Article
Notes on the Psychopathology of Confusional States in Chronic Schizophrenias
A short paper on chronic schizophrenia in which Rosenfeld describes confusional states as the outcome of a failure of the normal, structuring split between good and bad objects, and between the loving and hating parts of the self. When that split breaks down, love and hatred become mixed, and the patient fears that the destructive impulses will overwhelm the loving ones and destroy the good self and the good object. Where envy predominates, the good object itself is attacked, so that good and bad can no longer be told apart and the confusion becomes unbearable. Rosenfeld places confusion between splitting and integration, and finds such difficulties in separating good from bad, to a lesser degree, in less disturbed patients too. Klein took up the idea in Envy and Gratitude (1957); the paper was reprinted in Psychotic States (1965).
Main ideas
- Confusional states arise when the normal split between good and bad objects, and between loving and hating parts of the self, breaks down.
- In confusion the patient fears that destructive impulses will overwhelm the loving ones and destroy the good self and object.
- Envy, by attacking the good object itself, makes good and bad indistinguishable.
- Confusion stands between splitting and integration, and difficulties in separating good from bad appear to some degree in less disturbed patients as well.
What it shows
- 1950
Herbert Rosenfeld introduced Confusional states
Rosenfeld's 1950 paper described the confusional states of chronic schizophrenia as a failure of the normal splitting of good and bad objects, so that love and hatred and the good and bad self become mixed up; Klein took the idea into Envy and Gratitude.
- 1950
Confusional states derives from Splitting
Confusional states are defined against Klein's splitting: they arise when the primary split between good and bad objects, and between loving and hating parts of the self, fails or breaks down, so that the two cannot be told apart.