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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Interpretation of Schizophrenia | 3/5 | https://en.wikipedia.org/wiki/Interpretation_of_Schizophrenia | reference | science, encyclopedia | 2026-05-05T03:32:51.800940+00:00 | kb-cron |
== Pre-psychotic panic == In Part three of Interpretation of schizophrenia Arieti describes how in spite of its efforts to stay in reality, the patient's defenses finally succumb when attacks on the self-image both from outside and within cause the anxiety to become too unbearable. When the patient "cannot change the unbearable situation of himself any longer, he has to change reality". Arieti examines the inner world of the person with schizophrenia, and the genesis of the schizophrenic regression. Arieti maintains that even with the schizophrenic potentiality laid down in early childhood and by genetic predisposition, not all of these cases will develop psychosis, as new defense mechanisms are acquired throughout the life of the individual. For schizophrenics however, all such attempts eventually fail at staving off a complete break. The negative self-image that is dissociated from the conscious mind of the individual may be reactivated by any number of life events, such as entering a into a new relationship, the birth of a child, or a tragic accident, the death of a relative, especially the death of parents, moving out of home, stress at work, the loss of a job, or a promotion at work which destabilizes the individual's sense of competency at his own job, or a combination of several of these factors. This anxiety triggers the pre-psychotic period, which precedes the eventual psychotic break. These adverse life events bring the dissociated, negative self image from early childhood into consciousness, causing the person to view themselves as utterly defeated, unlovable, incompetent, worthless, etc. This type of anxiety cannot be tolerated by the individual for long, and as his defenses fail to defuse this anxiety, he will resort to increasingly inadequate coping mechanisms to maintain a positive self-image and reduce their anxiety. Arieti describes the concept of paleological/teleological thinking, which is typical of small children and primitive peoples, with concrete examples of such thought in African tribal societies and in small children. At the beginning of the pre-psychotic panic, the individual's feelings of self-accusation and self-defeat are slowly transformed into feelings of vulnerability, fear and anguish. He feels cut off from the world itself because of his failure and worthlessness, and feels like he cannot join in with the rest of the world. He is overwhelmed by a vague perception of danger, a need to escape, and of confusion. He feels threatened from all sides, as if he were in a jungle. It is not a jungle where lions, tigers, snakes and spiders are to be found, but a jungle of concepts, where the threat is not to survival, but to the self image. The dangers are concept feelings, such as that of being unlovable, inadequate, unacceptable, inferior, awkward, clumsy, not belonging, peculiar, different, rejected, humiliated, guilty, unable to find his own way amongst the many different paths of life, disgraced, discriminated against, kept at a distance, suspected, and so on. These feelings of terror and persecution are then transformed into concretized concepts and projections. The schizophrenic, in an attempt to ward off unbearable anxiety, will resort to using paleological thinking to distort reality in such a way that reduces anxiety. Projection is used to displace self-accusations and attacks on the self-esteem to the outside world in the form of persecutors and persecutory forces. The individual in the pre-psychotic stage may still recover if he manages to adopt adequate coping mechanisms, but if this fails, the pre-psychotic period will eventually be followed by a complete schizophrenic break when he experiences a total and complete defeat of his self-worth and self-esteem.