Some Observations on the Nature and Value of Psychotherapy with Schizophrenic Patients

  • Stephen Fleck


Medical practitioners, meaning physicians during the scientific era as much as during the prescientific millennia, have always drawn inferences from more or less impressionistic therapeutic effects upon the nature of causation or etiology. Equally often, an etiological theory, once formulated, has led to therapeutic prescription, or even, in the case of schizophrenia, to therapeutic nihilism. The history of the treatment of schizophrenics is replete with enthusiastic therapeutic endeavors, sometimes based on very erroneous premises, such as the alleged mutual exclusion of epilepsy and schizophrenia, which led to convulsive treatments, therapies which then led to other etiological credos.1–4 Psychotherapy, effective as it can be with schizophrenics, is no exception to such post hoc propter hoc etiological hypothesizing. We know that the pathogenic mechanisms in psychological development and in familial behaviors which we can identify during psychotherapeutic work are basic, but we do not know if they are the only, sine qua non etiological factors. They, or some chromosomal aberration, may or may not be the first level in a spiral of abnormalities, but this is as uncertain as is the position or role of abnormal dopamine activity in such a developmental spiral culminating in schizophrenic manifestations.


Schizophrenic Patient Object Constancy Neurotic Disorder Therapeutic Nihilism Convulsive Treatment 
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Copyright information

© Plenum Publishing Corporation 1980

Authors and Affiliations

  • Stephen Fleck
    • 1
  1. 1.Department of Psychiatry, School of MedicineYale UniversityNew HavenUSA

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