THESI: This is to certify that the thesis entitled Nostalgia and the Regressive Tendency as Expressions of Escape: A Clarification of Their Role in Schizophrenia presented by Don J. Brand has been accepted towards fulfillment of the requirements for Ph.D. Psychology degree in f , , V 0///.Z/‘-17/% W Major professor 1 1/20/80 Date 0-7639 LIBJQL-LIZY " ;" MW) zgaj? Sam: Umvcmtyflrb OVERDUE FINES: 25¢ per day per item RETURNING LIBRARY MATERIALS: Place in book return to remove charge from circulation records NOSTALGIA AND THE REGRESSIVE TENDENCY AS EXPRESSIONS OF ESCAPE: A CLARIFICATION OF THEIR ROLE IN SCHIZOPHRENIA BY Don J. Brand A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Psychology 1980 6H6 {8% ABSTRACT NOSTALGIA AND THE REGRESSIVE TENDENCY AS EXPRESSIONS OF ESCAPE: A CLARIFICATION OF THEIR ROLE IN SCHIZOPHRENIA BY Don J. Brand Reviews of the literature on schizophrenia, the process-reactive dichotomy, regression, and nostalgia led to the speculation that nostalgia and potential for regres- sion are related and would differentiate reactive from process schizophrenics. This is a consequence of the idea that for "reactives," in contrast to the more "fixed" "pro— cess" patients regression is an escape into the remembered gratification of the earliest stages of development. Based on this understanding predictions were made that more "re- actives" than "processes" would tell nostalgic stories on the TAT, that more "reactives" would evaluate interactive autistic Rorschach percepts positively and interactive realistic percepts negatively, that more "reactives" than normal subjects would evaluate interactive autistic Rorschach percepts positively and interactive realistic percepts nega- tively; that this difference would not occur in contrasting "processes" and "normals," and that more nostalgic than non— nostalgic schizophrenics would evaluate interactive autistic Rorschach percepts positively and interactive realistic Rorschach percepts negatively. Don J. Brand The TAT's and Rorschachs of 36 reactive and 18 process schizophrenics were compared. Also Rorschachs of 28 normal individuals were compared to the protocols of the schizophrenics. Based on a statistical analysis of the material obtained, the following were the results: 1. Significantly more "reactives" than "processes" told nostalgic TAT stories. 2. Significantly more "reactives" than "processes" evaluated interactive autistic Rorschach percepts positively and there was a strong tendency for more "reactives" than "processes" to evaluate interactive realistic Rorschach percepts negatively. 3. There was a strong tendency for more "reactives" than "normals" to evaluate interactive autistic Rorschach percepts positively; also there was a trend for more "reactives" than "normals" to evaluate interactive realistic Rorschach percepts negatively. 4. "Processes" did not evaluate autistic interactive Rorschach percepts more positively than "normals" nor did they evaluate realistic interactive percepts more negatively than "normals." 5. Significantly more nostalgic than non-nostalgic schizo- phrenics evaluated interactive autistic Rorschach percepts positively and interactive realistic Rorschach percepts negatively. The results were interpreted as consistent with the hypothesized relationships between nostalgia, regression, and the process-reacitve dichotomy. To Peninah Because I love her. ii ACKNOWLE DGMEN TS These acknowledgments cannot express the debt I owe to each member of my dissertation committee. Each, in his own way, represents to me a model of professional scholar- ship and integrity that has inspired me in my own profes- sional life. Firstly and most importantly, I would like to thank the chairman of my committee, Prof. Albert I. Rabin, who not only carefully and caringly guided me throughout my academic life at MSU, but also through both my thesis and dissertation. Indeed, the evidence of his careful super- vision appears on literally every page of this dissertation. I wish to express my appreciation to Prof. Arthur A. Seagull, who, through thoughtful and meaningful discussions, gave me so much in so many ways, both subtle and obvious, and maintained a sense of humor and faith throughout. The non-clinical member of my committee, Prof. Robert Spira, has constantly and creatively inspired me in so many areas of interest, not the least of which is psychology, and not the most of which is the substantial statistical help on this paper. Prof. Griffith O. Freed has taught me to explore and to integrate psychoanalytic theory and to realize its iii implications in the process of active psychotherapy. More than advisors, these men have been mentors in the most profound sense. I must also thank Dr. Robert Schnitzer, of McLean Hospital, whose interest in and regard for my research sus- tained me, in ways he could not have known, through the dis- heartening moments of my work, and Dr. James Muller, chief psychologist, Erich Lindemann Center outpatient department, who helped me resolve essential problems of the dissertation. I would like to especially acknowledge Mr. Roger Whittaker, whose song "Durham Town," heard over my car radio, forced upon me the recognition of the power of nostalgia. This, in turn, immediately touched off an association to a random comment by Prof. Rabin referring to a feature of my own earliest upbringing and caused me to recognize a possible connection between the two—-a connection which anticipated this dissertation. This is perhaps an example of the sensitivity and evocative power of the artist touching, through the person of the researcher, the awareness of the scholar, giving rise to scientific achievement. iv TABLE OF CONTENTS Page FIXATION, REGRESSION, AND SCHIZOPHRENIA . . . . 1 Research . . . . . . . . . 4 Research on Regression/Fixation in Schizophrenia . . . . . . . 5 Criticism and Analysis of Regression Research . . . . . . . . . 7 Process and Reactive Schizophrenia . . . 9 Differential Apperceptive Styles of Process and Reactive Schizophrenics . . 10 Further Theoretical Review and Integration . . . . . . . . ll NOSTALGIA . . . . . . . . . . . 15 Nostalgia, Escape, and Process— Reactive Schizophrenia. . . . . . l7 STATEMENT OF THE PROBLEM . . . . . . . . 20 STATEMENT OF HYPOTHESES AND OPERATIONAL PREDICTIONS . . . . . . . . . . . 22 OPERATIONAL PREDICTIONS . . . . . . . 23 METHOD . . . . . . . . . . . . 25 Subjects . . . . . . . . . 25 CHARACTERISTICS OF THE SAMPLES . . . . . . 27 Schizophrenic Sample . . . . . . 27 Reactive Group . . . . . . . . 27 Process Group . . . . . . . . 28 Normal Group . . . . . . . . 28 Page INSTRUMENTS OF MEASUREMENT . . . . . . . 29 I. The Nostalgia Measure. . . . . 29 II. The Process-Reactive Measure . . . 29 III. The Malevolent-Benevolent Scoring of the Rorschach . . . . . 3O TREATMENT OF THE DATA . . . . . . . . 32 RESULTS . . . . . . . . . . . . 33 Hypothesis I . . . . . . . . 33 Hypothesis IIa . . . . . . . . 33 Hypothesis IIb . . . . . . . . 35 Hypothesis IIC . . . . . . . . 36 Hypothesis III . . . . . . 37 Supplementary Results . . . . . . 38 Additional Comparisons . . . . . . 39 DISCUSSION . . . . . . . . . . . 40 Theoretical Implications and Speculations . . . . . . . 42 Further Integration of Conceptions of Nostalgia and Schizophrenia . . . . 44 Further Areas for Research . . . . . 45 SUMMARY . . . . . . . . . . . . 47 APPENDICES . . . . . . . . . . . 