The psychodynamic study of these cases is hindered by several difficulties. The first is the rarity of these cases. Whereas in the past catatonic patients were quite numerous, now they have drastically diminished in number. The second difficulty lies in the manifest symptomatology, which lends itself to a psychodynamic study much less than do other types of schizophrenia.

The case of a patient suffering from schizophrenia manifesting as a syndrome in which the paranoid defenses failed to arrest the process, which proceeded toward a rapid regression will be illustrated.

Postpartum schizophrenic and schizophrenic-like psychoses must be considered in a larger frame of reference that includes all psychiatric conditions occurring after childbirth. The relations between pregnancy-labor-puerperium and the occasional occurrence of psychiatric conditions must be investigated.

This chapter presents a general description of schizophrenia, and then discusses the various types.

In this chapter we discuss patients in whom a slow psychodynamic development that appeared directed toward a schizophrenic outcome was diverted, arrested, or slowed down.

The competency of the psychiatrist is often measured by his ability to rule out from the classification schizophrenia many patients who present a schizophrenic-like symptomatology. Although no one can be absolutely sure what course a given patient will follow, a certain group of symptoms and factors tend to occur more frequently in patients who recover; on the other hand, other symptoms and factors tend to occur in patients with a poor outcome.

In this part of the book we shall examine the mechanisms with which the patient attempts to envision life in a less frightening manner.

A psychodynamic understanding of any human being and, in our particular case, of a person who will eventually suffer from schizophrenia, requires that we study the following:

1. The world which the child meets.

2. The child’s way of experiencing that world, especially in its interpersonal aspects.

3. The way the child internalizes that world and the effects of such internalization.

4. The ways by which the sequence of later experiences weaken, reinforce, distort, neutralize, expand, or restrict the effects of the early experiences.