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.

We shall now study schizophrenia from the point of view of its progression, meaning progression toward regression.

This chapter discusses primary prevention aimed at lowering the incidence (or making less probable the onset) of psychiatric disorders.

1. Basic prevention, which aims at the elimination of those items that increase potentiality or increase the vulnerability for the disorder.

2. Longitudinal prevention, which aims at assisting the individual throughout his life to avoid those developments that will enhance actualization of schizophrenia.

3. Critical prevention, which aims at avoiding those factors or specific events that will precipitate an attack or onset of schizophrenia.

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.