Violent behavior in chronic schizophrenia and inpatient psychiatry

The author describes how work with inpatients with chronic schizophrenia has contributed to a better understanding of antisocial behavior. She has used the concept of regression, along biological and psychological lines, to hypothesize fantasies of primitive object relationships which drive the behavior. Engaging patients in thoughtful reflection, she has introduced a third perspective on the potential state of mind of the important people in their lives; the possibility of a concerned object, rather than that of a vengeful or rejecting object. Finding that even those with resistant schizophrenia respond with change in behavior, she found that she could more easily employ the same psychoanalytic concepts in engaging those who present with more acute problems of violent and suicidal behavior.