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Rosenfeld, H. (1950). Note on the Psychopathology of Confusional States in Chronic Schizophernias. Int. J. Psycho-Anal., 31:132-137.

(1950). International Journal of Psycho-Analysis, 31:132-137

Note on the Psychopathology of Confusional States in Chronic Schizophernias

Herbert Rosenfeld


During the last ten years I have been treating by psycho-analysis a number of schizophrenics, some of very long standing. My aim was not only to achieve a therapeutic result, but to find out more about the psychopathology of this disease group. To achieve this aim I adhered to the regular analytic situation and deviated as little as possible from the established technique employed in treating neurotics, because I felt, and still feel, that only thus may it be possible to increase our knowledge of the psychopathology of schizophrenia.

This paper deals with the psychopathology of confusional states which I was able to investigate during the analyses of chronic schizophrenic patients. Feelings of confusion are part of normal development and they are a common feature in many pathological conditions. But in the schizophrenic process severe states of confusion seem to play an important part; I also noticed that following the confusional state there was either an improvement or a deterioration in the condition of my patients.

I shall use material from one chronic paranoid schizophrenic patient to illustrate my points. He is a painter, forty years of age (in 1948), and a manifest homosexual. From 1933, he gradually developed delusions of reference and persecution. In 1946 he started psycho-analytical treatment with a male colleague, and soon felt much better. After three months sudden changes took place in his condition. He stopped treatment, and soon afterwards began to act as if he were a young homosexual prostitute.

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