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Pao, P. (1973). Notes on Freud's Theory of Schizophrenia. Int. J. Psycho-Anal., 54:469-476.

(1973). International Journal of Psycho-Analysis, 54:469-476

Notes on Freud's Theory of Schizophrenia

Ping-Nie Pao

SUMMARY

In this presentation I have attempted to summarize and evaluate Freud's contributions to the understanding of schizophrenic phenomenon. The contributions, covering a period of 40 years, can be divided into three phases: the first phase of the 1890s, the second phase beginning with the Schreber case of 1911 and the third phase following the publication of the structural theory. The second phase attempt was most comprehensive and may be called the 1911 theory which absorbed most of the concepts of the first phase. Many pertinent concepts of the third phase were scattered around and were not integrated into the 1911 theory.

In formulating the libido theory, Freud taught that it is the uniqueness of the human to establish cathexis of objects and to develop conflicts with the removal of the cathexis. He observed that neurosis or psychosis results from conflicts (i.e. when the need to cathect and the need to decathect are in opposition to each other) and that neurosis and psychosis are not different in terms of conflicts but in terms of the ego's capacity to deal with the conflicts. In 1911, when he attempted a theory for schizophrenia, he noted that he must take into consideration three factors, (1) continuousness of conflicts over the relation with the current object, (2) regression to the early developmental stage and (3) the structure of the ego. Hamstrung by lack of a definite concept of ego, as well as an insufficient knowledge of early object relations, he did what he could, i.e. leave a theory which is incomplete. In subsequent years he pursued the study of ego (also recommended the direct observation of child development). But, to the end of his life and work, he did not quite acquire a satisfactory understanding to the alteration of ego. Thus he was not able to reformulate his 1911 theory. Today psychoanalytic thinking has advanced on many fronts. We have learned a great deal about ego structure, about aggression, about defence and its relation to anxiety, about early object relations, about separation-individuation processes, about the concept of self, about the interlocking influence of disturbance of ego functions and object relationships, etc. If the advance is all what Freud himself would have intended and if he was asked to reformulate a theory of schizophrenia, what would it be like? My postulate is that he would be likely to make use of all the new knowledge and build his theory on the 1911 theory, which specifically depicted the continuity of the struggle of the opposite forces.

By today's standards, the 1911 theory cannot stand alone. The 1911 theory only tells that a ground is paved for the formation of symptoms; it does not really explain how and why the symptoms result. What Freud considered in 1911 an explanation for symptom formations is, in fact, really not an explanation. To explain how and why the various symptoms result we must add to it our knowledge of the structural theory, as exemplified by the work of Beres (1956), Arlow & Brenner (1964), (1969) and others.

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