The role of anxiety in schizophrenia.

Abstract

An attempt was made to look at anxiety as the primary symptom of schizophrenia, while all other symptoms seem to be of secondary nature—either consequences of, or defenses against anxiety, but always attempts of the individual at restituting and integrating. Horney's view of anxiety as the dynamic center of neurosis was extended to schizophrenia, but the differences in quantity and/or quality, and the consequences of anxiety in the neurotic and schizophrenic were stressed. Goldstein's parallel between the brain injured and the schizophrenic patient also points to the primary importance of anxiety and catastrophic reaction in both conditions. Finally, the existentialist's conception of schizophrenia as a way of being-in-the-world in the mode of anxiety confirms my assumption of the primary role of anxiety modifying the “Dasein”. I have focused on the disruptive aspect of anxiety and conflicts with the need to dichotomize, to streamline and repress one set of alternatives, while idealizing the other set and the formation of a rigid pride-system. I have compared the schizophrenic to a man drowning in a sea of chaos, attempting to cling to a raft, namely, the concrete, practical attitude, with abandonment of the abstract one. The influence of this on his way of perceiving, thinking, acting, relating and communicating was discussed, with special emphasis on the disruption of the stream of thought and words, and the distortion of time and space experience. I then illustrated some of the points discussed with brief case histories of two schizophrenics.