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Dr. Searles and his associates have rendered a distinct service to the psychodynamic exploration of violence in their study of four patients who were capable of murderous acts. Murder and suicide (self-murder) are the most terrifying human acts with which we are confronted in the gamut of violent behavior, which extends from wars and genocide—where murder is rampant, universal, and even condoned—to the criminal murder that we read about constantly in the newspapers. Although we are all familiar with this kind of human behavior, the dynamics of it are as yet poorly understood. Dr. Searles has attempted to evaluate the nature of these acts through a verbatim presentation of clinical material.
The patients described, although they were unquestionably psychotic at the time of their acting out, do not seem to me to fit into the classical categories of schizophrenia. Perhaps this form of psychosis requires a separate clinical category altogether; I myself find it difficult to know where to place them on the psychotic scale. They have been designated as paranoid schizophrenic, but I do not see in them the organized and systematized delusion which would be necessary for this designation. It is my feeling that the difficulty in accurate diagnosis stems from the lack of study of these kinds of patients.
Dr. Searles's study, which includes verbatim material, seems to me to be the kind of approach necessary to the understanding of the etiology of violent disorders. Unfortunately, it is a little difficult to experience the emotional impact implicit in the material presented and in his reaction to it without having actually been present during the therapeutic dialogue, as were his students. I also think—and this
has always been my position—that psychotherapy should be taught by live demonstration before students. It has been my experience in many decades of treating schizophrenics in this way that they do not object to it and as a matter of fact are very often impressed by it and