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Aarons, Z.A. (1951). Some Aspects of Theory and Treatment of Schizophrenia. Psychoanal. Rev., 38(2):113-126.

(1951). Psychoanalytic Review, 38(2):113-126

Some Aspects of Theory and Treatment of Schizophrenia

Z. Alexander Aarons, M.D.

The theory applicable to the treatment of schizophrenia stresses faulty ego development during the preoedipal period of infancy, especially during that phase of the infant's development when the distinction between self and outer-world is in the making. This is a crucial time in the life of an infant because it seems that this is the time frustration and deprivation are first encountered. This is the time the wish for the mother's breast is not always coincident with the satisfaction of that wish; and it is the time the infant's dependency upon mother is greatest, and it is most susceptible to feelings of helplessness. We have reason to believe that if the infant feels too much frustration in its quest for the object that will satisfy his oral need, the basis for anxiety is laid. If added to this primeval frustration the infant is made to feel unprotected and helpless in its contacts with the animate and inanimate objects in its environment, there may develop a reluctance to venture forth into relationships with the outer world because these first attempts were too painful. The formation of the ego begins, as Freud says, when the infant first makes the distinction between itself and the objects outside. If this exploratory process is impeded by attendant frustration and pain, the tendency will be to recoil from contacts with things, and thus perhaps the archaic pattern is laid for all further withdrawal from relationships with people and objects.

The dependency upon mother, as we know, may make either for security or insecurity in the feelings of the infant. If the mother accepts the dependency needs of the infant, and if the infant feels protected by mother, instead of a fear of helplessness, the infant acquires a feeling of strength. It is not fearful of objects; it is outgoing towards people and assertive in its demands. It has in its dependency upon mother a secure base from which to explore and experiment with the outer world. It is also able to bear frustrations because its basic needs are satisfied. In early infancy, of course, there is no clear distinction between physical and emotional needs.

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