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Deutsch, H. Roazen, P. (1985). A Case that throws light on the Mechanism of Regression in Schizophrenia. Psychoanal. Rev., 72(1):1-8.

(1985). Psychoanalytic Review, 72(1):1-8

A Case that throws light on the Mechanism of Regression in Schizophrenia

Helene Deutsch and Paul Roazen, Ph.D.


Pre-Freudian psychiatry has often been underrated. R. D. Laing (1965, pp. 29-31), for example, has taken one of Emil Kraepelin's textbook illustrations to show how the patient could be understood as making subtle fun of even the greatest of old—fashioned psychiatrists. But it is easy to overlook the achievement of classical psychiatry in encouraging case histories which are ample enough to allow for such later self—correction. By now the pendulum has swung so far that throughout the literature individual patients tend to get lost in abstract speculation.

In 1919, when she first published “A Case That Throws Light on the Mechanism of Regression in Schizophrenia,” Helene Deutsch was a newcomer to Freud's circle. This was her first paper published in a psychoanalytic journal. She was combining her psychiatric training, under both julius Wagner von jauregg (who, in 1927, became the first and only psychiatrist ever to win a Nobel Prize) in Vienna and Kraepelin in Munich, with psychoanalytic concepts based on the examination of neurosis, in order to describe a psychosis. Although Freud had himself been standoffish about the treatment of psychosis, some of his adherents wanted to follow his example in using his principles to understand the phenomenon of schizophrenia.

In this paper Helene Deutsch was trying to show, by means of a concrete case of a patient who had been blind since her second or third year of life, the correctness of some of Freud's fundamental ideas. Her account was one of the earliest attempts to understand delusions psychologically. She followed the psychoanalytic psychiatrist Victor Tausk's lead about the role of ego boundaries in schizophrenia, and how inner feelings can be projected onto the outside world; he cited her clinical material in his famous “influencing machine” paper (Tausk, 1948). The patient's dreams of sight are interpreted by Helene Deutsch both as a response to living for the first time in a psychiatric hospital, as well as a regression back to earliest childhood.


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