49 A: SUMMARY OF SAMPLE CHARACTERISTICS . . . 49 B: SUMMARY TABLE OF RORSCHACH AND TAT RESULTS . . . . 50 C: EXAMPLES OF MALEVOLENT AND BENEVOLENT RORSCHACH PERCEPTS . . . . . 51 D: EXAMPLES OF NOSTALGIC AND NON- NOSTALGIC TAT STORIES AND THEIR ABSTRACTS. . . . . . . . . 52 BIBLIOGRAPHY . . . . . . . . . . . 53 Vi LIST OF TABLES Table Page 1. Demographic Data of Samples. . . . . . 28 2. Number of Individuals Telling at Least One Nostalgic Story and the Number Telling None . . . . . . . . . 33 3. Number of Individuals Describing Benevolent Interactive M— Percepts and the Number Describing None (Reactive-Process) . . . . 34 4. Number of Individuals Describing Malevolent Interactive M+ Percepts and the Number Describing None (Reactive-Process) . . . . 34 5. Number of Individuals Describing Benevolent Interactive M- Percepts and the Number Describing None (Reactive-Normal) . . . . 35 6. Number of Individuals Describing Malevolent Interactive M+ Percepts and the Number Describing None (Reactive—Normal) . . . . 36 7. Number of Individuals Describing Benevolent M- Percepts and the Number Describing None (Process-Normal) .. . . . . . . . 36 8. Number of Individuals Describing Malevolent Interactive M+ Percepts and the Number Describing None (Process-Normal) . . . . 37 9. Number of Schizophrenics Describing Benevolent Interactive M- Percepts and the Number Describing None . . . . . . 38 10. Number of Schizophrenics Describing Malevolent Interactive M+ Percepts and the Number Describing None. . . . . . . . . 38 ll. Results of t - Test Comparisons of Reactives, Processes, and Normals on TAT Story Lengths and Total Rorschach R's, Given in 3 Scores . . 39 vii FIXATION, REGRESSION, AND SCHIZOPHRENIA Fixation: The arrest of psychosocial develOpment (Werner, Campbell, Frazier and Stone, 1980, p. 118). Regression: A retreat to an earlier phase of instinctual organization, especially of the infantile period. Such a falling back occurs if, in the life process, a biologically predeterh mined maturational step presents the individual with difficulties which he is unable to master. Often this is deter- mined by unresolved conflicts and anxi- eties at earlier phases which leave 'areas of weakness' in the preceding de- velopmental phases (i.e. fixations) to which the individual is more likely to regress (Moore and Fine, 1968, p. 86). The analytic descriptions of schizophrenia seem con— sistently to involve fixation and regression as prime fac- tors in its etiology. Freud (1911) saw schiZOphrenia as a regression past the narcissistic stage to the autoerotic, presumably because the frustration of satisfaction caused by external obstacles leads the schizophrenic to hark "back to former happier days" (1924, p. 368). For the schizophrenic, Freud felt, only the very earliest stage of his existence "is one in which his libido could attain satisfaction, one in which he was happy" (p. 374)._ Fenichel (1945) expands upon this more systematically by stressing the dynamic con- nection between the strength of the fixation and the l 2 readiness to regress to it. "The stronger the occupation troops left behind the weaker is the army that marches on" (p. 65) and subsequently "it is easy to give up something that is not very important" (p. 305). He further details the causes of fixation (here only abbreviated) as great sat- isfaction at an early stage, perhaps followed by severe frus- tration or, alternatively, early frustration resulting in a refusal to develop further in a demand for the withheld satisfaction.1 This latter point is contested by Greenson (1967) who (echoing Freud) states "Fixations are caused pri- marily by excessive gratification and regression is set in motion by excessive pain or danger. One does not cling to some absent satisfaction unless there is a memory of exces- sive pleasure connected to it. . . . The more advanced grat- ification is too dangerous and the more regressed one is too unrewarding. Thus the fixation point is the most satisfying. It offers the best combination of gratification and security" (p. 83). Also in apparent agreement with Freud and in con- trast to Fenichel, Fairbairn (1954) connects the fixation with its psychotic manifestation by explaining "the orienta- tion toward partial objects found in individuals displaying schizoid features is largely a regressive phenomenon deter- mined by unsatisfactory emotional relationships with their 1It would seem, however, difficult to equate a fixa- tion which is based on excessive satisfaction, to a fixa- tion which is the result of pain and frustration. One would expect consistent differences between the two. 3 parents, and particularly their mothers, at a stage in childhood subsequent to the early oral phase in which this orientation originates" (p. 13). (Italics my own.) This positive aspect of regression, in that it represents an attempted retrieval of a more adequate past, is transformed into active functional movement by Jung (1928) who sees in regression to the point of fixation the possi- bility of a reintegration into the personality of those functions which had been abandoned in the process of later development. More recently, Laing (1962) has, in a similar vein, seen in the regression of schizophrenia and the poten- tial reintegration a possibility of great existential crea- tivity. They both underscore a theme present in, but infrequently emphasized by, the previous theories, that the fixation exerts a drawing power, a pull on the individual to regress. (This is even more explicit in Sechehaye, 1951a, 1951b, 1956, 1963; Schwing, 1954; and Schiff, 1970.) Searles, (1960) too, sees regression "as an expression of the individual's unconscious striving to recapture some form of existence, some mode of interpersonal relatedness which he experienced at a chronologically earlier age . . . in g£dg£_to achieve sufficient satisfaction, security, peace, physical and psychological strength . . . so as to be able to make a fresh attempt to overcome the particular matura- tional obstacle upon which he has so far come to grief"2 2 . The mode of relatedness was, then, at one time felt (p. 251). Though Arieti (1955, 1974) does away completely with the concept of fixation (except in a very broad sense), he, too, sees regression as an attempted resolution of an intol- erable situation, albeit an almost inevitably unsuccessful one. Regression, according to Arieti, is a retreat to a level of development and method of problem solving at a stage of more satisfactory interaction with the world. He points out that "These habits, however, have lost their original purposeful meaning and are not integrated with the rest of the life of the patient. No matter how much the patient regresses he will always be disintegrated" (1974, p. 435). In response to this disintegration he regresses further for a solution, leading to further disintegration, inciting further regression, to the point of losing contact with the concensually validated world. Research It would be surprising indeed if there were no ex- perimental interest in so important an analytic concept as regression, beginning, apparently, with the now classic studies by M0wrer (1940) (in which rats "regressed" to a previously learned or "fixated" response when a later- learned response produced shock) and Barker, Dembo and Lewin to exist, hence fixation is again viewed as premised on a relatively