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While research has steadily begun to explore thoughts and beliefs linked with helplessness and despair in schizophrenia, it is less clearly understood how to account phenomenologically for the related experience of being unable to commit to action in the midst of grave discomfort. To explore this issue, the current paper presents an analysis of the experience of volitional paralysis of two persons over the course of long-term integrative psychotherapy. In particular, we explore the experience of the inability to commit to action and the consequences of the gradual recovery of a sense that one is capable of action. Results suggest that in both cases inaction was tethered to a sense of self as insufficiently centered to survive action. In particular, we suggest both men appeared initially unable to commit to action because such a commitment threatened them with forces both felt would undo the tenuous conversations that comprised their identities. Finally, as a sense of self as capable of action emerged, both men began to experience themselves as relatively more complex human beings and to sustain more complex conversation within themselves and between themselves and others. Implications for psychotherapy and rehabilitation are discussed.

Expressed emotion is a measure of an individual's critical and/or emotionally overinvolved attitudes toward another person. The characteristics of parents who are high in expressed emotion are not fully understood. This study examined some variables potentially associated with expressed emotion, as measured by the Camberwell Family Interview, in 54 parents of schizophrenic young adults. Statements of (1) self-blame for the patient's illness, (2) controlling behaviors toward the patient, and (3) controlling behaviors toward others were assessed. As predicted, parents who blamed themselves for the patient's illness had higher emotional overinvolvement ratings than non-self-blaming parents. Measures of controlling behavior revealed that highly critical parents were not more controlling than less critical parents; however, parents high in emotional overinvolvement reported higher levels of patient- and other-controlling behaviors than parents low in emotional overinvolvement. These results suggest that the emotional overinvolvement component of high expressed emotion is associated with self-blaming attributions and controlling behaviors in parents, but that the criticism component is not.

The present study reports longitudinal data on individuals who ten years ago were fully recovered from a previously diagnosed schizophrenia. Seven out of ten subjects consented and were reexamined at the present follow-up, and data on an eighth subject was secured elsewhere. A semistructured interview was used to examine psychosocial functioning of the subjects in the follow-up period. Out of the six subjects with a confirmed diagnosis of schizophrenia, only three subjects were still fully recovered; one had a deteriorating course and two had a fluctuating course of illness. The results from the study indicate that recovery from schizophrenia may take the form of time-limited remissions for half of the reexamined subjects when strict criteria for full recovery are used. Protective factors such as willpower, a (partly) intact capacity for object attachment, and a supportive family may be important prerequisites for recovery. Two different courses of schizophrenia are illustrated by cases.

Science has finally caught up with the fact that literary narrative can convey truth more strongly by arousing the reader's power to empathize. Those in the sciences are slowly recognizing the fact that the genre 'scientific writing,' in representing empirical reality is as selective and as partial fiction and that its verity is as 'questionable.' 'Interviewing Eddie,' written in fictive style, recreates the situation for the reader by allowing the characters to speak and by giving them corporeality. It takes the reader to the space and time in which the situation took place. This sense of 'being there' results in greater empathy and perceptual clarity.

PERSONS with schizophrenia commonly have impaired social functioning (Wallace 1984). Those with greater impairments, particularly as measured by premorbid social attainment, have a poorer clinical prognosis (Strauss and Carpenter 1972). Interventions designed to improve social competence, such as social skills training, have yielded generalizable and durable effects and may have reduced relapse rates (Wallace and Liberman 1985; Liberman et al. 1986; Hogarty et al. 1986). Thus, a valid measure of social skills should be a useful clinical and research tool. This research explores the validity of a new instrument for measuring such skills, the Assessment of Interpersonal Problem Solving Skills (AIPSS) (Donahoe et al., this issue). The AIPSS differs from more conventional social functioning measures because it 1) utilizes observations of role-playing, rather than self-report or third-party report; 2) provides a rating of the patient's current rather than past functioning; 3) involves videotaped simulated 'real life' situations that pose challenges to the patient's ability to solve socially relevant problems; 4) permits assessment of patient's social perception, processing of social information for action planning, and verbal and nonverbal social responses. In this study, we examined the relationship between these parameters of schizophrenic patients' social functioning and their recent relapse history.

A NEW instrument for assessing social skills of schizophrenic patients, Assessment of Interpersonal Problem-Solving Skills (AIPSS), is a videotaped-based test with an examiner's administration and scoring manual. The test measures an examinee's ability to describe an interpersonal social problem, to derive a solution to the problem, and to enact a solution in a role-played simulation test. In a study using a sample of schizophrenic outpatients and a comparison group of nonpatients, we found that the test had adequate psychometric properties, and the patients demonstrated deficits on all scales relative to the nonpatients. The results of the study also provided partial support for the validity of an information-processing model of social skills, which was used as a basis for constructing the AIPSS. Thus, the AIPSS represents a departure from previous methods of assessing social skills.

IN A psychiatric hospital setting, 15 patients under treatment for schizophrenia and 15 healthy persons were asked to draw (1) a human face, (2) another face that expressed their own feelings at that moment, and (3) afterward the facial expressions of rage, fear, disgust, joy, sadness and shame within a standardized egg-shaped face matrix. Both groups were matched for age, sex and education, and all drawings were coded independently. The schizophrenics drew fewer facial action units, and their facial drawings were more stereotyped than the control group's. Neutral faces without any affective expression were twice as frequent within the experimental group. According to Ekman and Friesen's table of emotion prediction, the accuracy was the same for both groups with the exception of sadness. Only 20% of the action units in the schizophrenics' sadness drawings were accurate compared to 51% in the control group. Based on observations during the drawing process, findings are discussed within the theoretical framework of cathexis defense as an attempt to reduce the impact of the affective stimuli the schizophrenics created themselves.

IN his earlier works, one of the present investigators attempted to show that psychologically disturbed persons may be characterized by their tendency to induce their social partners to reveal relatively stable and constant leitmotivs, inclinations to react, emotions and fantasies; hence, it should be possible to describe psychological illnesses by means of the patient's specific interaction strategies (Krause 1988; Krause and Lutolf 1988). We assume that this process of induction is neither deliberate nor self-reflective. Inductive modes of behavior are viewed as part of an unconscious process of problem solving -- a process, however, which is unsuccessful, since it is no longer appropriate to the reality of the adult patient. The present paper is part of a more comprehensive research project, the object of which is to account for these kinds of interactive strategies.