Learning to Think about Schizoid Thinking

Psychoanalytic knowledge has much to contribute to the understanding and treatment of the seriously mentally ill. It can make apparently bizarre manifestations comprehensible, can facilitate the formulation and implementation of a psychotherapeutically-oriented treatment plan and can allow the selection of those individuals suitable for psychological treatments in general and psychoanalytic psychotherapy in particular.

All staff working with psychotic patients can be helped by acquiring some understanding of the nature of psychotic communication, and learning to think about schizoid and schizophrenic thinking could be regarded as a most important activity. It requires a hospital milieu where there is an interest in psychodynamics, staff who are actually wanting to undertake psychotherapeutic work with psychotic patients, and opportunity for supervision and discussion. Appropriate theoretical concepts are essential, and those of Klein and Bion are particularly helpful.

The author describes experience of such work in hospital settings in Scandinavia. All those participating learned how to begin to think about schizoid thinking, and to understand the nature of psychotic communication in greater depth. Ward staff appreciated the approach, and psychotherapists improved their skills, learning of the dangers of poor work with inappropriate patients, and of the benefit of careful work within a properly supportive context. Many patients who would not normally have been regarded as suitable for psychotherapy have been helped by this approach.