Adlerian Concepts of Schizophrenia Symposium at the Second International Congress for Psychiatry

Modern Drug Treatment during Psychotherapy oj Schizophrenia. ALEXANDRA ADLER, New York. During the last years new drugs have been offered to the medical profession, which have decided advantages inasmuch as, although they do not induce sleep in the patient, they still have a definite influence on the symptomatology of the mental disease process. For the treatment of schizophrenia, chlorpromazine and the rauwolfia derivatives are used in preference to other chemicals. Under their influence, the patient experiences a diminution of responses to various stimuli, which has desirable as well as undesirable effects. Most patients complain of a lack of drive while using the tranquilizing drugs, which often leads to difficulties, particularly in the professional field. If the patient works in a group, his co-workers will object to his slowness and lack of initiative, which, in turn, leads to conflicts in interpersonal relations and often to his unhappiness. On the other hand, the patient may be freed from the hallucinations and delusions which before the new drug treatment would have made it impossible for him to join in any communityactivities. The dream life of the schizophrenic patient, while under modern drug treatment, shows definite changes, which evidently are the result of a diminution of goal-directed planning. Consequently, such dreams are less useful for the elucidation of psychodynamics. Occasionally such patients also report an appearance of vivid and detailed recollections of long-forgotten material. Such recollections do not go back as far as to the first years of childhood, to which commonly greatest importance is attributed during psychotherapy. The origin of this phenomenon needs further investigation. The psychiatrist has to use even greater skill than before in order to differentiate between symptoms of the psychosis itself and, on the other hand, effects of the drug treatment. He has to use a holistic approach, using thorough knowledge of the schizophrenic's reactions, which, except for the impact of hallucinations and delusions, are basically related to the same problems as in any other human being.