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Treatment of schizophrenia involving psychoanalytic principles has developed concurrently in Europe and the Americas. Its course has varied on the three continents, with its greatest impetus in South America having been afforded by the thinking of Melanie Klein. The historical development of the thinking of Freud's followers concerning the therapy of the schizophrenias before the introduction of the Kleinian system of thought and its application to the treatment of this group of disorders must be traced from Freud's thinking concerning the psychopathology of schizophrenia which can be divided somewhat arbitrarily into three phases.
Between 1893 and 1910, Freud viewed the psychoses from the aspect of libido development and laid stress on fixation points, defense mechanisms, the aims of the sexual instinct and on object cathexis. During this first period, he groped with the problem of whether psychopathological states could be attributed solely either to organic or psychological causes, and he apparently concluded that some psychical disturbances had their origins predominantly in hereditary, constitutional and/or degenerative phenomena but the genesis of others could be ascribed mainly to conflicts between libidinal forces and socialization agents. Psychoanalytic therapy was considered to be useful in the treatment of the second group and to be operative by means of making elements of the System Ucs. (Unconscious) available to the Systems Pcs. (Pre-conscious) and Cs. (Conscious) through removing repressions.
Between 1911 and 1923, Freud's views concerning the structure of the psychical apparatus changed fundamentally. Becoming dissatisfied with the topographical theory, he presented the dual instinct theory (20) and introduced the structural hypothesis. (21) Concerning the psychoses, he presented a formulation which used the libido theory within the framework of the topographical hypothesis. (18, 19) Freud concluded
that in psychosis there was a break with reality w