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Bornstein, M. Gonzalez, R. (1983). Epilogue. Psychoanal. Inq., 3(1):177.

(1983). Psychoanalytic Inquiry, 3(1):177

Epilogue Related Papers

Melvin Bornstein, M.D. and Raphael Gonzalez, M.D.

Upon reading the commentaries we see an agreement with Pao's formulation of a nature-nurture interaction resulting in experiences leading to schizophrenia and the panic of self fragmentation leading to schizophrenic symptoms. The commentaries also testify to the value of bringing to bear the metapsychological viewpoints of psychoanalysis in an effort to understand schizophrenia and to respond therapeutically to the schizophrenic patient. The either-or framing of the debate regarding conflict versus deficit theory in schizophrenia of previous years in these essays seems to have become transformed to a question of degree: whether the schizophrenic process is instigated by a deficit that results in conflict and a schizophrenic adaptation, or whether the conflict aggravates a deficit resulting in a schizophrenic adaptation.

Qualitatively similar if not identical to classical analysis are the fundamental issues that influence the psychotherapeutic technique of schizophrenia: the fear of attachment, the avoidance of fragmentation of the ego and self organization, establishing a therapeutic alliance, and the use of empathy. Further investigation of these issues with an emphasis on their relevance to classical technique may prove valuable in developing a deeper understanding of the therapeutic interaction. Finally, the papers as a whole, highlight the necessity of continuing to investigate the pharmacological-biological, and psychoanalytic study of schizophrenia.

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