Schizophrenia is a disease of the brain, therefore it
is likely to parallel disease of other organs for example, myocardial
infarctions diabetes, whose courses are affected by PSYCHOSOCIAL stress. Hence,
it is mandatory to consider both psychosocial and biological factors affecting
schizophrenia.
Sigmund Freud holds the “fixations” responsible for
many disorders. Similarly he postulated that schizophrenia resulted from
developmental fixations that occurred earlier than those culminating in the
development of neuroses. These fixations produce defects in the ego
development. Fixations occurs to the time when the ego was not yet or had just
began to be established. We know that the ego regulates our superego and id and
is the only window to realty, regulates the inner drives, such as sex and
aggretion. When ego functioning is impaired, the schizophrenia patients are cut
with reality and hence generate some positive symptoms of hallucinations and
delusions. Thus, intrapsychic conflict arising from the early fixations and the
ego defect, which may have resulted from poor early object relations, fuel the
psychotic symptoms (Kaplan and Saddock,2009).
Another psychoanalyst Margerat Mahler, described that
there are distortions in the reciprocal relationship between the infant and the
mother. The child is unable to separate from and progress beyond the closeness
and complete dependence that characterize the mother-child relationship in the
oral phase of development. As a result, the person’s identity never becomes
secure.
Paul Federn hypothesized that the dysfunctioning of ego
allows the hostility and aggretion to distort the mother infant relationship,
which leads to eventual personality disorganization and vulnerability to
stress. The onset of symptoms during adolescence occur when teenagers need a strong
ego to function independently, to separate from the parents, to identify tasks
, to control increased internal drives and to cope with intense external stimulation.
Harry Stack Sullivan viewed schizophrenia as a
disturbance in interpersonal relatedness. The patients massive anxiety creates
a sense of unrelatedness that is transformed into parataxic distortions, which
are usually, but not always persecutory. To Sullivan schizophrenia is a
adoptive method used to avoid panic terror and disintegration of the sense of
self. The source of pathological anxiety results from cumulative experiential
traumas during development.
Psychoanalytic theory also postulated that the various
symptoms of schizophrenia have symbolic meaning for individual patients. For
example, fantasies of the world coming to an end may indicate a perception that
a person’s internal world has broken down. Feelings of inferiority are replaced
by delusions of grandeur and omnipotence. Hallucinations may be substitutes for
a patient’s inability to deal with objective reality and may represent inner
wishes or fears. Delusions, like hallucinations are regressive, resitutive
attempts to create a new reality or to express hidden fears or impulses.
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