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Through modern psychoanalysis, an acting out, psychotic schizophrenic patient can be enabled to become a cooperative and well-functioning analytic patient. Contrary to the commonly held view, such a patient is capable of transference attachments, albeit narcissistic transference rather than object (oedipal) transference. I suggest that psychosis, regardless of culture and etiology, may have a specific meaning; that its symptoms, ideas of reference, hallucinations and paranoid ideation serve the specific defensive purpose of warding off life-threatening impulses (suicidal and homicidal); and that psychotic schizophrenia is a psychologically reversible disease when treated by modern psychoanalysis.
The treatment of a single patient will be reported, with detailed recording and analysis of the processes occurring within the patient; the induced feelings (objective and subjective countertransference) of the analyst; and the transformation of these feelings by the analyst into therapeutic communications within the dyadic relationship.
Freud (1913) consistently held the view that “every advance in our knowledge means an increase in our therapeutic power… When we know all that we now only suspect, and when we have carried out all the improvements in technique to which deeper observation of our patients is bound to lead us, our medical procedure will reach a degree of precision and certainty of success which is now to be found in every specialized field of medicine