Schizophrenic thought

Summary

• 1. A case of dementia præcox of the paranoid type which has been studied through its entire course of about fifteen years. It demonstrates in an unusually clear manner the various mechanisms and the forces at play in this disorder. It occurs in a girl of 22 of good intelligence (I. Q. 134) and advanced power of description. Apparently no intellectual deterioration has occurred.

• 2. The influence of psychotherapy is indicated. As is frequently the result, psychotherapy in schizophrenia aggravates the condition by making the patient more acutely aware of the internal conflicts. Lacking the ability to cope with these conflicts, the schizophrenic cannot benefit by this interpretation and goes on to further ruminations in phantasy.

• 3. It is also interesting that after the above examination was made the patient went into a state of catatonic stupor for a week and became inaccessible for further examination. After this period the mutism disappeared and she became talkative again. She has shown no improvement and has been unable to resolve or sublimate her conflicts although she is acutely aware of their abnormality.

• 4. As might be expected from the tendency to adopt father surrogates or substitutes she has transferred her emotional objectives to the writer and has frankly expressed her strong sexual inclination to him.

• 5. In spite of her apparently well-preserved intelligence and personality it is felt that she will deteriorate unless some satisfactory external attachment or sublimation can be achieved.