest and compassion while able not to be overwhelmed.
These two sets of issues were scanted (not because of their lack of importance, for they are considered foremost among the predictors of success or failure) in favour of metapsychological inquiry.
In effect we attempted to address ourselves to what we considered to be the core of the schizophrenic's difficulties and, by delineating it as clearly and acrimoniously as possible, to outline rational psychosocial therapies. Unwittingly, we circled again and again round the incisive question Freud (1926) put before us: 'What we need and cannot lay our finger on is some factor which will explain why some people are able to subject the affect of anxiety, in spite of its peculiar quality, to the normal workings of the mind