Freud’s Conflict with Schizophrenia and its Working Through

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Length: 30 minutes


Orna Ophir, PhD

In this paper, I will suggest that Freud’s theories of schizophrenia were partially based on his efforts to professionalize psychoanalysis. Since from its very beginning psychoanalysis did not gain a position of an independent academic discipline, Freud and his followers had to use professionalization strategies in order to convince the public, medical doctors, and laymen of the historical and epistemological necessity of psychoanalysis and of the need for its psychotherapeutic praxis. In the context of his jurisdictional struggles with psychiatry, Freud created two competing theories of schizophrenia: the unitary theory and the specific theory, the first seeing schizophrenia as only quantitatively different from neurosis and the latter seeing it as qualitatively different and thus unsuitable for psychoanalytic therapy. In his attempt to prove psychoanalysis’ supremacy over psychiatry, Freud aspired to supply psychoanalysis with a theoretical explanation of all human behavior and to offer a cure for all mental diseases. With this in mind he was preoccupied with formulating a theory for schizophrenia, but since he feared that schizophrenic patients were immune against a technique that sought to establish the “ego where id was,” he could not afford them to spoil psychoanalysis’ initial success as a therapeutic method compared to psychiatric approaches. Though his explicit statement was that schizophrenics were not analyzable, research has shown that Freud did actually analyze psychotic patients.

In the paper, I will argue that when Freud became more realistic about psychoanalysis, he gradually also became more optimistic about the analyzability of schizophrenic patients and even supported, notably through his correspondence with Ernst Simmel, the first psychoanalytic sanitarium for psychiatric patients, which was the inspiration for such institutions as the Meninger Clinic, Austin Riggs, and Chestnut Lodge, in the USA.

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