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Rosenfeld, H. (1954). Considerations Regarding the Psycho-Analytic Approach to Acute and Chronic Schizophrenia. Int. J. Psycho-Anal., 35:135-140.

(1954). International Journal of Psycho-Analysis, 35:135-140

Considerations Regarding the Psycho-Analytic Approach to Acute and Chronic Schizophrenia

Herbert Rosenfeld


The aim of this paper is to illustrate that in the analysis of acute and chronic schizophrenics the psychotic manifestations attach themselves to the transference and a transference-psychosis develops. The relevant transference phenomena can be interpreted to the patient and his response to interpretations can often be clearly observed.

At this state of our research we shall not overestimate the therapeutic possibilities of psycho-analysis in severe acute and chronic schizophrenic conditions, because the analysis, particularly of acute schizophrenia, however promising, is a very difficult and strenuous task and the management also still presents almost unsurmountable difficulties. At present therefore we can only hope to be successful in a minority of cases. However, this does not invalidate the psycho-analytic approach. Every acute or chronic schizophrenic patient, even if he is being treated for a short time only, enriches our understanding of the psychopathology and makes the analysis of subsequent patients easier.

I have discussed the many difficulties which we encounter in this work. But we should remember that there are acute and chronic schizophrenic patients who respond more easily to our analytic approach. They gain insight, co-operate in the analysis and seem to improve from the beginning. In these cases there seems to be a part of the personality not completely involved in the psychosis. So in spite of their severe psychotic manifestations they do not completely lose touch with reality once the analysis is going ahead. The information gained from these less difficult schizophrenic patients has been of great value in understanding the more serious ones; for we need a great deal of knowledge of the psychopathology in order to gain access, for instance, to a silent schizophrenic patient, or in order to understand and utilize the sometimes very scanty information which some schizophrenics are able to give us.

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