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After observing that only a small percentage of psychoanalysts believe that psychotherapy is the treatment of choice in schizophrenia, Kurt Eissler notes the lack of a precise statement of the problem. He then proposes to present in this paper some of the theoretical problems particularly relating to the 'psychoanalysis' of schizophrenia. He divides the schizophrenic disorder into two phases. 1. The acute phase in which 'the patient's ego feels itself as one with the … symptomatology … accepts delusions and believes in the reality of hallucinations'. In this phase, the ego integrates the disorder to such an extent that it acts in accordance with the symptoms and usually must be protected. 2. The phase of relative clinical muteness in which the ego is accessible to a discussion of symptoms and the affinity between ego and symptom is less intense. The majority of reports deal with the acute phase, but the 'whole question of psychoanalysis of schizophrenia can only be decided in the second phase'.
When an analyst has succeeded in terminating the acute phase of the disorder, this does not justify the claim that the patient has been psychoanalyzed. Analogously the termination of an acute hysterical attack does not indicate cure of a hysteria. Clinical experience shows that the methods of stopping hysterical attacks are nonspecific, ranging from soothing words to a cold shower or abuse. Likewise there is no specific technique for the treatment of the acute phase of schizophrenia if disappearance of symptoms is the main goal. During the acute phase the patient is prone to react favorably to any help which is offered in an acceptable form. Eissler illustrates this fact with examples of his treatment of army casualties in which he employed a maximum of love and attention so that the contacts were highly charged with affective interchanges. He concludes that the effectiveness of his measures lay in their nearness to the primary process. Any technique secures ter