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A psychodynamic view of pseudoneurotic schizophrenia
4"76
A .~I 1:;141(L t X I'.S.'Y(71l f J ' l i k ' l ' l l f l l X ) ( ; l ( "AL ,~lgS()Clh'l'lO.\"
A P s y e h o d ) ' n a n i i e V i e w of P s e u d o n e u .relic S c h i z o p h r e n i a Ja.',~i::s
p.
M . I ) . , ()oh*..t!'.M
(:A'l-rv:l.i.,
(.:nit:~,r,vilt/ l l o e h ct al. tiave d e s c r i b e d otir COlic e p t +it: iii]lereltt d~'tici~-ltc'v ~lf ilitegr;itixt~ capat'ilv ill tlit~ p ~ l t e l i l i a l l v ps('lldOlll--llroll{: s c i i i z o p i l r e l i i t " p¢,rsoil. T h i s defteielicv, i i l t e r a e t i i ~ w i t h d i s t o r t e d e~lvirolm~mital o p p o r t u l i i t y , c a n | m m a n i f e s t e d as prirriar.v d i l l | C a ] s)'r~lptonas of tills svli(.|l't)llll[.~: disorders of t h i t i k i l i g , ~3' " " t'ill~)tiOilal l'e~ l],itlOil ~ilid ,~;elisotilllOtOl'a lltolltitilli(- fltliCtil)liillg. As ilit(,I'llliI i l l ] d ('x tel'li;i ! s i i l I l t i i a t/i)ll ])ec()llle 11ll)l'e {.'f)! t1})1 (£,x, t]ie i r i d i v i d l i a l al'l'iVC'S ;t{ distorted eciliC:fc~pts ()f" s e l f a l i d w o r l d .... l e a d i n g lo ; l b l i O t ' l l i i t l patteriis (if t ) e h a \ ' i o r . These, in tl.irll, elicit r e a c t | o i l s fl'¢/lll the C,liVil'Oltlllellt t h a i f l l r l h e r ] i n | i t opt)err u i l i t)'. These l'everlieratilig i n t e r a c t i o n s lead tO elllergellC't2 o f s e e o l l d a r v e i i r i i e a ] s y n / p t o l l l a t i ):i o .~<,. v pali-ailXii,lv,., p:t11-11eiir~)sis a l l d c h a o t i c sexllaiiitv, C ] i l i i e a ] i l l u s t r a t i ~ ) n s w i l l illso a l h i d e to t r e a t a b i l i t y .
Schizol)hrenie Cognition SILvANo AItIETI,
M.D.,
New
}.'ork
3lerdical College S c h i z o p h r e n i a h a s r e c e n t l y b e e n int e r p r e t e d as it r e s u l t of ; l b n o r m a I i n t r a f m n i l v t~syehodvilamic:s. E v e n t h e c o g u i t i r e d i s o r d e r s of t h e s e l ; i z o p h r e n i c h a v e b e e n i n l e r p r e t e d as t h e r e s u l t of a b n o r lrtal COlilUlilllicalioii ( B a t e s o n ) or as direct t r a n s m i s s i o n of i r r a t i o n a l i t y f r o m t h e parerits ( L i d z , V~.'ynne, e t c . ) . A l t h o u g h i n t e r p e r s o n a l factors u n d o u l l t e d l ) , play,, an i m p o r t a n t role in e l | c i t i n g t h e a n x i e t y w h i c h m a y read to s c h i z o p h r e n i a a n d ill d e p r i v i n g t h e p a t i e n t of a n t i s e h i z o p h r e n ic defenses, the present m i t h o r feels t h a t tills a p p r o a c h is onl)" it p a r t i a l one ill the understarldilag o f the s c h i z o p h r e n i c svlidl'f)lllt~ arid e s p e c i a l l y of s c h i z o p h r e n i c cognition. S c h i z o p h r e n i c c o g n i t i o n is v i e w e d as t h e r e e m e r g e n c e , in p a r l i c u l a r d i s t r e s s f u l
situatioi~s. ,ff c ~ g n i t i v e m o d e s of o r g a n / z a l i o n w h i c i i exist ii~ e v e r y h u m a n b~*iiJg i~ a state {~f p o t e n t i a l | l ) . Ttlis i n : m a t u r e c'oKliitive olr~r;iliiZ;.ttiOll i l l s its m v n laws. iill(] c'}larac,teristic's a i i d reI)r~>duc'es tqir]v st ~i~'s. wltic'ti tic:('| i r ilt C'v t-l-V not'ilia| t/l~>ligllt o r i ) O r t ' e p t u a ] proet,ss. ",vitliolil I)t, ill~ a c c ' l ) l i i p a l l i e d |)\' :F%VaIl't'l leSS. Ill tilt'st" stag¢.s ]):lrl-l)cwC'el)tioti illld a p p r t ' il~'llSiOti o f FJ;il'tia] (l~l" p r e d i c a t i v e ) s i n t i i zii'ilv l e a d t
of view.