positive past. 5 (1941) (in which frustrating children by not allowing them to play with visible interesting toys resulted in them play- ing with greater immaturity). Unfortunately, the criticisms aimed at these early experiments, that Mowrer's experiment bears little relationship to the analytic concepts of fixa— tion and regression since these are inextricably tied to the idea of stages, unaddressed by this experiment (Hunt, 1964), and that Barker et_al. dealt not with true regression but with "lowering of quality of performance" or simple primiti— vation (Child and Waterhouse, 1962), are to a large part valid for subsequent research on regression/fixation in schizophrenia. Research on Regression/Fixation in Schizophrenia In general, reviews of research on schizophrenia pre- sent studies which are not specifically connected with re- gression as a primary feature of schizophrenia (Rabin and Winder, 1969) or describe at best equivocal or modest support for it (Buss and Lang, 1965). The more specific studies, however, do lend credence to regression as a consistent if not basic component of schizophrenia. Klorman and Chapman (1969) found that schizophrenics differ most from normals in making "stronger meaning" errors for word interpretations in inappropriate contexts much as younger children differ from older ones. "There is apparently, a developmental progression in propensity toward this differential error [i.e., the propensity to err decreases with age], and the 6 performance of schizophrenics corresponds to an early stage of this developmental trend" (p. 203). Similarly, schizo- phrenics paralleled younger children as compared to older children in making more literal misinterpretations of figu— rative usages (Chapman, Burstein, Day, and Verdone, 1961). As could be expected, (because of its psychodynamic sensitivity) the Rorschach has been used, with much success, to demonstrate regression in schiZOphrenics. Using Werner's (1948) orthogenetic principle, Friedman (1952) devised a scoring system to assess developmental maturity by the degree of differentiation and integration expressed in the percept. In his review of subsequent research, Hemmendinger (1960) stresses how consistent the findings based on this scoring method are with the hypothesis of regression in schizophrenia. Most recently, Glatt and Karon (1974) found that unmedicated schizophrenics displayed more regression (using Friedman's method) as their symptomatology became more severe and less as they improved. Scoring the level of development on the Rorschach not only differentiates between schizophrenics and normals, it also differentiates process schizophrenics (who appear to be developmentally lower on the Rorschach) from reactive schizo- phrenics (Becker, 1956). This finding was later replicated by Fine and Zimet (1959). It would seem from this that the process schizophrenics are more regressed than the reactive schizophrenics. This has, indeed, been corroborated in that 7 the developmental level of the process schizophrenics' formal operations (as defined by Piaget) as measured on an analogies test, was lower than that of the "reactives" (which in turn was lower than that of the normals) (Kilburg and Siegel, 1974). Similarly, while reactive schizophrenics, like normal adults, quickly learn to reverse the set when previously correct responses become incorrect (and vice versa), process schizophrenics, like children, maintain a non-functional dependence on incidental cues rather than reverse set—patterns (O'Keefe and DeWolfe, 1973). Criticism and Analysis of Regression Research Though at first glance research evidence appears to impressively corroborate the regression hypothesis, the essential criticism of the earlier studies profoundly chal— lenges their claim of relevance to the issue of psychodynamic regression. In fact, all these studies address themselves to a primitivation of functioning at best and simple non- development of mature functioning at worst. The issue of regression to a previous stage, so central to psychodynamic thinking and psychodynamic regression therapies (Sechehaye, 1956; Schwing, 1954; Azima, 1963) is not dealt with. Indeed, many of the authors (Glatt and Karon, 1974; Klorman and Chapman, 1969; Youkilis and DeWolfe, 1975) explicitly refer to Lewin's (1951) distinction between "retrogression" (analytic-style regression) and "regression" (primitivation). Furthermore, a major discrepancy appears to exist between 8 the research findings and the expectations leading from an analytic understanding of regression-fixation in schizophre- nia. The latter depicts a regression to the very earliest periods of existence while, in sharp contrast, the research shows them to be merely more childlike (fourth grade func- tioning rather than eighth grade functioning) rather than primitively early-infantile. A clarification of these issues may be found in A. Freud's (1965) distinction between regression in drive and libido development (affecting the aim, object, and/or mode of discharge) and regression in ego development. "While the former are determined above all by the stubborn adhesion of the drives to all objects and positions which have ever yielded satisfaction," (p. 98) "the retrograde moves on the ego scale do not lead back to previously established posi- tions, since no fixation points exist. Instead they retrace the way, step-by-step, along the line which has been pur— sued during the forward course" (p. 104). The regression ascribed to schizophrenia by the theorists and regression- therapists is clearly drive and libido regression while that dealt with by the research is, in contrast, ego-function regression. The separation between the two is, however, by no means absolute, for as A. Freud points out further, libidinal regression exerts a "regressive pull" to cause a complementary regression (in psychosis) of ego and superego (cf. Jacobson, 1946). Hence the experimental findings 9 assessing the level of ego functioning are consonant with the psychodynamic conceptualizations (and do not refute them in the assessment of a more "advanced" maturational level) but do not test them directly. Like the aforementioned theorists (and especially the regression-therapists) A. Freud recognizes the "draw to regress" exerted on the indi- vidual by the fixation. Fixation, then, implies a regres- sive position, a pull toward regression that would distin- guish the regressive from the non-regressive. This, indeed, may well be testable. Process and Reactive Schizophrenia The conceptualization of process schizophrenia as contrasted to reactive schizophrenia has been aptly summar- ized by Normington (1964). Process schizophrenia "is viewed as a behavioral disturbance of gradual and insidious onset often beginning in early childhood with a lack of clearly discernible stress factors. Prognosis is poor in contrast to the more positive outlook for those at the other end of the continuum, the reactive schizophrenics. Reactive schiz- ophrenics are considered to have a relatively normal pre- psychotic personality adjustment and to have experienced a sudden onset of psychosis in the presence of precipitating factors" (p. 10). Research on the process-reactive continuum has been comprehensively reviewed by Kantor and Herron (1966), by Higgins (1969), and more recently by DeWolfe (1974). It may 10 be generalized that process