Psychoanalytic principles in psychosocial rehabilitation.

Major mental symptomology in schizophrenic patients is alleviated when isolation and withdrawal are replaced by improved object relationships. This can best be accomplished through the enhancement of social, emotional, and environmental support systems. Psychosocial rehabilitation, that is, the establishment of a corrective living situation for emotionally isolated individuals, is a dynamic process. Staff in psychosocial centers are presented with unusual challenges and opportunities for helping people. Freudian psychoanalytic theory helps explain the causation of major mental symptomatology in schizophrenics as well as the mechanisms for the alleviation of those symptoms. It is postulated that the basic defect is exaggerated narcissistic libido and deficient cathexis of libido onto objects, which is accompanied by dammed-up libido. Like a festering boil, the dammed-up libido continues to exert noxious and deleterious effects, ultimately by way of chemical and neuronal pathways presently not well understood. The release of the dammed-up libido through improved object relationships is accompanied by lessening symptomatology and improved functioning. Indiscriminate and prolonged utilization of psychotropic medication is antitherapeutic in that it prevents delabeling, interferes with the resocialization process, and inhibits ego growth and development.