Early psychoanalysis stressed that it could explain essential things about psychosis, in tact could explain why therapeutically nothing could be done. This may reflect a kind of tacit transaction: the psychiatric establishment can keep the psychotic, we only claim the neurotic patient. Freud's (1915) theory about schizophrenic thinking disorder (in the Unconscious) proved, agains organicists, that a purely psychological theory was possible.
Since the work of the Palo Alto group, a second and complementary psychological theory about the origin of thinking-disturbances exists. This reflects a growing concern with the family-point-of-view in schizophrenia.
Paradoxical communications, f.i. double-binds, have been held responsible for an array of very different conditions and phenomena, like schizophrenia, humour, hypnosis, alcoholism, psychotherapy. This lack of specificity is of ten held against it as an explication of schizophrenia. The author thinks this argument is not valid. He argues that thinking disturbances look exactly as one would expect if the use of metamessages is impaired. In the other conditions the victim of double bind situations reacts in some other way. In schizophrenia the disturbance corresponds so well with its causation that this in itself calls for an explanation. It is felt that a masochistic kind of over-adaptation with a vengeance (of the kind so well described by Berliner) is at the bottom of this. Patients of the author are quoted, who are obviously aware of their peculiar style of thinking. Also it is feit that schizophrenic utterances can be of ten understood and used to foster contact, if the probability is kept in mind that the patient refers to himself as a victim, a scapegoat, an object etc. Once he feels understood he can abandon the distorted way of expressing himself.
A case of family therapy with incipient schizophrenia in a girl of twenty-three is described. After eight sessions with the family a clinical remission was achieved. Thorazine had been of no avail; primary process thinking and delusions had been present. (Foudraine, a Dutch authority on schizophrenia-and-the-family gave advice).