Introduction to “Communicating with the Schizophrenic Superego Revisited: A New Technique”

This provocative and clearly written article poses (among others) the question: why was Freud so repulsed by psychotic patients? He said, “I am annoyed with them …I feel them to be so far distant from me and from everything human” (, pp. 318-319). Levin is not burdened with such annoyance, and perhaps she indirectly provides an answer. This work requires a different sort of theater from the couch and the analyst's hidden chair. Treating psychosis, the analyst must act on a stage whose very floor is unpredictable. This article provides two illustrative dramatic scripts where the analyst takes charge. It has historic echoes to the early days even preceding psychoanalysis, when concepts such as “introjects” and “dissociation” began. Pierre Janet (1859-1947) developed his ideas at the Salpêtrière, working with psychotic patients. Morton Prince (1854-1929) saw trauma at the root of personality “splits” (Prince, 1906). James Jackson Putnam (1846-1918)—founder and first president of the American Psychoanalytic Association— took issue with Freud on the role of the superego, and of spirituality; I imagine him agreeing with Levin's approach and trying it out. He was very open to new techniques, as Prochnik's very engaging new biography illustrates (Hale, 1971; Prochnik, 2006).

W. D. Fairbairn in 1952 said,

such dissociative phenomena as somnambulism, the fugue, dual personality, and multiple personality [,] so far as the manifestations of dual and multiple personality are concerned, their essentially schizoid nature may be inferred from a discreet study of the numerous cases described by Janet, William James, and Morton Prince. And here it is apposite to remark that many of the cases described by Janet as manifesting the dissociative phenomena

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on the basis of which he formulated his classic concept of “Hysteria” behaved suspiciously like schizophrenics—a fact which I interpret in support of the conclusion, which I have already reached on the basis of my own observations, that