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November 1958

Preadaptive Attitudes to Hallucinations in Schizophrenic Patients

AMA Arch NeurPsych. 1958;80(5):625-628. doi:10.1001/archneurpsyc.1958.02340110095016
Abstract

In this paper the initial reaction to hallucinations will be discussed. Other authors have alluded to this phenomenon and have shown an awareness of its existence but have not described it in detail. Both Federn and Freud recognized the period of onset. Federn1 stated that "there is always a struggle before the ego gives way," and Freud2 described mounting anxiety, which increased ego cathexis for the purpose of warding off oncoming danger. Sullivan3 apparently was aware of this state, and he described an uncanny feeling as a reaction to hallucinations. This study of a series of patients interviewed at the Syracuse Psychiatric Hospital reveals a fairly consistent pattern of reaction.

In the early state the most prominent elements are apprehensiveness and fright. These occur most frequently with the appearance of hallucinations but may occur with feelings of estrangement. The patient often attempts to reassure himself by trying

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