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Stierlin, H. (1974). Psychoanalytic Approaches to Schizophrenia in the Light of a Family Model. Int. R. Psycho-Anal., 1:169-178.

(1974). International Review of Psycho-Analysis, 1:169-178

Psychoanalytic Approaches to Schizophrenia in the Light of a Family Model

Helm Stierlin


So far, no generally accepted family theory of schizophrenia seems in sight. Rather, we find competing viewpoints whose therapeutic implications differ. In this paper, I shall take up one of these viewpoints, trace some of its therapeutic implications, and compare it with psychoanalytic approaches to schizophrenia.

This family viewpoint, more than other such viewpoints, is shaped by psychoanalytic considerations but, in a strict sense, is not psychoanalytic. For psychoanalytic theory and practice grow out of the special analytic situation, delineated by Freud, which obtains between analyst and analysand. Family theory and practice grow out of a differing situation—that obtaining between therapist(s) and family. This situation, like any other, reveals certain data while it conceals others; for example, it reveals typically recurrent multi-person transactions while it conceals—or at least makes less visible—certain offshoots from the unconscious (e.g. dreams, fantasies, subtle perceptual transference distortions, etc.)—on which psychoanalysis focuses. Out of these differing situations with their differing observational frameworks and hence differing primary data, evolve the differing concepts and theories of the psychoanalytic and family approaches.

Despite—and to some extent because of—these differences, the two approaches can crossilluminate issues that are central to both. The nature and treatment of schizophrenia is one such issue.

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