The author purposes to present evidence that symptoms in schizophrenia are an attempt to internalize certain severely hostile impulses. He draws his conclusions from 'individual intensive analytically oriented psychotherapy' of six schizophrenic patients. Hostile impulses during therapy were kept latent by the psychotic symptoms. As the psychotic defenses were weakened by treatment, the hostile impulses became manifest. Cohen asks, 'Why should these schizophrenic patients have such intensely hostile feelings? What is their source and genesis?' An inquiry into the intensity and primitive quality of the schizophrenic's need for love, his sensitivity to rejection, and the weakness that renders his ego too weak to deal with his ensuing hostility, would have been enlightening for both reader and therapist.

This paper unfortunately exemplifies a tendency faced by psychoanalysis in its earliest days. The concepts of the unconscious, transference, and resistance were to be made palatable by eliminating the objectionable sexual elements.