schizophrenics have lower devel- opmental level personality organizations (Kantor and Herron, 1966; Lerner, 1968; Ullman and Eck, 1965), generally show greater deficit in intellectual functioning (Belmont, Birch, Klein, and Pollack, 1964; Heath, Albee and Love, 1965; Schwartz, 1968) and have a poorer prognosis (Kantor and Herron, 1966; Gittelman-Klein and Klein, 1969). Differential Apperceptive Styles of Process and Reactive Schizophrenics After a detailed analysis of research pertaining to the process-reactive dichotomy, DeWolfe (1974) concludes that "process schizophrenics have failed to learn to think like other people because their early and continuing emo- tional social withdrawal left them little opportunity to do so. . . . The performance decrement of the reactives re- sults from fragmentation of their relatively normal thought processes. It is suggested that this fragmentation is caused by response interference due to excessive reaction to irrelevant stimuli and task demands." Brand (1975) hypothesized independently that process schizophrenics never learned how to relate to the world and perceptually grasp it in a realistic way. In contrast, re- active schizophrenics have learned to interact with the world, but under pressure escape it into schizophrenia. The pre— diction stemming from this hypothesis (that "reactives" would like timelessness, representing escape from the world, 11 more than "processes" would) was confirmed. It would seem, then, that if anything, reactive schizophrenics, rather than process schizophrenics, are those characterized by regression (in that they are involved in the active regressing into schizophrenic adaptation). But the process schizophrenics, generally viewed as the most "disturbed" schizophrenics (Kantor and Herron, 1966) are those who appear in research to be the more "regressed," at least in ego functions. How can one most effectively con- ciliate these findings? Further Theoretical Review and Integration Recent attention has been focused on the specific development of schizophrenia through childhood. "The under- lying anxiety and deep frustrations he has suffered and con- tinues to suffer from what he perceives as a lack of sympathy and understanding of the environment . . . grow out of his underlying unsatisfied need for love, the never-met need for primitive security that becomes established through the very earliest of infantile relations" (Shakow, 1971, p. 312). "These needs push to be satisfied though the individual has outstripped them by physical and mental growth and the con— comitant change in environment" (p. 311). An important part of him has stayed behind, undeveloped. Lidz (1973), in the statement of his subtle and detailed theory of schizophrenia, describes the schizophrenic as one who has never developed out of egocentrism. In this he apparently agrees with 12 Abraham (1955) that, in schizophrenia, "a person who has never passed out of the primary stage of his psychosexual development is thrown back more and more into the autoerotic stage" (p. 77). These views are magnified by Winnicott (1958) in his description of the "lost core of the real self," the "true self" (of the schizophrenic) "that is hidden away out of touch" with reality. A "true self" that as Guntrip (1961) summarizes so aptly, "has been hidden for a lifetime behind a false self constructed on the basis of compliance to the demands and expectations of the outer world" (p. 411). With this, Winnicott (and the others) de- lineates an essential fixation independent of a regressive urge. The individual, in actuality, in his "real self" re- mains at this early stage. The core self has not genuinely progressed, it has merely, under growth and environmental pressure, adaptively imitated true maturation. In the Freudian analogy, the main force has remained behind, while only very few troops were sent ahead. For this person there is no push to regress . . . he is there already. When he "confronts the clinician he does so equipped with a mental state nearer to that of the young infant than that of the grown adult. The cognitive deficiencies and other symptoms that characterize the patient's mental state can thus be crudely equated with infantile mental condition. It is not considered to be equivalent to or identical with a specific developmental phase, but to contain within it important 13 features which belong to the infantile period" (Freeman, Cameron, and McGhie, 1966, p. 27). This conceptual divorce of fixation from regression may clarify the relationship between process and reactive schizophrenia. The reactive schizophrenic is, as we men- tioned, regressive; the process schizophrenic is not so much regressive as primarily fixated. There is subsequently insufficient cathexis (psychological energy available for psychological investment in objects or experiences) for genuine development through the later stages. He does not have to go back; he has never left. It is understandable that he is consistently more inadequate than the reactive schizophrenic, he never really advanced except in a pseudo- fashion. The process-reactive continuum would be, in fact, an expression of the degree of fixation that characterizes the schizophrenic. The extreme process schizophrenic has developed relatively little beyond the point of fixation, while the more reactive a schizophrenic is, the more of him was able to develop, though a great deal of his existential self yet remains behind, exerting this regressive pull.3 It is this relatively intense fixation-point-pull that dis- tinguishes even the reactive schizophrenic from the neurot- ic-normal (cf. Balint, 1968). 3Indeed, as Erikson (1963) views development, dis- turbance at the earliest stage would make development through subsequent stages less successful. 14 This may shed further light upon Fenichel's observa— tion that sometimes regression seems premised upon a fixation caused by extreme frustration at the very stage of fixation. Why would one be drawn back to a most miserable period? (cf. note 1). The answer may be that in fact, in these cases, the schizophrenic does not regress to this position. Because of the extreme deprivation and libidinal investment at this stage, he simply failed to truly develop beyond it.4 He neatly fits the description of a process schizophrenic. This formal difference between process and reactive schizophrenics, that the latter is an expression of regres— sive pull, and the former more clearly represents a lack of genuine maturation, should be manifested in differential characteristic approaches of the two groups. 