Notes: The World of a Schizophrenic Woman

Hilda was a twenty-nine-year-old, white female, diagnosed as “chronic undifferentiated schizophrenia.” I shall describe the course of her treatment during her third state-hospitalization.

I first met her in an admission ward's patient meeting. She was asking questions about her anxiety and her unconscious. Obviously familiar with psychiatric terminology and keenly able to penetrate the facades of others, she proceeded to create quite a widespread negative reaction to herself. She was given thorazine and other medications, situational therapies, periods of intensive group therapy, and she had two interviews a week with me for four-and-a-half months.

Prior to this current hospitalization she had been unemployed; had “floated around and almost starved.” Her relationships with females were negative and hostile; with men, always rather “shady, mistress types of things.” She expressed feelings of failure, inadequacy, anger and dread. She was loud, boisterous, brutally frank and blistering to anyone who “crossed” her.

I became rather close to Hilda and the eight other patients who considered themselves the therapy group. Out of several subjects that Hilda discussed, there seemed to emerge a pattern, and I became interested in what it was she was trying to convey to me. She seemed to have a different conception and experiencing of time (hopelessly entangled in the past) and of social space (tremendous gaps between individuals). Quite often she would describe her feelings of “hopelessness,” “emptiness,” “the void,” and a general kind of despair and futurelessness.

The questions that interested me most were: What was her world? What was she to herself? I decided to attempt to meet her in her world, hoping to achieve some understanding of her—she had had the gamut of traditional types of treatment. I knew that I would have to encounter her where she was before she would be able to accept me as a helping person, who was—in essence—criticizing her way of