Saturday, 7 December 2013

PSYCHOANALYTIC THEORIES BEHIND SCHIZOPHRENIA

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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