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The author observes that most analysts avoid treating schizophrenic patients because of the belief that such patients, having regressed to an objectless, autoerotic state, are incapable of forming a transference. He summarizes those reports in the literature dealing with transference phenomena in schizophrenics. Alluding to the great stimulus that Melanie Klein's research has given to the treatment of psychotic patients, Rosenfeld devotes the remainder of his paper to an elaboration of the Kleinian formulation of the role of the 'paranoid schizoid position', 'projective identification', and ego splitting in the schizophrenias. 'The schizophrenic … seems to become confused with [his] object … due not only to identification by introjection, but to impulses and fantasies of entering inside the object with the whole or parts of himself in order to control it.' These impulses 'may be regarded as the most primitive type of object relationship, starting from birth… The schizophrenic has never … outgrown this … and in the acute … state he regresses to this early level.'
The author mentions in passing the defenses of the ego against these impulses and cites negativism as an example. He then presents in some detail clinical material from a twenty-year-old schizophrenic whom he 'treated by psychoanalysis' for four months. 'One may say that the analytic procedure in this case was in all essentials the same as in neurotic cases.' How this is compatible with a subsequent statement, 'I had at times to understand and interpret quickly with very little material', is left to our conjecture.
The case material presented does strikingly illustrate schizophrenic 'ego splitting', the confusion of subject and object, and the sweep of introjection and projection in the transference, and is well worth reading.
The author concludes that he has endeavored 'to illustrate that the withdrawn state of the schizophrenic patient cannot be considered simply as an autoerotic regression'. He also