Patient and Therapist Observations on the Circumstances of a Schizophrenic Episode

Now see that noble and most sovereign reason, Like sweet bells jangled, out of tune and harsh. —Hamlet Bateson, Jackson, Haley, and Weakland1have recently outlined a theory of schizophrenia in rather general terms. This paper consists of the verbatim transcript of the major portion of a psychotherapeutic interview with a schizophrenic patient, with accompanying analytic comments based on the concepts presented in the earlier article. Thus their theory is here shown in relation with basic psychiatric data, the actual interpersonal communication of a patient, including the messages of the other party, which heretofore have too often been neglected. This particular interview is focused on the circumstances of the patient's psychotic break (his second). Apart from acute psychotic states during military service, there has been a paucity of data available in the literature about the factors surrounding the onset of a schizophrenic psychosis, although this period of remarkably rapid