You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Fromm-Reichmann records the increasing application of psychoanalytic therapy to the treatment of schizophrenics. One of the early deterrents to this was, she believes, Freud's concept of the narcissistic and regressive character of schizophrenic disorders which precluded the possibility of a workable relationship between the schizophrenic and the psychoanalyst. The experiences of a number of later authors, including her own, led to a revision of this concept and to the feeling that no matter how tenuous the interpersonal relationships in the schizophrenic may be, 'they are sufficient for the establishment of a new relationship, the doctor-patient relationship'.
In recent years changes in the technique of psychoanalytic treatment of psychotics are found in both the establishment of the doctor-patient relationship and the approach to the contents of psychotic communication. The sensitive, cautious, and overpermissive approach to the patient formerly used is not the best way of establishing an effective interpersonal treatment background. This type of relationship addresses itself too much to the rejected child in the schizophrenic and too little to the grown-up person. This attitude must therefore be blended with one of respect and understanding relevant to the patient's chronological age. As far as the interpretation of content is concerned, the chief therapeutic emphasis at the present time is directed toward an understanding of the genetics and dynamics which determine the content, rather than an overemphasis of the content itself.
The author makes some practical comments on technique with special reference to the timing of therapeutic endeavors, the contraindication of the couch, the necessary flexibility of the schedule, the amount of attention paid to dreams, the reasons against the use of free association, etc. Finally some pitfalls to be avoided and the personality prerequisites of the therapist are lucidly discussed.