You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Dr. Boyer's highly condensed and scholarly summation of Freud's and the early Freudians' contributions to the psychotherapy of schizophrenia is stimulating and informative but suffers from the depressing fact that we do not really know what we are talking about when we apply the diagnosis “schizophrenia” to this diffcult and puzzling disorder.
This concept may cover a multitude of psychic disturbances ranging from a nuclear group with a distinct inborn error of metabolism to psychic aberrations due to disturbances in the early object relationships, particularly between the infant and a “schizophrenogenic” mother or other unsatisfactory substitutes for the ideal and loving mother. In other words, schizophrenia may be an abstraction without validity.
Most likely there is no specific cause of schizophrenia, since both somatic and psychological factors are involved. Many students of this protean problem have the conviction that the boundaries between the neuroses and the psychoses are entirely artificial and of our own making. Dr. Boyer points this out as the thinking of Abraham and Jung. And Tausk, in rediagnosing Freud's “hysterical” patient, Miss Emma A., as a case of “paranoia somatica,” emphasized how difficult is a distinction between neurosis and psychosis. Boyer calls attention to the fact that Freud, who attended Tausk's presentation in 1919, raised no objection to his stand in this matter.
Many psychiatrists now refuse to be shackled by Kraepelinian diagnosis and accept in each patient a potentiality for humanity, for a healthy development of ego and a healthy adaptation to reality, the growth of which can be promoted into maturity by superhuman psychotherapeutic efforts of many years duration, thus making possible progressive developments from infantile symbiosis to mature object relationships and reality testing with distinct ego boundaries. These considerations override the abstract thinking and formulation we know as diagnosis—which may be an obsolete approac