You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In no other type of psychopathology is the therapist's personal orientation as significant as it is in the psychotherapeutic treatment of schizophrenic patients. Since antiquity, psychotic patients have fascinated both professionals and laymen and have exerted both an attraction and repulsion, causing observers to either become involved with them or violently ostracize and incarcerate them. These strong antithetical reactions require exploration because they may help us pinpoint unique features of psychopathology that are characteristic of the schizophrenic process.
Thus, we are led to the question as to what distinguishes the schizophrenic patient from other patients. All patients, to some extent, distort reality according to their needs and seek to deal with an external world that is consonant with their adaptive techniques. The grossly disturbed schizophrenic has practically no adaptive techniques to cope with reality. Consequently, these patients have to create a private reality that conforms to their distorted perceptions of themselves. The observer and the clinician refer to such construction as delusions, the basic and fundamental phenomenon that causes us to label them schizophrenic.
Delusions have been defined as distortions of reality, which eventually interfere with adaptations to the external world. Still, there are many facets to the clinical picture of schizophrenia. There are some patients who, if carefully investigated, would be considered to be schizophrenic, but they make highly successful adaptations to the external world. Schreber, whom Freud (1911) wrote up as a paradigm for paranoid schizophrenia, had been a highly successful jurist. Freud investigated his regression into a