Physical therapies of schizophrenia are not as frequent as they used to be. However, because they remain in the therapeutic armamentarium of many psychiatrists, a brief description of them and a critical discussion of their use is presented.

Three syndromes that are briefly illustrated in this chapter (paranoia, anorexia nervosa, and childhood schizophrenia) are probably related to schizophrenia.

In the presence of a schizophrenic disorder the therapist’s first duty is to choose the type of treatment. Each therapist must learn to counterbalance his own biases in order to evaluate properly each individual case.

The concept of schizophrenia is useful and should be retained when applied to a particular psychological dysfunction of the human being that manifests itself in many varieties. The disability is real, and in almost all cases painful and harmful. The dysfunction can therefore be included in the medical model, provided this model is enlarged to comprehend those biological functions that are called psychological and are partially related to the social environment.

No psychiatrist can ignore individual psychotherapy of schizophrenia, nor can he escape practicing psychotherapy with schizophrenics even if he is inclined to do so.

We have now come to the fourth, or last, stage of schizophrenia during which a new set of phenomena occurs. Some of the symptoms appear no longer as predominantly psychological but neurological. It seems as if the disorder has reached a level where psychology and neurology coalesce.

A summary of the progression of of schizophrenia from the first through fourth stages.

In the studies on the origins of schizophrenia, the constitutional, cardiovascular, endocrinological, and neuropathological researches have lost ground. On the other hand, the genetic, biochemical, and neurophysiological approaches have gained support.

A large number of researchers have carried out biochemical investigations of schizophrenia, pursuing the hypothesis that a biochemical or metabolic error is at the basis of the disorder.

We shall study separately gesture, action, and volition. By gesture we mean a motion of the body (or of parts of it) that expresses a special psychological state of the individual. By action we mean a purposeful or meaningful behavior, even if the purpose or meaning is not known to the subject. Volition is the process of choosing and of initiating, continuing, actualizing, interrupting, or terminating the chosen action. When we study volition, we refer to the process of choosing and putting into effect the action.