Contributions to the Etiology of Schizonphrenia

As regards the origin of neurosis and psychosis Freud set forth the so-called completion series “Ergänzungsreihen” which comprised dispositional causes as well as accidental experience factors producing the disorders. The term “disposition” refers partly to the fate of the libido, its developmental trends, disturbances and fixations in certain stages biogenetically determined by prehistoric experiences,1 partly to infantile experiences which may lead to new fixations, or strengthen old ones that have already been constitutionally established, producing thereby what we may term acquired dispositions. The infantile experience elements of the disposition and the accidental experiences constitute a new completion series.

Here we disregard the dispositional part of the etiology of schizophrenia; not because we think it unimportant, but because we are aware that our present knowledge of the dispositional causes is rather scarce and vague. In our analytical research and therapeutic work dispositional factors mark the physiological borderline that, with the means at our disposal, we can hardly approach, let alone alter in any way.

Concerning the mental etiology of schizophrenia we have but few data. In his paper on libidinal types Freud asserts that the narcissistic type is inclined to this psychosis. This would mean that the libido fixation underlying the inclination should occur in a stage when no object choice has yet been reached, that is, in the earliest oral stage.2 Based on my clinical observations I now attempt to show that this fixation alone is not the cause of schizophrenia, and that traumatic infantile experiences additional to the existing disposition play a great part and determine the main trends in the development of the schizophrenic personality.

A formulation of the difference between neurosis and psychosis was given by Freud. According to him a neurosis mainly involves