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This excellent eighth annual Hutchings lecture summarizes the essential deviations from classical psychoanalytic technique in treatment of schizophrenia, manic-depressive psychosis, and the delinquency described by Johnson and Szurek. The initial transference relationship differs in these several conditions. These differences dictate modifications of technique and demand that the therapist have a personality different from that of the child's parent.
In the treatment of schizophrenics, patience, tolerance, and ready availability of the therapist are required. Communication must be established on the basis of the patient's private symbolizations. The therapist interprets these in relation to reality. He must be an active participant, free to disclose his feelings and the meaning of his actions. Full resolution of the schizophrenic process has so far not been achieved, and should not be attempted because it would produce some undesirable effects.
In treatment of manic-depressives, transference develops into a clinging dependency to a severely critical parent figure. Interviews should occur once or twice weekly. Interpretation should be elastic but firm, nondemanding, and active, but with cautious regard for the severe superegos of these patients. Delinquents who act out by identifying with the unconscious antisocial wishes of their parents require special caution in the therapist lest his passive or active