Author's Response

I am grateful to Drs. Faergeman, Condon and Kapp for their thoughtful—even elegant—comments. To recapitulate and discuss in detail their arguments would be redundant.

Dr. Faergeman pinpointed problems which confronted the early clinicians and experimental investigators and still face us today. He indicated that some of the difficulties are inherent and that others may well be of our own making. With an approach probably based originally on religious concepts, and later continued for purposes of simplification and adumbration, scientists artificially conceptualized psyche and soma to be divisible. Subsequently, this arbitrary separation often has been treated as though it were valid, a stand which has led to

what seems to be logical absurdities of criteria pertaining to diagnosis and treatment. Thus, thinking within the framework of this artificial conceptualization has led some workers to view the causes of the schizophrenias to be strictly organic and others to see them solely as the result of faulty socialization. Perhaps even the notion that neuroses and psychoses can be sharply divided stems ultimately from such a standpoint.

Today the labors of geneticists and ethologists belie the validity of such a separation of organic and socialization causes. The empirical observations of clinicians seem to me, as to Faergeman, to require abandonment of the idea that the neuroses and psychoses can be sharply distinguished; to view all psychopathological disturbances which cannot be clearly ascribed to toxic or traumatic causes as elements of a continuum.

Dr. Faergeman underscored also that therapeutic nihilism was implicit in the fact that early psychoanalysts, initially enthusiastic concerning the results of psychoanalytic therapy when applied to the treatment of psychotics, wrote but a single article lauding its effects. In a sense, this nihilism was again a product of our own making, since the treatment was conducted along the lines prescribed by the topographical theor