The Creation of Schizophrenia: An Integrated Psychodynamic Model and Treatment for Schizophrenia

Abstract

Throughout the history of psychoanalysis, theorists and clinicians have offered theories and treatment recommendations for treatment of schizophrenia, but a comprehensive review of the literature aimed at integrating these works has not been conducted. The author reviews salient works on theory and treatment of schizophrenia within psychoanalytic literature and offers a comprehensive model of schizophrenic psychodynamics and treatment recommendations based on this model. The comprehensive model includes 5 primary features and 10 secondary features of schizophrenic psychodynamics. The 5 primary features include: a dominant psychotic part of the mind, a narcissistic structure aimed at protection, a dysfunctional paranoid schizoid position, an inability to create and acquire a sufficient reality principle, and paleologic reasoning as the primary form of cognition. The 10 secondary features of schizophrenia include ego/mind/body disconnection, hallucinatory and delusional mechanisms, an archaic superego, a stunted emotional life, a unique experience of time and space, concrete thinking, concrete language, disturbed dependency, violence and suicide, and repair vs. reparation. Inpatient and outpatient recommendations for psychodynamic treatment of schizophrenia are offered based on this comprehensive psychodynamic model.