Tag Archive | "Dementia Praecox"

Schizophrenia: An Orgonomic Perspective


This article is partially based on the lecture I presented at the Orgonomic Conference in Italy on October 4, 2013.

In Reich’s book (1952), Reich Speaks of Freud, which includes the transcript of an interview between Dr. Wilhelm Reich and Dr. Kurt Eissler, Reich states:

In 1929 – I think it was then – I began to work in character analysis with physiological emotions, with physiological feelings, in the patients. You are acquainted with character analysis?
Eissler: Yes
Reich: You are. You know what I call preorgastic streamings? Orgonotic current?
Eissler: I know a little about that.
Reich: You know something about it? Otherwise, there’s no use.
Eissler: Well, I know your literature pretty well up to the time you left the psychoanalytic movement.
Reich: It was already in by then. You didn’t read the third edition of Character Analysis?
Eissler: No, not the third edition.
Reich: Well, in schizophrenics, the bio-energetic emotions or excitations break through into consciousness. In the so-called normal human beings, these excitations are more or less shut off. This is particularly the case in the affect-blocked compulsive neurotic. In investigating the difference between the typical neurotic and the schizophrenic, I learned that the neurotic recognizes the excitations which may break through spontaneously, or in the course of treatment, as biological, as arising from within. The schizophrenic fails to recognize these primary, biophysical sensations and plasmatic streamings as an inner process and, thus, comes to misinterpret and distort them. That is, he believes the excitations – the sensations, the crawlings, the stirrings in him – are due to outside influences, for example, to persecutors trying to electrocute him. He does perceive his bio-energetic emotion, but he misinterprets it.

In this article, I discuss schizophrenia, the single-most important illness in psychiatry. In fact, professionals in contemporary psychiatry, psychology, and medicine view schizophrenia as a bizarre illness primarily because they do not comprehend its basic physical and psychological pathology and consequently they do not comprehend the wide range of unrelated symptoms which is unexplainable by current theories within these professions.

The historical background of schizophrenia dates back to the mid-1800s when Emil Kraepelin, a prominent German psychiatrist, referred to the illness as dementia praecox, underscoring a deterioration of the cognitive process (dementia) and early onset of it (praecox).

Emil Kraepelin

In 1910, Eugene Bleuler, a Swiss psychiatrist, coined the term schizophrenia to describe the presence of splits or schisms between thought, emotion and behavior, thereafter replacing the term dementia praecox in the literature.

Eugene Bleuler

Several other psychiatrists also began to discuss the phenomenon of schizophrenia but described different criteria for it. Eugene Bleuler in his book, Dementia Praecox (1910) reported his accumulated observations of schizophrenic patients, describing their behavior in great detail. This description of schizophrenic symptoms is one of the most comprehensive, informative reports. For example, he defines the disease as follows:

A group of psychoses whose course is at times chronic, at times marked by intermittent attacks, and which can stop or retrograde at any stage, but does not permit a full restitution ad integrum. The disease is characterized by a specific type of alteration of thinking, feeling, and relation to the external world, which appears nowhere else in this particular fashion.

In every case we are confronted with a more or less clear-cut splitting of the psychic functions. If the disease is marked, the personality loses its unity; at different times different psychic complexes seem to represent the personality. Integration of different complexes and strivings appears insufficient or even lacking. The psychic complexes do not combine in a conglomeration of strivings with a unified resultant as they do in a healthy person; rather, one set of complexes dominates the personality for a time, while other groups of ideas or drives are “split off” and seem either partly or completely impotent. Often ideas are only partially worked out, and fragments of ideas are connected in an illogical way to constitute a new idea. Concepts lose their completeness, seem to dispense with one or more of their essential components; indeed, in many cases they are only represented by a few truncated notions.

Thus, the process of association often works with mere fragments of ideas and concepts. This results in associations which normal individuals will regard as incorrect, bizarre, and utterly unpredictable. Often thinking stops in the middle of a thought; or in the attempt to pass to another idea, it may suddenly cease altogether, at least as far as it is a conscious process (blocking). Instead of continuing the thought, new ideas crop up which neither the patient nor the observer can bring into any connection with the previous stream of thought.

