The main trends of the studies in the historical development of the transference of psychotics are discussed. After Freud's pessimism about the treatment of psychotic patient, due to his belief that they formed no transference, two main trends have appeared. There were those who believed that the narcissism of the psychotic patient presented a complete obstacle to treatment unless the therapist changed his usual therapeutic attitude. Exponents of this approach were particular by Clark, Fromm-Reichmann in her early period, and Winnicott in his later work. Waelder, Jacobson, Federn, Searles and Fromm-Reichmann in her later work differ from others in this group in so far as they analyse both the negative and the positive transference. The second group of therapists attempted to deal with the narcissism and other psychotic manifestation of the patient by the classical psychoanalytic approach with only minor changes. Abraham found that the narcissisic defences of his patients were markedly diminished by interpretations. Then Stern, Cohn and Bullard described characteristics of the positive and negative transference of psychotic patients, which they felt could be treated by verbal transference interpretations. Segal and Rosenfeld stressed that no change in the psychotherapist's attitude and only minor changes in technique were necessary. The developemont of the study of psychosis over the last 50 years suggests that Freud's hope that some approach to the treatment of psychosis might become possible is now justified.
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