Aggression in the Therapy of Schizophrenia*

It is a great pleasure to present the O. Spurgeon English Honor Lecture, especially since it coincides this spring with the hundredth anniversary of the discovery of the “talking cure” by Breuer's now celebrated patient Anna O. In preparing for the occasion, I did a little investigation of the individual for whom the lecture series was named and found, to my surprise, that Dr. English and I have repeatedly crossed trails physically, intellectually, and emotionally. We have had many common experiences, interests, and associations.

I understand that Dr. English came to the conclusion at one time that the best way to understand personality was through Freudian psychoanalysis. I came to the conclusion that the best way to understand schizophrenia was through psychoanalysis. Investigations of schizophrenia and psychoanalysis then convinced me that it would be possible to treat schizophrenia successfully through analytic therapy.

The first patient I treated as a resident at the New York State Psychiatric Institute was a young woman who had been hospitalized following an acute psychotic episode. This case illustrates how misleading appearances can be in the diagnosis of schizophrenia. On admission, the patient had appeared to be an anxiety hysteric. A