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Although it is a common belief that one person can drive another crazy, no one has systematically studied either the modes and motives for doing so or how this idea appears in the relation of patient and therapist. Searles describes a number of modes which have in common 'the initiating of … interpersonal interaction which tends to … activate various areas of [the other's] personality
in opposition to one another'. He lists eight motives encountered in schizophrenic patients or in their parents which may account for the desire to drive another person crazy: 1, the psychological equivalent of murder; 2, the attempt to externalize threatening craziness in oneself; 3, the attempt to find surcease from a situation of intolerable conflict and suspense; 4, the child's wish to expose covert craziness in the parent; 5, the desire to find a 'soul mate' (the precariously integrated parent is often a lonely person who hungers for someone to share his private emotional experiences and distorted views of the world); 6, a conscious or unconscious desire to draw the other person into a healthier closeness, which miscarries because of the weakness of the child's ego; 7, the mother of the schizophrenic keeps before the child the threat that she will go crazy if he becomes an individual by separating himself psychologically from her; 8, the attainment, perpetuation, or recapture of the gratifications inherent in the symbiotic relation.
The author also describes instances of the same motives and defenses in transference and countertransference.