4Seward (1969) in his discussion of Maier's (1949) fixation experiment provides an interesting insight into the reason for fixation at a stage marked by misery. He points out that rats faced with an intolerable choice are reinforced by reduction in tension attendant upon any choice. This tension reduction then reinforces the choice. Similarly, any success/happiness during an intolerable state would be an extremely pleasant experience. NOSTALGIA Though nostalgia may be comprehensibly described as the "individual's response to change . . . by a symbolic return to, or reinstatement of, those features of his past . . . which are perceived as having the greatest gratifica— tion value" (Zwingmann, 1960, p. 3849), the available psy- chological literature on nostalgia deals almost exclusively with its pathological manifestations (Martin, 1954), i.e., when the constant dwelling on the past has an insistent, obsessive character. McCann (1941) in his review details the "typical" physiological and psychological symptoms of nostalgia and concludes that nearly every symptom known to man has been interpreted at one time or another as nostal- gic (p. 182). It would seem, however, that pathological noStalgia (or homesickness) has most generally been viewed as "reaction depression" (Bleuler, 1935; Kretchmer, 1934; Wittson, Harris, and Hunt, 1943). The very earliest discussion of nostalgia, in 1688, insightfully states, "They do not know how to forget their mother's milk" (Hofer, 1934). This agrees almost precisely with Sterba's (1940) View and is essentially similar to Fodor's (1950) position that nostalgia represents the wish to return to the womb. 15 16 More recently, nostalgia and homesickness have been ascribed to a loss of the sense of personal continuity into the future (Zwingmann, 1960; Nawas and Platt, 1965). The latter felt this was corroborated by the low concern for future events by homesick college students as measured by future events conceptualized and.length of time span con- ceptualized (Platt and Taylor, 1967). This latter position is most compatible with an Adlerian approach (and, in fact, the Nawas and Platt and Taylor and Platt articles were published in the Journal of Individual PsychologY), while the former clearly fits more easily into a psychoanalytic framework. These conceptualizations seem most adequate in re- ferring to the patholOgical nostalgic state, the "abnormal yearning for return to or return of some real or romanti— cized period or irrecoverable condition or setting in the past" (the common meaning given in Webster's Third Inter— national Unabridged Dictionary). The overwhelmingly nega- tive nature of this affect might best define "homesickness" rather than the phenomenally experienced "bitter-sweetness" of "nostalgia." Martin, in his excellent review and inte- grative article (1954) points to this non-pathological nostalgia, "a healthy surrender to the rhythmic biological inclinations to return to the past, to our beginnings . . . and to the unconscious" (p. 102). It then allows the inte— gration of hitherto undiscovered insights and new l7 perspectives on one's confrontation with existence. This creative movement cannot be interpreted as a pathological loss of future orientation or simply as a limiting oral or preoral fixation. For him nostalgia is not a limiting or restriction of perspective, on the contrary, it has great creative potential. He is speaking of nostalgia as almost synonymous with a regressive pull especially as described (and noted in previous sections) by Jung, Laing, and Searles. Creative regression in the "normal" individual differs from the schizophrenic regression in that the latter is to a more highly cathected fixation point and is there- fore "at the mercy" of the regressive pull. One who is subject to creative regression has sufficiently fixated energy at earlier points of existence (the oceanic state is, after all, frustrationless) to feel, and occasionally succumb to, a pull to regress. But there is also sufficient satisfaction and energy investment at later stages to pull the individual back from the regression. Clearly, the regressive individual would feel the nostalgic pull far more strongly than the non—regressive. Nostalgia, Escape, and Process—Reactive Schizophrenia Nostalgia may be viewed as the affective expression of the regressive pull. It is the retrogressive desire, the wish to exist as one once was (or as one imagines one once was). The readiness with which one can experience nostalgia seems to depend on the degree to which one is tied to l8 concrete reality and the present. Where reality contact is secure, the nostalgic style implies the accessibility to the past as a resource, while one is ineluctably tied to the present. It implies a capac- ity to use "regression in service of the ego" (E. Kris, 1952). Where contact with reality is markedly weak, it suggests a relatively great capacity to escape from reality. In light of the previous discussions, the reactive schizo- phrenic's present reality is not as highly cathected as that of the more normal individual. Much of his existential self is yet bound in what was. It is understandable that an in- adequately cathected reality can be disregarded with rela- tive ease. For this individual, nostalgia (a) reveals the existence of a highly cathected past resulting in the inad— equately cathected present (b) expresses an unusual capacity to move away from this weakly cathected reality in response to its pressures. Clearly, in contrast to the reactive schizophrenic, the process schizophrenic, whose existence (as has been pointed out) is not genuinely tied to present reality, and who quite possibly never experienced himself as existentially changed, would not be nostalgic. He lacks the stance from which to hark back. Traditionally, the F+ (and its movement counterpart, M+) on the Rorschach has been viewed as the agreement of one's perception with consensual reality. Conversely, an F— (and M—) response is a movement away from this reality. 19 Recently, Blatt, Brennais and Schimeck (1976) unexpectedly found that, when compared to normal adolescents, psychotic adolescent "patients had a greater number . . . of male— volent interactions on accurately perceived responses (for Blatt gt_al., synonymous with F+) and a greater number . . . of benevolent interactions on inaccurate responses (synony- mous with F-)" (p. 370). As they explain "For psychotic patients, adequate interpretations of reality seem to be a painful and disruptive experience, and the patients re- treat and withdraw to find comfort and peace" (p. 372). On the basis of the previous analyses this would fit most closely the characteristic approach toward life of the reactive schizophrenic as compared to the process schizo— phrenic. STATEMENT OF THE PROBLEM On the basis of the previous analysis, it appears that the relation between fixation and regression is not a linear one. Where fixation is greatest, there is no need or impulse to regress, since the individual has essentially never left. Where fixation is high, but not so high that it forestalls genuine future development, there is a strong pull on the individual toward this relatively pleasant and fixated past state. Where "fixation" is mild (and it is questionable whether the term fixation can be correctly used here), the individual may feel attraction for this early stage and its pleasures, but later stages contain enough cathexis and satisfaction for the pull to be neither over- whelming nor intense. This clarifies central issues of schizophrenia--regression and fixation, and allows a new perspective on the process-reactive distinction. The present study is an attempt to show that, in keeping with the regression/fixation distinction, the process schizophrenic is marked by an essentially fixated position, while the reactive schizophrenic is characterized by a contrasting essentially regressive position. In addition, by focussing on both the "regressing activity" 20 21 (distinct from primitivation) and the sense of a happier previous time-state as characteristic of the regressive individuals, this study attempts to examine regression in its more classically