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This is an important paper that deals with current nosological practices applied to all forms of psychiatric disorders, not just schizophrenia as the title implies. After a historical perspective, Kubie presents a striking picture of the clinical and research difficulties that are produced not only by outdated Kraepelinian classification, but by our supposedly more sophisticated diagnostic nomenclature. Mental illness, like physical disorders, is viewed by Kubie as an ongoing process: a neurotic potential, an evolving neurotic process, the precipitating out of a neurotic state, the variegated distortions that, in turn, are produced by the symptoms themselves, and lastly, the possibility of a psychotic process supervening from an insoluble impasse.
Kubie feels that while it is possible and justifiable to characterize an individual moment of behavior as normal, neurotic, or psychotic, the application of the same terms to a whole individual or to an entire life is never permissible. Our nosology confuses the distinction between the severity of a neurosis as a process of illness and the degree of 'sickness' of the life it produces. A summary cannot do justice to the richness of the amalgam Kubie has created from the older concepts of others and newer ideas of his own.