Principles of Psychotherapy in Latent Schizophrenia: Paul Federn. Amer. J. of Psychotherapy, I, 1947, pp. 129–144.

Federn outlines a systematic therapy of schizophrenia, basing it on his theoretical concept of the disease, i.e., in the main a loss of cathexis of the ego boundaries. The therapeutic aim is to restore the lost cathexes to the psychotic ego. This loss of cathexis remains only partial for long periods, and is also reversible. Hence, with the aid of those parts of the ego that still function with sharp distinction between thought and reality, the deficient parts of the ego may be repaired. Federn epitomizes the therapy in a motto: 'What has become the ego's territory should be returned to the id'. To that end, the patient should be assisted in re-repressing unconscious material and his attention should be directed to the special conflicts in his current life situation which precipitated the psychotic break. Resurgence of repressed infantile ego states should be guarded against and the patient should be encouraged to adhere to the normal adult ego state for increasingly longer periods. The main levers at the disposal of the therapist are object libido transference and identification. Transference counteracts narcissistic withdrawal by increasing object interest; transference improvements occur with psychotics as with neurotics. Unlike the customary procedure with neurotics, however, 'with psychotics one must preserve the positive transference and avoid provoking a negative one'. The therapist can also strengthen the healthy part of the patient's ego through identification, with resultant increase in self-reliance and in striving for normalcy. However, because there is danger that the patient may imitate the therapist too much, identification should be resolved early. Once a good relationship between therapist and patient is established, a cautious attempt may be undertaken to rectify the falsifications of reality, not by criticizing the patient's productions but by merely juxtaposing the correct view of reality.

In latent schizophrenia one's aim is to preve