A psychosocial orientation to schizophrenic disorders

The address considers the regression that has taken place in American psychiatry during the second half of this century, one which has resulted from attempts to locate the origins of many psychiatric disorders in the brain, and particularly from the misguided attempt to revitalize the nineteenth-century conviction that schizophrenia is a clear-cut disease entity that is chronic and incurable. The orientation has again become self-fulfilling because of the relative neglect of psychosocial therapies. A basic reason for the regression lies in a misunderstanding of the nature of human adaptation that rests greatly on the capacities for language, which has led to the need for children to acquire a culture in order to survive and become integrated individuals-an acquisition that depends largely on the parental persons, and inevitably creates some emotional conflicts and adaptive shortcomings; and, when extreme, leads to the escape into a fantasy life and a breaking through confines imposed by the meaning system and logic of the culture that we term schizophrenia.