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October 1969

Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique.

Arch Gen Psychiatry. 1969;21(4):512. doi:10.1001/archpsyc.1969.01740220128019

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This is a concisely written, well-organized monograph whose roots lie in a series of lectures given by Dr. Spotnitz in 1962. Subsequent schematization of theory is presented here for the student-analyst and the psychoanalytic clinician. The book is "designed to serve as a theoretical guide to the management of ambulatory cases of schizophrenia." He holds that the etiology is multidetermined, a combination of constitutional and experiential factors with a probable biologically inherited predisposition, and that, prognostically, there is no evidence that the condition, whatever its etiology, "is not completely reversible."

Spotnitz modifies Freud's early position that schizophrenics manifest no transference; schizophrenics manifest "insufficient object transference" and manifest instead narcissistic transference, the result of "prefeelings or early ego states experienced in the first months of life before the infant differentiates self from non-self." Such undifferentiated feelings prevent the transfer of feelings that developed for significant objects later on; the goal

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