You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The following views on the problem of anxiety in schizophrenia are drawn from my therapeutic work with the deep psychoses. My intention here is to encourage a practical, as opposed to, say, a merely theoretical, interest in the immense suffering in schizophrenia with a hope that such an interest will lead us closer to the therapeutic possibility of offering psychotic patients a decent measure of relief.
Reviewing the literature on anxiety in schizophrenia, I came across a panel discussion held almost a decade ago.* The panelists, some of them leaders in the treatment of schizophrenia, were theorizing on the origin of the anxiety that was so universally found in schizophrenic patients. All of them being clinicians, they rightfully thought that if they could elicit a single dynamic concept for the origin of their patients’ anxiety, which was the cause underlying the symptomatology, this concept would lead to more successful therapy. Although most agreed that the schizophrenic's symptomatology was an expression of anxiety as well as the defenses against it, marked disagreement remained as to why the anxiety existed in the first place.
One panelist said that it was because of the patient's latent hostility; another because of fear of separation; still another the widespread diffusion of libidinal feelings. A sense of loneliness because of the inability to communicate was also mentioned. My personal belief is that all that was said is essentially true, but that no patient would benefit to the maximum, therapeutically, unless a more basic