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This presentation has attempted to create a confluence of the neurobehavioural and biological data and the psychoanalytic metapsychology of schizophrenia so as to allow for its ultimate conceptualization. In so doing, I have tried to show that the present psychoanalytic model which is based on instinctual drive theory and the centrality of the phallic Oedipus complex does not do justice to schizophrenia. I have tentatively hinted at a psychoanalytic theory which is based upon the infantile 'psychosis' as the progenitor of psychosis, narcissistic disorders and the neurosis, in order to enfranchise the infantile psychotic positions, and the narcissism under which they serve, as the most important determinants of personality development. An unresolved or bizzarely derived infantile psychosis eventuates in schizophrenia. Psychoanalysis needs to be a theory which can subtend such a concept. Furthermore, it needs a theoretical framework which is based upon the importance of internal objects which, more than drives, constitutes the scaffolding of the personality from the beginning to the end of life. In short, schizophrenia requires a psychoanalytic theory worthy of it. In return, this theory can clarify the narcissistic core of all the other disturbances, can bring normal personality development and its pathological vicissitudes into line with all psychopathology generally, in a manner which is more sophisticated and phenomenologically precise than has hitherto existed.
As a result of the application of this revised theory to schizophrenia, this presentation has tried to distinguish (a) schizophrenia from psychosis; and (b) reactive schizophrenia (psychotic regression) from true schizophrenia, in which an altered behavioural development has been going on from the beginning of life. The 'conflict' school and the 'ego defect' school are then reconciled by a unified theory of psychoanalysis which emphasizes the interrelationship between narcissism, infantile psychosis and infant development. Thus a quantitatively significant fixation in early infancy may confirm the 'ego defect' point of view, and a quantitatively serious regression could confirm the 'conflict' point of view. In short, both are correct; they erred largely in terms of their generalizations and in the mutual exclusiveness of their definitions.