Psychoanalysis and schizophrenia: a cautionary tale

The history of psychoanalysis and schizophrenia is used as an example of psychoanalytic theories of etiology that have not stood the test of time. Those theories pointed to three main factors: very serious inadequacies in the caretaking person; the presence of these inadequacies so early, during the preverbal period, that they led to the impairment of early object relations, the development of psychic structure, and basic ego functions; and the absence of underlying biological abnormalities. Today, many analysts are still reluctant to acknowledge biological etiological factors for other psychiatric conditions. For illnesses such as borderline conditions and various severe character disorders for which biological factors are still much in doubt, analysts are today proposing etiological formulations similar to those once advanced for schizophrenia. These formulations may indeed prove correct for these disturbances, but analysts are urged to heed the cautionary tale of psychoanalysis and schizophrenia.