analytic sense. STATEMENT OF HYPOTHESES AND OPERATIONAL PREDICTIONS The regressive individual who feels the pull of the relatively pleasant past most strongly should experience nostalgia more strongly than the non-regressive. The amount of nostalgia experienced should therefore differentiate the characteristically regressive reactive schizophrenics from the characteristically fixated process schizophrenics. Hypothesis I: Reactive schizophrenics will be more nostalgic than process schizophrenics. Regression may be viewed as a characteristic escape reaction from the pressures of reality into an expected more pleasant existence. The difference in connoting greater pleasantness to autistic perceptions than to realistic per- ceptions should therefore differentiate the regressive re— active schizophrenics from the fixated process schizophrenics and the less regressive normal individuals. Hypothesis IIa: Reactive schizophrenics will have a more positive perception of their autistic world as compared to their perceptions of reality than will process schizophrenics. Hypothesis IIb: Reactive schizophrenics will have a more positive perception of their autistic world as compared to their perceptions of reality than will normal subjects. 22 23 Hypothesis IIc: In contrast to reactive schizophrenics, process schizophrenics will not have a more positive perception of their autistic world as compared to their perception of reality than will normal subjects. Regression represents both the possibility of escape from the strictures of present reality and the sense of possible movement to a more pleasant past. Therefore, a group with potential for autistic thought and which is characterized by nostalgia should also be characterized by a relative accessibility to unrealistic perceptions/fanta— sies as a more pleasant refuge for escape than one not so characterized. Hypothesis III: Nostalgic schizophrenics as a group will have a more positive per- ception of their autistic world as compared to their perceptions of reality than will non-nostalgic schizophrenics. OPERATIONAL PREDICTIONS Hypothesis I: I. Significantly more reactive schizophrenics than process schizophrenics will tell nostalgic stories on selected TAT cards. Hypothesis IIa: II. Significantly more reactive schizophrenics than process schizophrenics will describe benevolent interactions on M: responses to the Rorschach. 24 III. Significantly more reactive schiZOphrenics than process schizoPhrenics will describe malevolent interactions on M: responses to the Rorschach. Hypothesis IIb: IV. Significantly more reactive schizophrenics than normal individuals will describe benevolent interactions on M: responses to the Rorschach. V. Significantly more reactive schizophrenics than normal individuals will describe malevolent interactions on M: responses to the Rorschach. Hypothesis IIc: VI. There will not be significantly more process schizophrenics than normal individuals who describe beg: evolent interactions on M: responses to the Rorschach. VII. There will not be significantly more process schizophrenics than normal individuals who describe ma- levolent interactions on M: responses to the Rorschach. Hypothesis III: VIII. Significantly more nostalgic schizophrenics than non-nostalgic schizophrenics will describe benevolent interactions on M: responses to the Rorschach. IX. Significantly more nostalgic schizophrenics than non-nostalgic schizophrenics will describe malevolent interactions on M: responses to the Rorschach. METHOD The hospital records of psychiatrically hospitalized, psychologically evaluated, diagnosed schizophrenics were re- viewed. In order to minimize the possibility of biasing the results, first the Rorschach records and TAT's were scored on the Malevolent-Benevolent and Nostalgia dimensions respec- tively. The TAT stories were also abstracted and independ- ently scored for nostalgia by a psychology intern. Agreement was reached on all stories. Then the Social History chart of each patient was examined and scored for the process-reactive differentiation and assignment to each of the two categories was made. Subjects The schizophrenic sample was made up of all male McLean Hospital admissions from 1968 through 1977, aged 18 to 45, diagnosed on the basis of psychological testing as schizophrenic. Excluded from this sample were those describ- ed as "schizo-affective," those with the statement "with a severe affective component" included in the diagnosis, those with a diagnosed organic impairment, and those with WAIS verbal IQ scores below 90. Excluded also were those whose Rorschach or TAT protocols were unreadable, and those either 25 26 lacking a social history report or having one of insuffi- cient detail to score it confidently on the Harris scale. The normal sample was made up of male applicants to teachers' seminaries, diagnosed by an experienced senior Ph.D. psychologist with extensive diagnostic experience as "Normal" or Normal+." They, too, ranged in age from 18 to 45 and had WAIS verbal IQ scores of 90 or above. No TAT data was available for the normal group. CHARACTERISTICS OF THE SAMPLES Schizophrenic Sample Of the more than 180 schizophrenic test protocols reviewed, 107 fulfilled the diagnostic, verbal IQ and clar- ity of test transcription criteria. Of these 54 had suffi- ciently detailed social histories (yielding discriminating data) to provide a reliable process-reactive distinction. Because just one nostalgic story given as a response to any of the six pre—selected TAT cards resulted in a posi- tive nostalgic score, only those individuals who were given all six cards 22d had readable responses could be included in the "non-nostalgic" statistic. (On the other hand, simply responding to only one card, if the response was nostalgic, resulted in being included in the nostalgic sample.) Thus, the TAT's of 22 individuals (18 reactives and four processes) were eliminated, five having been shown no TAT cards, two having been shown three, six having been shown four, and five having been shown five. Reactive Group This group, consisting of the 36 schizophrenics scored as reactive on the Harris scale (1975), had a mean age of 24.7, a mean verbal IQ of 115.2 (S.D. = 13.2) a mean 27 28 Rorschach R of 23.1 (S.D. = 10.8) and a mean TAT story length of 65.2 words (S.D. = 25.3). Process Group This group, consisting of the 18 schizophrenics scored as process on the Harris scale, had a mean age of 23.0, a mean verbal IQ of 118.7 (S.D. = 18.0), a mean Rorschach R of 23.7 (S.D. = 11.8), and a mean TAT story length of 98.6 words (S.D. = 72.8). Normal Group This group, consisting of 28 individuals judged by a senior psychologist as normal had a mean age of 25.6, a mean verbal IQ of 123.7 (S.D. = 10.7), and a mean Rorschach R of 38.7 (S.D. = 28.0). Table 1: Demographic Data of Samples N Mean Age Mean Verbal IQ Normals 28 25.6 123.7 Reactives 36 24.7 115.2 Processes 18 23.0 118.7 INSTRUMENTS OF MEASUREMENT I The Nostalgia Measure The TAT has been used as a measure of nostalgia (Cleveland & Johnson, 1962). Each patient's TAT cards 1, 2, 3 BM, 4, 10, and 13 MF was reviewed. Each story in which the past situation is specifically described as more posi- tive than the contrasted "present" experience of the depicted protagonist was scored as "nostalgic." The terms "nostalgia" and "nostalgic" as used henceforth in this dissertation are meant