This paper seeks to showthe impact of reconceptualization of a clinical case and the consequent change in therapeutic practice. It explores the shift in conceptualization from “schizophrenia” to “pseudostupidity” using Freud’s idea of the “wish not to know.” The wish not to know is a hysterical reaction to primal scene and other early traumas (usually sexual) in which the child is so traumatized by the exposure and abuse that she develops a style of cognition of “not knowing” not only in relation to the traumas but to life in general. Her communication tended to be characterized by her previous therapists as “thought disordered” and was seen as indicative of schizophrenia. After reconceptualization the latest therapist began to attend to the issues of psuedostupidity with the result of a major lessening of her “thought disorder.”
Get full access to this article
View all access options for this article.
References
1.
Abraham, K. (1913). Restrictions and transformations of scoptophilia in psychoneurotics. In Selected papers (Vol. 1, pp. 169-234). New York: Basic Books.
2.
Bellak, L., & Meyers, B. (1975). Ego function assessment and analysability. International Review of Psycho-Analysis, 2, 413-427.
3.
Bettleheim, B. (1955). Schizophrenia as a reaction to extreme situations. American Journal of Orthopsychiatry, 26, 507-518.
4.
Briere, J. (1996). Therapy for adults molested as children: Beyond survival(2nd ed.). New York: Springer.
5.
Eissler, K. (1951). Remarks on the psycho-analysis of schizophrenia. International Journal of Psycho-Analysis, 32, 139-156.
6.
Erickson, E. (1963). Childhood and society. New York: Norton.
7.
Fairbairn, W. (1952). Psychoanalytic studies of the personality. London: Tavistock.
8.
Fenichel, O. (1953). The scoptophilic instinct and identification. In H. Fenichel & D. Rapaport (Eds.), The collected papers of Otto Fenichel(Vol. 1, pp. 373-398). New York: Norton.
9.
Freud, S. (1950). Psychogenic visual disturbance according to psycho-analytic conceptions. In J. Riviere (Trans.), Collected papers(Vol. 2, pp. 105-112). London: Hogarth. (Original work published 1910)
10.
Fromm-Reichmann, F. (1959). Psychoanalysis and psychotherapy: Selected papers of Frieda Fromm-Reichmann. Chicago: University of Chicago Press.
11.
Guntrip, H. (1969). Schizoid phenomena, object relations and the self. New York: International Universities Press.
12.
Herman, J. (1997). Trauma and recovery: The aftermath of violence—Fromdomestic abuse to political terror. New York: Basic Books.
13.
Jones, E. (1910). Simulated foolishness in hysteria. In E. Jones (Ed.), Papers on psychoanalysis(1st ed., pp. 141-153). London: Balliere, Tindall and Cox.
14.
Jones, E. (1949). Hamlet’s place in mythology. In E. Jones (Ed.), Hamlet and Oedipus(pp. 146-171). NewYork: Doubleday-Anchor.
15.
Karon, B. (1992). The fear of understanding schizophrenia. Psychoanalytic Psychology, 9, 191-211.
16.
Karon, B.,& VandenBos, G. (1994). Psychotherapy of schizophrenia: The treatment of choice. Northvale, NJ:Jason Aronson.
17.
Klein, M. (1975). A contribution to the psychogenesis of manic-depressive states. Love, guilt and reparation & other works, 1921-1945(pp. 262-289). New York: Delacorte. (Original work published 1935)
18.
Klein, M. (1975). The origins of transference. Envy and gratitude& otherworks, 1946-1963(pp. 48-56). NewYork: Delacorte. (Original work published 1952)
19.
Klein, M. (1975). Our adult world and its root in infancy. Envy and gratitude& other works, 1946-1963(pp. 247-263). New York: Delacorte. (Original work published 1959)
20.
Kline, J., Becker, J.,& Giese, C. (1992). Psychodynamic intervention revisited: Options for the treatment of schizophrenia. Psychotherapy, 29, 366-377.
21.
Lane, R., & Storch, R. (1984). “The wish not to know”: A fool cannot be blamed for his actions. CurrentIssues in Psychoanalytic Practice, 1, 53-72.
22.
Mahler, M.(1942). Pseudo-Imbecility: Amagic cap of invisibility. InM. Mahler (Ed.), The selected papers ofMargaret S. Mahler(Vol. 1, pp. 3-16). New York: Jason Aronson.
23.
Mahler, M., Pine, F., & Bergman, A. (1975). The psychological birth of the human infant. NewYork: BasicBooks.
24.
Searles, H. (1965). Collected papers on schizophrenia and related subjects. New York:InternationalUniversities Press.
25.
Sullivan, H. (1962). Schizophrenia as a human process. New York: Norton.
26.
Winnicott, D. (1965). The maturational processes and the facilitating environment. Madison, CT:International Universities Press.
