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February 27, 1951. ON THE DEVELOPMENT OF FREUD'S CONCEPTION OF THE ATTEMPT AT RESTITUTION. Maurits Katan, M.D.
Freud's analytic study of psychosis, largely based on the Schreber case, led to a number of important formulations. For example, schizophrenics betray, in a distorted way, those things which neurotics hide in the unconscious. Thus, Schreber's delusions represented a defense against homosexuality. Also, the delusion was defined as an attempt at restitution: a new reality is constructed, to take the place of the former reality which no longer exists. Freud interpreted Schreber's delusion of the 'end of the world' as a total withdrawal of libidinal cathexis from people. It is this concept which Dr. Katan examines.
Schizophrenia is sharply distinguishable from neurosis at the point at which there is such withdrawal of cathexis from the representations of the outer world. The decathexis of the unconscious prevents it from participating in the process of projection, which takes place only in the preconscious and the conscious. After examination from various points of view, Dr. Katan rejects Freud's concept that the delusion of grandeur is merely a recathexis of an infantile part of the ego.
The concept that the delusion is the result of a defense against an intensified homosexual urge is supported by clinical observations, but it is unclear why this results in a delusion rather than a neurosis. The concept of the delusion as an attempt at restitution does explain the schizophrenic delusion. This is compared with the hypochondriacal delusion, in which libidinal energy is withdrawn from objects and concentrated on an organ.
Freud's paper, The Unconscious, provided the basis for a uniform theory of delusions, a theory clearly differentiating between the delusion and the neurotic symptom. In the language of schizophrenia, a word is not a symbol, but has