S o m e Q u a l i t i e s o f t h e Visu.'tl l l a l l u e i n a tions of S c l a i z o p h r e n i a
l ) a v l D A. lqutcsKl-:, M . I ) . arid \\"ILLIAM P. \\;~l.sox, ~1.I)., 13ttkc" Urii-
co'ratty St,vcra] fiivestigators }rove prese,~ted t h e artistic r e e r e a t i o i l of tile /uilhieiliatiolis of a f e w s e l , i z o p l i r c n i e s . T h e g e o i n e t r v auld o t h e r c h a r a c t e r i s t i c s of false p e r c e p t i o n s h a v e b e e n n e g l e c t e d in tim lil(.'ratllre. T h e r e f o r e t h e visual h a l l u e i n a lions ~t: fifty, p a t i e n t s w i t h a c u t e a n d ehronic, sc'hizop/trenia w e r e s t u d i e d for t h e f o l l o w i n g factors: c h m l t i o n , t i m e of occurrence, rehlih~ to o l h e r types, colors. (lllalities of o b j e c t s , m o v e m e n t . sI)atial r e l a t i o n s h i p s , a n d o t h e r faetors. O n e - i l a l f or o v e r o c c u r r e d d u r i n g t | l e d a y a n d n i g h t . Nlost w e r e ill cMor, t h r e e d i m e n s i o l m l , n o r m a | in size, n n d s e e m e d to b e real a n d c o m p l e t e . Sixty p e r c e n t w e r e signifieattt a n d f r i g h t e n i n g alid were mobile. Understanding the Adaptive Struggles of Schizophrenic Patients. A ~[ethodologiell Study SAN'DOll I~.,%DO, NI.[)., School of Psych iatry
Note:
York
T o g r a s p - t h e rmtln-e of s c h i z o p h r e n i a . t h e i n v e s t i g a t o r n-Itlst f i r s t l e a r n to u n d e r -
A .~I 1:;141(L t X I'.S.'Y(71l f J ' l i k ' l ' l l f l l X ) ( ; l ( "AL ,~lgS()Clh'l'lO.\"
A P s y e h o d ) ' n a n i i e V i e w of P s e u d o n e u .relic S c h i z o p h r e n i a Ja.',~i::s
p.
M . I ) . , ()oh*..t!'.M
(:A'l-rv:l.i.,
(.:nit:~,r,vilt/ l l o e h ct al. tiave d e s c r i b e d otir COlic e p t +it: iii]lereltt d~'tici~-ltc'v ~lf ilitegr;itixt~ capat'ilv ill tlit~ p ~ l t e l i l i a l l v ps('lldOlll--llroll{: s c i i i z o p i l r e l i i t " p¢,rsoil. T h i s defteielicv, i i l t e r a e t i i ~ w i t h d i s t o r t e d e~lvirolm~mital o p p o r t u l i i t y , c a n | m m a n i f e s t e d as prirriar.v d i l l | C a ] s)'r~lptonas of tills svli(.|l't)llll[.~: disorders of t h i t i k i l i g , ~3' " " t'ill~)tiOilal l'e~ l],itlOil ~ilid ,~;elisotilllOtOl'a lltolltitilli(- fltliCtil)liillg. As ilit(,I'llliI i l l ] d ('x tel'li;i ! s i i l I l t i i a t/i)ll ])ec()llle 11ll)l'e {.'f)! t1})1 (£,x, t]ie i r i d i v i d l i a l al'l'iVC'S ;t{ distorted eciliC:fc~pts ()f" s e l f a l i d w o r l d .... l e a d i n g lo ; l b l i O t ' l l i i t l patteriis (if t ) e h a \ ' i o r . These, in tl.irll, elicit r e a c t | o i l s fl'¢/lll the C,liVil'Oltlllellt t h a i f l l r l h e r ] i n | i t opt)err u i l i t)'. These l'everlieratilig i n t e r a c t i o n s lead tO elllergellC't2 o f s e e o l l d a r v e i i r i i e a ] s y n / p t o l l l a t i ):i o .~<,. v pali-ailXii,lv,., p:t11-11eiir~)sis a l l d c h a o t i c sexllaiiitv, C ] i l i i e a ] i l l u s t r a t i ~ ) n s w i l l illso a l h i d e to t r e a t a b i l i t y .
