Hector Warnes’ reply to John Court’s comment on Thomas A. Ban’s Capsule 17 (Adrenochrome hypothesis of schizophrenia and treatment with nicotinic acid)

I appreciate John Court’s questions; the first one regarding the hypothesis that schizophrenia is the outcome of stress-induced anxiety is indeed a very complex one. Anxiety pervades just about every psychopathological symptom. There are many types of “Angst” which calls forth defense mechanisms to cope with an overwhelming danger, internal or external. We are well aware of the psychotic defenses. The most primitive type of anxiety is related to annihilation, fragmentation, loss of identity and separation.

I would like  further to clarify the fate of several psychological theories regarding the etiology of schizophrenia, which is undoubtedly multi-factorial, though some earlier theories, as pointed out by Professor Ban, have fallen by the wayside.  Attachment behaviour; perinatal trauma;  mother child symbiosis; disturbed family interaction, including the transmission of irrationality to the child and the double-bind theory; the psychological or real absence of a father  who did not  foster the child’s separation from the mother; the lack of a sense of identity; the use of primitive defenses, including regression and magical thinking in dealing with basic anxiety, which is the perception  and anticipation  of a  danger signal, which is real or the result of projection, among others are all contributing factors but are not sufficient and necessary conditions for the onset of  schizophrenia.

The concept of the so called “schizophrenogenic mother” was launched by Frieda Fromm-Reichmann and John Rosen. Many studies of the family of schizophrenic patients have confirmed the altered mode of communication in these families including the double bind transmission of irrationality to the vulnerable child. However Silvano Arieti  (Selected Papers,  Brunner/Mazel, New York, 1978) has opposed the view of the schizophrenogenic mother. According to his statistics, only about 25% of the mothers of schizophrenics fit the description of the schizophrenogenic mother and 75 % do not fit. Arieti also pointed out that “We have made a mistake reminiscent of the one made by Freud when he came to believe that his neurotic patients had been assaulted sexually by their parents. Later, Freud realized that what he had believed to be true was, in by far the majority of cases, only the product of the patient’s fantasy’ (p. 8).” In this light, you are right to question both hypotheses.

Hector Warnes

December 18, 2014