The treatment of the schizophrenic cannot consist only of the sessions, but an active participation in his life is necessary, as many authors have reported. The patient needs to feel that many events in his life are shared by the therapist.

In this chapter Arieti reports the cases of two patients who have been treated with intensive and prolonged psychotherapy. The psychodynamics and the psychostructure of the symptomatology are interpreted, and the psychotherapeutic procedure is described in great detail.

In spite of the limitations of the social treatment of chronic schizophrenia, there seems to be no doubt that good social conditions and a spirit of therapeutic community are helpful.

This chapter deals with the major aspects of drug therapy in reference to schizophrenia only. The criteria for selecting drug therapy over other types of treatment or in conjunction with psychotherapy are discussed in The Choice of Treatment.

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.

The second, or advanced, stage of schizophrenia is reached when the symptoms seem crystallized, to have assumed a fixed and definite form.

I gave the name “preterminal” to a stage of schizophrenia that is rather difficult to delimit or to differentiate. This stage occurs generally from five to fifteen years after the beginning of the illness but may occur sooner or later. Particular attention will be given in this chapter to two habits that are the most common—the hoarding and the self-decorating habits.

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.