Schizol)hrenie Cognition SILvANo AItIETI,
M.D.,
New
}.'ork
3lerdical College S c h i z o p h r e n i a h a s r e c e n t l y b e e n int e r p r e t e d as it r e s u l t of ; l b n o r m a I i n t r a f m n i l v t~syehodvilamic:s. E v e n t h e c o g u i t i r e d i s o r d e r s of t h e s e l ; i z o p h r e n i c h a v e b e e n i n l e r p r e t e d as t h e r e s u l t of a b n o r lrtal COlilUlilllicalioii ( B a t e s o n ) or as direct t r a n s m i s s i o n of i r r a t i o n a l i t y f r o m t h e parerits ( L i d z , V~.'ynne, e t c . ) . A l t h o u g h i n t e r p e r s o n a l factors u n d o u l l t e d l ) , play,, an i m p o r t a n t role in e l | c i t i n g t h e a n x i e t y w h i c h m a y read to s c h i z o p h r e n i a a n d ill d e p r i v i n g t h e p a t i e n t of a n t i s e h i z o p h r e n ic defenses, the present m i t h o r feels t h a t tills a p p r o a c h is onl)" it p a r t i a l one ill the understarldilag o f the s c h i z o p h r e n i c svlidl'f)lllt~ arid e s p e c i a l l y of s c h i z o p h r e n i c cognition. S c h i z o p h r e n i c c o g n i t i o n is v i e w e d as t h e r e e m e r g e n c e , in p a r l i c u l a r d i s t r e s s f u l
situatioi~s. ,ff c ~ g n i t i v e m o d e s of o r g a n / z a l i o n w h i c i i exist ii~ e v e r y h u m a n b~*iiJg i~ a state {~f p o t e n t i a l | l ) . Ttlis i n : m a t u r e c'oKliitive olr~r;iliiZ;.ttiOll i l l s its m v n laws. iill(] c'}larac,teristic's a i i d reI)r~>duc'es tqir]v st ~i~'s. wltic'ti tic:('| i r ilt C'v t-l-V not'ilia| t/l~>ligllt o r i ) O r t ' e p t u a ] proet,ss. ",vitliolil I)t, ill~ a c c ' l ) l i i p a l l i e d |)\' :F%VaIl't'l leSS. Ill tilt'st" stag¢.s ]):lrl-l)cwC'el)tioti illld a p p r t ' il~'llSiOti o f FJ;il'tia] (l~l" p r e d i c a t i v e ) s i n t i i zii'ilv l e a d t
of view.
S o m e Q u a l i t i e s o f t h e Visu.'tl l l a l l u e i n a tions of S c l a i z o p h r e n i a
l ) a v l D A. lqutcsKl-:, M . I ) . arid \\"ILLIAM P. \\;~l.sox, ~1.I)., 13ttkc" Urii-
co'ratty St,vcra] fiivestigators }rove prese,~ted t h e artistic r e e r e a t i o i l of tile /uilhieiliatiolis of a f e w s e l , i z o p l i r c n i e s . T h e g e o i n e t r v auld o t h e r c h a r a c t e r i s t i c s of false p e r c e p t i o n s h a v e b e e n n e g l e c t e d in tim lil(.'ratllre. T h e r e f o r e t h e visual h a l l u e i n a lions ~t: fifty, p a t i e n t s w i t h a c u t e a n d ehronic, sc'hizop/trenia w e r e s t u d i e d for t h e f o l l o w i n g factors: c h m l t i o n , t i m e of occurrence, rehlih~ to o l h e r types, colors. (lllalities of o b j e c t s , m o v e m e n t . sI)atial r e l a t i o n s h i p s , a n d o t h e r faetors. O n e - i l a l f or o v e r o c c u r r e d d u r i n g t | l e d a y a n d n i g h t . Nlost w e r e ill cMor, t h r e e d i m e n s i o l m l , n o r m a | in size, n n d s e e m e d to b e real a n d c o m p l e t e . Sixty p e r c e n t w e r e signifieattt a n d f r i g h t e n i n g alid were mobile. Understanding the Adaptive Struggles of Schizophrenic Patients. A ~[ethodologiell Study SAN'DOll I~.,%DO, NI.[)., School of Psych iatry
Note:
York
T o g r a s p - t h e rmtln-e of s c h i z o p h r e n i a . t h e i n v e s t i g a t o r n-Itlst f i r s t l e a r n to u n d e r -