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As I mentioned in Chapter 1, the development of a psychotic transference in the treatment of schizophrenic (or similar) patients, and its interpretation to them, is the main road along which their successful psychoanalysis can progress. Central to the understanding of this psychotic transference is a full appreciation of the various ways in which projective processes can be involved.
In this chapter I shall attempt to examine the transference of the schizophrenic in detail and shall present some material gathered from colleagues with whom I have regularly discussed their schizophrenic patients. The theoretical formulations presented here are not meant to be a final statement, but before presenting two cases I want to discuss some background theory.
The technique used in the psychoanalytic investigation of the schizophrenic has not changed appreciably during the last twenty years, in so far as the patient has sessions five or six times a week in the analyst's consulting room or is seen regularly at a hospital or nursing home. The patient in the acute state generally does not use the couch. Not only his verbal communications but also his gestures and actions are used to help us to understand and interpret the relationship. Although the capacity of acutely ill schizophrenic patients to communicate in analysis varies considerably it is often astounding how clearly the analytic material develops. The language of the schizophrenic differs a great deal from ordinary language, particularly when the patient is deluded. Often it sounds more like a dream; in other words, it seems to be based on what might be called ‘the primary process’. One has reason to believe that the patient himself does not understand his communications to the analyst, in