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Gottschalk advocates complete flexibility in the psychotherapy of functional psychoses. As far as rules can be laid down, he recommends the following: a therapist-patient relationship simulating a congenial parent-child relationship should be fostered. The therapist must try to be the representative of the external environment; he should try to establish a contact with the patient during the acute stage of the psychosis, but follow no rigid rule, rather individualize as much as possible. The technique of free associations is not usable. The provocation of a transference neurosis is avoided for this rapidly develops into a transference psychosis. The analysis of resistances which maintain repression is avoided because it is not desirable to free more repressed material and thereby make the patient more psychotic. Interpretations of psychotic material should be made cautiously, and the patient's hostility should be met without fear or counterhostility. It is desirable to try to establish the precipitating and contributing factors in the psychosis and to formulate the behavior patterns and personality trends that seemed to lead to unsatisfactory adjustments before the onset of the psychosis. Retraining and modification of personality may be sought as with neurotics; many of the unsatisfactory behavior patterns and psychological mechanisms will be found modifiable if the patient understands their origin or their inconsistency.
The literature on the subject is extensively discussed but no case histories are given.