to refer to this operational definition. Examples of "nostalgic" and "non-nostalgic" TAT stories are provided in Appendix D. The interrater reliability was .98 (point bi- serial correlation). II The Process-Reactive Measure Harris (1975) has developed and validated an abbre- viated version of the widely accepted Phillips process- reactive scale (1953). The information necessary for scor- ing on the Harris scale is more commonly available in the social history sections of hospital records, removes the re- dundancies of the Phillips scale, and allows for the effects of age on expected attainments in the sexual history. It consists of a scale of premorbid sexual adjustment and a 29 30 scale of premorbid personal-social adjustment. These aspects of the individual's history are scored in terms of exhibited past competence, the extent and seriousness of love and social relationships. On each scale a score of four (4) or more indicates process, in contrast to reactive (two or less), schizophrenia. A score of three is indiscriminative and not assignable to either category. Where possible, both scales of the Harris measure were used. Where they contradict each other, the sex scale alone was used. This is consistent with Harris' suggestions and previous literature (Harris, 1975). Where the individ- ual's age was below 20, or if there was insufficient discrim- inative data for a reliable score on the sexual scale, the social scale was used.' All these are consonant with the data and suggestions in the article and are also in line with previous uses of the Phillips process-reactive scale. III The Malevolent—Benevolent Scoring of the RorSChach Blatt et_al. (1976b) have devised a manual which, in part, divides interactions on the Rorschach into Benevolent ("The activity is not destructive, harmful or aggressive. It may be neutral or it may reflect a warm positive rela- tionship between objects,") and Malevolent ("The interaction is aggressive or destructive or the results of the activity implies destruction or harm or fear of harm"). Numerous examples of each are provided by Blatt et al. (1976a) and 31 can be found in the appendix. The inter-rater reliability has been consistently found to be above .90 (Blatt et_al. 1976a; Blatt et_al. 1976b). The form level of the responses are based on the F+, F— categories of Beck et_al. (1961). The M scores in each category are the number of individuals in the specified group who gave at least one M response with the characteristic under investigation (i.e., benevolent M+, benevolent M-, malevolent M+, or malevolent M-) . TREATMENT OF THE DATA Because of the limited sample size and the character- istics of the data, the Fisher exact test for 2x2 contingency tables (Hays, 1963) was used throughout (with the logarithmic transformation of the gamma function used for computation of the factorials). This non—parametric test computes the exact probability of a sample's chance showing of as much or more evidence of association between two variables as that obtain— ed in the course of investigation. In order to check on the possibility of artifactual statistical significances result— ing from the number of experimental responses covarying with the number of total responses, 3 tests were performed compar— ing the means of the total response numbers on the Rorschach as well as the means of the response lengths on the TAT. As supplementary data, mean verbal IQ scores of the process, reactive and normal groups were compared and phi coefficients were computed for the correlation of the TAT data with the reactive/process dichotomy and with the Rorsch- ach dimensions. 32 f . .15 . is). 3N. -lmx RESULTS Hypothesis I Operational Prediction 1: It was predicted that more reactive than process schizophrenics would tell nostalgic TAT stories. The results were in the direction hypothesized and the Fisher exact test gave the probability of these findings occurring by chance as .002. Table 2: Number of Individuals Telling at Least One Nostalgic Story and the Number Telling None Nostalgic No Nostalgic Reactive ll 7 Process 1 13 p = .002 .55 Phi correlation Hypothesis IIa Operational Prediction 2: It was predicted that more reactive than process schizophrenics would describe benevolent interactive M- percepts on the Rorschach. The results were in the direction hypothesized and the Fisher exact test gave the probability 33 34 of these findings occurring by chance as .08. Table 3: Number of Individuals Describing Benevolent Interactive M— Percepts and the Number Describing None (Reactive-Process) Benevolent M- No Benevolent M- Reactive 9 27 Process 1 17 p = .08 Operational Prediction 3: It was predicted that more reactive than process schizophrencis would describe malevolent interactive M+ percepts on the Rorschach. The results were in the direction hypothesized and the Fisher exact test gave the probability of these findings occurring by chance as .02. Table 4: Number of Individuals Describing Malevolent Interactive M+ Percepts and the Number Describing None (Reactive-Process) Malevolent M+ No Malevolent M+ Reactive 18 18 Process 3 15 p = .02 35 Hypothesis IIb Operational Prediction 4: It was predicted that more reactive schizophrenics than normal individuals would describe benevolent inter- active M- percepts in the Rorschach. The results were in the direction hypothesized and the Fisher exact test gave the probability of this occurring by chance as .06. Table 5: Number of Individuals Describing Benevolent Interactive M— Percepts and the Number Describing None (Reactive-Normal) Benevolent M- No Benevolent M- Reactive 9 27 Normal 2 26 p = .06 Operational Prediction 5: It was predicted that more reactive schizophrenics than normal individuals would describe malevolent inter— active M+ percepts on the Rorschach. The results were in the direction hypothesized but the Fisher exact test showed the probability of this occurring by chance as too great to reject the null hypothesis. Table 6: Malevolent M+ Reactive 18 Normal 9 Hypothesis 11c 36 Number of Individuals Describing Malevolent Interactive M+ Percepts and the Number Describing None (Reactive—Normal) No Malevolent M+ l8 19 p = .11 Operational Prediction 6: It was predicted that in contrast to the reactive- normal distinction, there would not be significantly more process schizophrenics than normals who describe benevolent interactive M- percepts on the Rorschach. As hypothesized, the difference is non—significant both by inspection and the Fisher exact test. Table 7: Benevolent M- Process 1 Normal 2 Number of Individuals Describing Benevolent M— Percepts and the Number Describing None (Process-Normal) No Benevolent M— 17 26 .50 (as hypothe— sized) N.S. J. . . lqulacl‘lvr . r . ‘11 1. I} ivl . 37 Operational Prediction 7: It was predicted that there would not be significantly more process schizophrencis than normal individuals who de- scribe malevolent interactive M+ percepts on the Rorschach. As hypothesized the difference was non-significant. In addition, in contrast to the reactive/normal distinction (Table 5) the process schizophrenics gave fgwg£_malevolent M+ responses than the normals. Table 8: Number of Individuals Describing Malevolent Interactive M+ Percepts and the Number Describing None (Process—Normal) Malevolent M+ No Malevolent M+ Process 3 15 Normal 9 19 p > .50 N.S. (as hypothe— sized) Hypothesis III Operational Prediction 8: It was predicted that more nostalgic than non-nostal- gic schizophrenics would describe benevolent interactive M- percepts on the Rorschach. The results were in the direction hypothesized and the Fisher exact test gave the probability of this occurring by chance as .05. 