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November 1955

A Mechanism in Schizophrenia: A Theoretical Formulation

Author Affiliations

Ann Arbor, Mich.

From the Neuropsychiatric Institute.

AMA Arch NeurPsych. 1955;74(5):544-555. doi:10.1001/archneurpsyc.1955.02330170078014

Ever since dementia praecox was first described by Kraepelin numerous theories have been proposed to explain its pathogenic mechanisms. These theories have varied widely in their conceptions and approach, but as yet no completely satisfactory solution to the problem has been found. Certainly the often-repeated and too-often-taught formulation, that schizophrenia represents a defensive withdrawal from reality in order to avoid the anxiety arising from the patient's neurotic conflicts, leaves something to be desired. For to consider schizophrenia as akin to severe neurosis fails to convey what every psychiatrist must at some time have perceived in his patients: their feelings of chaotic experience, of utter helplessness, of being unable to control their reactions or carry out intention, the feeling of having undergone some terrible, indescribable alteration which reaches somehow into the depths of the personality.

The impression that schizophrenics experience an inner dissolution of their integrative capacities leads one naturally to

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