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Broadly speaking, one may distinguish two groups of mental health professionals: One group may be said to have a genuine commitment to psychotherapy, whereas the second group espouses attitudes that range from noncommittal to skeptical or hostile. Of course, there are many shades of belief, but it is probably fair to say that many mental health professionals start with preconceptions that are relatively immune to scientific evidence, as is true of any issue where strong emotions are involved.
Nowhere, it seems, have the battle lines between proponents and opponents of psychotherapy been drawn more sharply than in the treatment of schizophrenia (however that elusive disorder may be defined). The authors of this book are not only fervent advocates of psychotherapy with schizophrenic patients, but they extol it as “the treatment of choice.” Thus, in this era dominated by psychotropic drugs, they carry the banner of an embattled minority who, at least in the view of many workers, are fighting a rear-guard action. Their partisanship is passionate. They begin with firmly held convictions, and not unexpectedly, they find them confirmed in their research (to be discussed later).
Their basic premise is familiar and in its “pure” form belongs to the 1940s rather than the 1980s: “Schizophrenic pathology is usually the result of a pattern of unconsciously malevolent parenting from the earliest days of infancy onward …. The child is the victim of a series of subtle and unsubtle rejections, the end effect of which is to make him or her worthless, unlovable …. This is the infantile terror that lurks behind the schizophrenic symptoms” (p. 74). The therapist, in the tradition of such exponents as Sullivan, Fromm-Reichmann, Rosen, Lidz, Searles, Will, and Mosher, must come to serve as a new model of reality, and his or her values must be internalized by the patient.