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The world of schizophrenia is a world of chaos, certainly to the patient and to the student of schizophrenia. Early in his career, Freud was pessimistic about the possibilities of psychoanalytic intervention in this condition. But later in his life, in An Outline of Psychoanalysis, he held out hope for comprehension and amelioration of schizophrenia. Freud says,
A dream, then is a psychosis, with all the absurdities, delusions, and illusions of a psychosis … and we learn from it that even so deep-going and alteration of mental life as this can be undone and give place to the normal function. It is too bold, then, to hope it must also be possible to submit the dreaded spontaneous illnesses of mental life to our influence and bring about their cure? (, p. 172)
In this article, I approach the problem of schizophrenia by making practical use of an important tool that Freud has given us, namely, the concept of the id, the ego, and the superego. With his description of psychic structure and the dynamics among the parts, I contend that Freud has given us a framework to begin to decipher an important aspect of the problem. Put simply, in his portrait of the internal relations between the ego and the superego, Freud has given us a means to understand the “method of madness.”
To avoid misunderstanding, an initial clarification is in order. The concept of the superego, as described in the totality of Freud's writing, and as I am using it here must be distinguished from the ego ideal. I have found it easier, and more practical, rather than trying to disentangle one from the other on the basis of metapsychological considerations, to distinguish them on the basis of the affects that are induced. That is, if the patient feels guilt, the problem is the superego. If the patient feels shame, the problem is