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Recently in working with patients in a hospital setting (Central Islip State Hospital*) I had the opportunity to employ, with rather encouraging results, the modified psychoanalytic therapy that has been recommended in the literature for schizophrenic patients.16,17 The new procedure retains the aims and structure of the classical psychoanalytic relationship (in which the patient free associates on the couch) but requires that the analyst modify his interventions in a way designed to promote the development of a transference relationship—a goal which Freud had concluded was impossible to achieve with schizophrenic and other narcissistic patients. In broadest terms the modifications consist of:
(1) the analyst “joining” (supporting) the resistances the patient presents to the therapeutic situation rather than responding to them with the usual analytic interpretations;
(2) deliberate use by the analyst of non-verbal modes of communication with the patient in contrast to the strictly verbal, intellectual interventions traditionally employed in psychoanalyic procedure.
The nonverbal manner of communication reflects the schizophrenic's own mode of expressing himself and, together with the technique of joining the resistance, enables the analyst to gradually train the patient to discharge, via mature verbalization, the intense feelings