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Appel, G. (1974). An Approach to the Treatment of Schizoid Phenomena. Psychoanal. Rev., 61(1):99-113.

(1974). Psychoanalytic Review, 61(1):99-113

An Approach to the Treatment of Schizoid Phenomena

Gerald Appel

Therapists, within their clinical experience, appear to be encountering in increasing numbers patients exhibiting schizoid symptomatology. Alienated young people, drug users, certain marital couples, persons with irregular work histories, hyperintellectuals—all may manifest the characteristic syndrome of the schizoid experience. This syndrome has become a major therapeutic challenge of our time, because of the increase in the number of schizoid persons seeking help, their propensity to use drugs, and the complexities of treating them.

The Schizoid Personality

Beneath the nihilism of the dropout, his rationalizations for drug use, and his intellectual sophism is an inability to make and sustain commitments, an in and out quality to his relationships, a lack of attachments and interests, and a basic apathy toward life. Once engaged in treatment, the schizoid person gradually acknowledges his fears of closeness, yet his panic in the face of aloneness. His identity and definition of self appear confused; he defines himself by possessions, his group, others' opinions, or frequently his own oppositional stubbornness and self-proclaimed independence. Under emotional stress, his veneers and defenses often appear fragile, his rage goes out of control, and he may develop primary process thinking, sometimes accompanied by psychoticlike productions. The schizoid's views of himself are revealed in his self-descriptions—”apathetic,” “uninvolved,” “small,” “an observer of life,” “empty,” and “crazy.”

He

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