Primary disturbances of perception, orientation, or memory are not demonstrable. In the severest cases emotional and affective expressions seem to be completely lacking. In milder cases we may note only that the degree of intensity of the emotional reactions is not commensurate with the various events that caused those reactions. Indeed, the intensity of the affective reactions may range from a complete lack of emotional expression to extremely exaggerated affective responses in relation to different thought-complexes. They affectively can also appear to be qualitatively abnormal; that is, inadequate to the intellectual processes involved.

In addition to the often-discussed signs of “deterioration,” many other symptoms are present in a majority of the hospital cases. We find hallucinations, delusions, confusion, stupor, mania and melancholic affective fluctuations, and catatonic symptoms. Many of these accessory symptoms and symptom-complexes betray a specific schizophrenic character so that their presence may be utilized in diagnosing the disease. Outside the hospital, there are schizophrenics in whom accessory symptoms are less apparent, or absent altogether.

Contemporary psychiatric textbooks define schizophrenia as a disease characterized by a very broad range of symptoms, including those described above by Bleuler. In fact, the symptoms are so diverse that they cover the entire spectrum of human thought, emotions and behavior with an unidentified psychopathology and no single clinical feature characteristic of schizophrenia. There is no clear consensus regarding what constitutes the disorder’s core symptoms. Currently, the symptoms are generally divided into two groups: positive and negative symptoms. Positive symptoms include delusions, hallucinations, disorganized speech, and purposeless movements or sequences of actions. In contrast, negative symptoms include diminished expression of emotion, blunted affect or apathy, withdrawal, lack of motivation or interest in social contact, poverty of speech, etc. Contemporary psychiatry divides schizophrenia into subtypes, such as paranoid schizophrenia, of which the most prominent feature is presence of persecutory delusions and auditory, visual, or tactile hallucinations. Disorganized schizophrenia, thought to be a more severe form of the illness, has an earlier onset and includes a low level of social and occupational functioning, poor long-term prognosis, and is typified by clinical features related to disorganization . The other term of this category was hebephrenic schizophrenia as used by Eugene Bleuler. Catatonic schizophrenia refers to an extreme motor state of either stupor or over excitation. In the catatonic stupor, the patient maintains a rigid body position for an extensive time without talking or reacting to others. In catatonic excitement, the patient engages in a series of apparently aimless and exaggerated rapid movements, which may include acts of aimless violence. Residual schizophrenia refers to an attenuated state of schizophrenia during which the positive or negative symptoms are relatively less apparent.

At the present time, contemporary psychiatry and psychology merely label, classify and describe the symptoms without providing any logical pathology relating these symptoms to each other. The symptoms described are as wide-ranging as those of Blueler, such as delusions, hallucinations, unusual behavior and outburst of anger, diminished expression of emotions, blunted affect, apathy or decreased motivation, withdrawal, lack of interest in social contact, poverty of speech, disorganized speech or purposeless movements or sequences of action.

Contemporary researchers in psychiatry acknowledge that the cause of schizophrenia is unknown. However, in spite of schizophrenia’s unknown etiology, researchers speculate about the causes of this illness. In the last several decades, researchers have, according to their orientations, attributed the etiology of schizophrenia to different phenomena such as genetics, neurotransmitters, environmental factors, and stress. The most revered and referenced textbooks in psychiatry in the United States, endorsed by American Psychiatric Association, state that “schizophrenia includes a group of disorders, probably with heterogeneous causes but with somewhat similar behavioral symptoms. Patients with schizophrenia show different clinical presentations, treatment responses, and the course of illness” (Kaplan & Sadock’s Synopsis of psychiatry 8th Edition. P.459).

A philosopher once said that hell is a place where events are not connected with each other, where cause and effect are unknown. With numerous, unrelated symptoms and no identifiable etiology, schizophrenia becomes a hell for the patient and for the clinician as well. Certainly, psychiatrists acknowledge that anti-psychotic medication, developed since Bleuler’s time, has significantly controlled and even minimized acute psychotic symptoms. However, in almost all cases, the residual symptoms and subtle progression of schizophrenia continue, rendering the patient vulnerable, fragile and marginalized during their life span.

