ON PSYCHOANALYSIS
the autistic schizophrenic, from an unaddicted person to one who has
made a chemical adjustment to heroin: all of these represent shifts
that so far as I know have not been dealt with successfully in therapy.
This does not mean that the explanations derived from Freudian
theory may not apply to any of these conditions, only that the therapy
does not work.
In addition to those who are recalcitrant to the dominant mode
of treatment in our society, there is an apparent increase in the
analytically untreatable among ordinary patients. It is a commonplace
that for years no one has seen the kind of patients treated by Freud.
The phobics and the hysterics, who made up the bulk of Freud's
patients, appear very rarely in a modem analyst's office. What ap–
pear now are what are called character disorders or ego defects. Un–
like the traditional cases of superego defect or overcontrol, these cases
are those of undercontrol. In contrast to the release of inhibition,
which was required of the traditional analytic patient, the problem
in
therapy today seems to be the problem of impulse control and of
undersocialization. There seems to be a group of patients, even among
those who are voluntary, who do not fall into the original theoretical
system. Another complication has been the widespread dissemination
of the terminology of analysis. The very possession of this vocabulary
may make the patient unreachable by the traditional process. The
patient has in this case already integrated the vocabulary of treatment
into the neurotic problem.
The healers in our society have not responded well to those who
have been intractable to treatment. In the case of observable deviants
-the criminal, the drug addict, the homosexual, the alcoholic-the
tendency has been to use pejorative terms as classifications. The drug
addict is described as infantile, oral regressive, with a fixated ego
impervious to treatment; the criminal is psychopathic; the homo–
sexual is compulsive and masochistic; each of the unreachables, for
whatever reason, is defined as a peculiar case. The defect is in the
individual rather than in the theory or the therapeutic method.
The schizophrenic whose disorder is in the area where the
stock-in-trade of verbal therapy exists is an even more difficult
problem. For language and social facility are precisely what the
schizophrenic lacks; hence he is linguistically unreachable.
In the face of these new difficulties and the extension of therapy
