THE LETTER 38 (Autumn 2006) pages 49-52
The psychoanalytic approach to psychopathology assumes that all symptoms are meaningful and are related to the life history as subjectively experienced.
Freud’s study on Schreber represents his attempt to form a theory on psychosis psychoanalytically on the basis of the patient’s own report of a delusional system. For Freud, psychosis represents the withdrawal of libidinal cathexes to the outside world and their redirection inwards to the ego. Schreber’s delusional system worked for him to the extent that it made sense of his world. As Freud commented in his work on Schreber, ‘What we take to be the pathological production, the delusional formation, is in reality the attempt at recovery, the reconstruction‘.
In writing about the generic difference between neuroses and psychoses Freud says, ‘neurosis is the result of a conflict between the ego and its id, whereas psychosis is the analogous outcome of a similar disturbance in the relations between the ego and the external world’. He discussed this further and writes: ‘Thus for a neurosis the decisive factor would be the predominance of the influence of reality, whereas for a psychosis it would be the predominance of the id. In a psychosis, a loss of reality would necessarily be present, whereas in a neurosis, it would seem, this loss would be avoided’? …