Contemporary psychiatrists, psychologists and physicians have no explanation for the causes of schizophrenia nor do they understand the relationship between the wide-ranging symptoms. Consequently, they are unable to understand schizophrenic patients. When the underlying cause of an illness is not understood, the clinician, like the patient himself, feels lost in the midst of these bizarre symptoms. Thus, the clinician is unable to logically treat this patient. Mental health clinicians know, from experience, that a structured environment, occupational therapy and antipsychotic medication, can bring some relief to these patients, but these approaches, although helpful, are based on practical experience rather than on knowledge of the illness and its etiology.

Having described the limitations of contemporary clinicians to understand and treat schizophrenia, I would like to offer the orgonomic perspective and hope that it will illuminate this “mysterious and bizarre” illness and thus aid clinicians in finding more effective treatment for the patient.

The orgonomic view of schizophrenia, as defined by Reich, is the patient’s misinterpretation of the biological energy that breaks through one’s armor and is experienced consciously but attributed to something alien.

Based on orgonomic theoretical understanding, in paranoid schizophrenia the biological energy breaks through the armor and the patient senses it. Consciously, he attributes these unfamiliar streamings and sensations to outside forces, thus causing the patient’s confusion, persecutory delusions, and deterioration. In contrast, in catatonic schizophrenia, the patient suffers from slow movement, contracted musculature, and immobility due to his or her heavy armoring. In order to elaborate on these two concepts, some descriptions of orgonomic theories are necessary for the reader who is unfamiliar with these theories.

Orgonomy is an offshoot of psychoanalysis and is based on Freud’s theory of the libido. Reich suggested that the libido is an actual energy, which Reich named orgone energy. This energy works in the body and Reich suggested that an autonomic (vegetative) nervous system propagates this energy in the human organism. The sympathetic and parasympathetic nervous systems, also known as vegetative or autonomic nervous systems, plays a major role in propagating this energy. This vegetative system also includes ganglia, which are most abundantly concentrated in the celiac and hypogastric area known as the solar plexus. In “Function of Orgasm” Reich (1942) stated that “There must be a vegetative center from which the biological energy issues and to which it returns. There are the large centers of autonomic nervous ganglia , essentially the solar plexus, the hypogastric plexus and lumbo-sacroplexus”.

Vegetative Nervous System

Unfortunately, medical researchers have not taken these suggestions seriously, and no systematic studies have been done to establish the propagation of energetic impulses from these centers. However, two papers in electrophysiological studies corroborate Reich’s theory on the propagation of energy from the solar plexus to the periphery of the body. Researchers at the Pavlov Institute of Physiology, Leningrad (Zamiatina, N. (1961). Electrophysiological analysis of excitation conduction through ganglia of the solar plexus. Journal of physiology of USSR. 47(6),1-8.), found that “after separation of ganglia of the solar plexus from the central nervous system, afferent impulsation is retained in the axons of the post ganglionic neurons. This impulsation testifies to the presence of tonic activity in the ganglional cells which may be regarded, on one hand, as manifestation of the intrinsic automatism of function of ganglia and, on the other hand, as the result of direct afferent influences from the receptors of visceral organs upon the ganglial cells.”

The autonomic life apparatus dysfunctions manifests itself in a variety of diseases, including schizophrenia. Different manifestations of schizophrenia can be explained based on this autonomic dysfunction and disruption of energetic flow in the body. Armoring of the body musculature and tissues is a pathological process which prevents the orderly flow of biological energy.

Armoring in summary is defined as an organism’s total defense, consisting of psychological rigidity and chronic spasms of the musculature which essentially defends against breakthrough of emotions, primarily anxiety, rage, sexual excitation and organ sensations.

From an orgonomic perspective, catatonic schizophrenia is a consequence of heavy muscular armoring against the flow of biological energy, which in turn causes withdrawal from the world and causes manifestations of muscular rigidities, slow movements, or resistance to any type of passive movement as well as withdrawal from the world and blocking of the feelings. Hebephrenic schizophrenia, more recently referred to as undifferentiated schizophrenia, consists mainly of a slow deterioration of biophysical functioning. The initial phase of paranoid schizophrenia is characterized by bizarre ideas and mystical experiences, ideas of persecution and hallucinations, loss of power of rational association and loss of factual meaning of words followed by a slow deterioration of psychological structure and loss of unity of functioning of the body in general. These types of schizophrenia are all consequences of disruption of biophysical energetic flow and process of armoring in the organism. Reich suggested that schizophrenia is related to the armoring and blocks in the ocular segment , “armoring of the structure encompassing eyes and base of the skull” causing the eventual disintegration of the organism, in a reverse order of its integration. In schizophrenics, the armoring is not as complete as it is in neurotic patients. Therefore, bioenergetic sensations break through their armor, manifesting themselves in different and unfamiliar sensations.

While conventional medicine, psychiatry and psychology are unable to explain the reasons of sluggish movements, muscular contractions, poor mobility, poor and shallow respiration in catatonic schizophrenics, orgonomists can explain these manifestations. A catatonic patient whom I was treating in the1980s was manifesting such contracted musculature and could hardly bend her neck; consequently, whatever she ate fell on her chin and shirt, the latter of which was always stained by food, thus emitting a foul odor. The same patient manifested shallow breathing far below average with no medical explanation for this abnormal respiratory function.

The respiratory function test of the patient

In contrast to catatonia, those patients who suffer from paranoid schizophrenia experience the biological energy that breaks through their armor and they experience unfamiliar movements and sensation in their bodies. Sometimes these patients feel painful sensations in the skin, attributing them to electrocution from outside hostile entities such as aliens or secret government agencies. These patients are sometimes afraid to go to places where they have previously experienced these sensations. They may also to feel as if the certain parts of their bodies do not belong to them. For example, one of my patients diagnosed with paranoid schizophrenia often complained that his arms had been replaced by those of a woman. Some patients complain that their minds are controlled by outside secret forces, or that a chip has been implanted in their brain, thus controlling them. Some of my patients have complained of other sensations. One patient, for example, insisted that there were worms in her stomach and intestine and claimed that she could feel them moving inside her. Such patients see a number of doctors, frustrating them by such complaints. Schizophrenic patients often complain that they are unable to focus on any issue for any length of time and their minds get blocked or they fixate on an idea and are unable to stop the fixation. Once during my psychiatric residency, a patient was admitted to the hospital because of his patricidal impulse to kill his father. He told me that he had been tortured by certain thoughts being stuck in his mind and not moving on. He attributed this stagnation of ideas in his mind to his father, “Mr. Lockin,” explaining that his thoughts were “locked in” because of his father’s name. Thus, he wanted to kill his father.

For schizophrenic patients who suffer from auditory hallucinations, orgonomists explain that these hallucinations are expansion of their orgonomic energy and projections of it on themselves.

The integration of orgonotic energy of different body organs into a single unitary function is an essential process resulting in the coordinated unitary functioning of the human organism and its sensation as a whole. This process of integration begins at infancy and gradually progresses to the integration of different orgonotic sensations into a single unitary functioning. In schizophrenia, however, this integrated structure starts to disintegrate in reverse order, causing deterioration of thought and speech and unfamiliar sensations in the body. While conventional physicians and psychiatrists have no explanation or understanding of the wide variety of symptoms in schizophrenia and view it as bizarre, orgonomists view these symptoms as manifestations of bioenergetic movement, armoring, and disintegration. From an orgonomic point of view, therefore, schizophrenic symptoms no longer seem strange and incomprehensible. A clinician who understands the patient can help the patient by empathizing, and developing an alliance, with her or him. Such an alliance will be evident in the clinician’s interaction with the patient and will thus have an integrating effect on the patient. The clinicians who have integrated this knowledge into their understanding become, themselves, integrating forces for their patients; they become capable of helping their patients beyond any other modality presented in psychiatry. Reich described the treatment of schizophrenic patients in his book, Character Analysis, 3rd edition. The reader is referred to Reich’s description of the treatment process. As a psychiatrist familiar with the orgonomic theories, I will, in turn, describe the process of integration and treatment of the schizophrenic patients in future articles. The reader also is referred to Reich’s clinical seminars from the 1950s now available on CDs from Wilhelm Reich Museum. Such knowledge is essential for understanding and treating patients with schizophrenia and should be brought to the forefront in the fields of psychiatry, psychology and medicine.

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