38 Table 9: Number of Schizophrenics Describing Benevolent Inter- active M- Percepts and the Number Describing None Benevolent M- No Benevolent M- Nostalgic 4 8 Non-Nostalgic l 19 p .05 Phi correlation .38 Operational Prediction 9: It was predicted that more nostalgic than non-nostal- gic schizophrenics would describe malevolent interactive M+ percepts on the Rorschach. The results were in the direction hypothesized and the Fisher exact test gave the probability of this occurring as .01. Table 10: Number of Schizophrenics Describing Malevolent Inter- active M+ Percepts and the Number Describing None Malevolent M+ No Malevolent M+ Nostalgic 6 6 Non-Nostalgic 1 19 .01 Phi correlation .53 Supplementary Results The phi coefficients showed the presence of nostalgic stories on the TAT to correlate .55 with the diagnosis of reactive schiZOphrenia. 39 The phi coefficient showed the presence of nostalgic stories on the TAT to correlate .38 with the presence of Benevolent M- percepts and .53 with the presence of Malevo— lent M+ percepts on the Rorschach. Multiple E tests were computed comparing the lengths of the TAT stories of process and reactive schizophrenics, the total R's of process and reactive schizophrenics and the total R's of reactive schizophrenics and normal subjects. Only the latter was significant, p < .01, with normals having the greater R. Table 11: Results of E - Test Comparisons of Reactives, Processes, and Normals on TAT Story Lengths and Total Rorschach R's, Given in E Scores TAT Length (number of words) R Reactive/Process 1.55 (N.S.) 0.19 (N.S.) Reactive/Normal 3.97 (p < .01) Additional Comparisons Multiple E - tests of the differences between the three groups shown in Table 1 revealed no significant differ- ences in the ages of the process, reactive and normal samples, nor was there a significant difference between the verbal IQ's of the reactive and process samples. The verbal IQ of the normal sample, however, was significantly higher than that of either of the schizophrenic groups (p < .05). DISCUSSION The findings were, in general, consistent with the hypotheses and their theoretical underpinnings. Signifi- cantly more reactive than process schizophrenics expressed "nostalgia" on the TAT (Table 2). In fact, only one process schizophrenic produced a "nostalgic" TAT story. Significant- ly more reactive than process schizophrenics described well formed interactive movement responses on the Rorschach as malevolent (Table 3), while more reactive than process schizophrenics also described unrealistically perceived Rorschach interactions as benevolent (Table 4) (though this latter result narrowly missed attaining statistical significance). These results suggest that this sample of reactive schizophrenics shows more "nostalgia" than the sample of process schizophrenics, as well as more characteristically viewing "unreality" as pleasant and "reality" as unpleasant than the process schizophrenics. More of the reactive schizophrenics than normal individuals described unrealistically perceived Rorschach interactions as benevolent (Table 5) (though this very narrowly missed attaining statistical significance), while more reactive schizophrenics than normals also described 40 41 realistically perceived Rorschach interactions as malevolent (Table 6) (though this did not attain formal statistical significance). In contrast, there was little, if any, dif- ference between the process schizophrenics and the normals in their unrealistically perceived Rorschach interactions (Table 7) and the process schizophrenics had EEEEE benevo- lent realistically perceived Rorschach interactions (Table 8), a pattern opposite that of the reactive-normal distinction. The correspondence between the nostalgia measure and the Rorschach measures is attested to by the significances of the relationships and the correlations obtained (Tables 9 and 10). Since these levels of significance are greater than those of the process-reactive distinction relating to the Rorschach categories (Tables 4 and 5), it suggests that the TAT and Rorschach measures may be tapping a common factor not limited to the process-reactive dimension. The various comparisons between the groups (TAT story length, verbal IQ, R, age) show only two significant differ- ences (data summaries and tables can be found in Appendices A and B). Both verbal IQ and Rorschach R's of the normal group were significantly higher than those of the reactive group. However, since a higher IQ and greater R would tend to increase the complexity, variety, and number of M on the Rorschach, the opposite findings in these respects obtained in this study suggest that these experimental variables 42 override the influence of IQ and R production. The care taken in selecting as "pure" samples as possible resulted in a very limited N. This would contribute to a minimization of the statistical significance derived by characteristically conservative non-parametric tests. The clarity of the results in spite of these limitations lends even greater credence to the conceptualizations that led to the corroborated expectations. A caveat must be recognized, however. The average verbal IQ of all three sample groups was extremely high, reflecting the unusually high intellectual abilities of these population pools. It is therefore important to exer— cise care before generalizing from these samples so atypical with respect to intelligence. Nonetheless, there does not seem to be a reason to suspect that high IQ's of all three groups would bias differential results. Theoretical Implications and Speculations The picture of process and reactive schizophrenia that emerges from this study is consistent with the theo— retical position presented in the first section. The individ- ual on the more reactive end of the process-reactive continu- um appears to perceive a realistic world suffused with malevolence and an unreal world of relative harmony (the dimension tapped by the Rorschach). Given this perception, he is characterized by an unusual involvement with and attraction to the experienced and expected pleasantness of 43 that which is not (the dimension assumed to be tapped by the Nostalgic TAT). Consequently, this individual can be viewed as actively regressive. For him there is an evaluative dis- equilibrium between reality and unreality, with the gradient of attraction favoring the latter. Though existing in the real world, he has never completely left his autistic posi- tion. Both his attitude about the real world and his demon— strated investment in the unreal world seem expressed in his yearning for what once was and no longer is. This positive evaluation of unreality, therefore, persistently threatens his hold on the perceived-as-unpleasant reality. This would not be true for "normal" individuals (for whom the disequi- 1ibrium and attendant strain do not exist, perhaps because, as the very few M- shows, the autistic world is not deeply invested in) or for process schizophrenics (for whom the evaluative gradient does not favor the autistic nor is there an urge to existentially shift). It is therefore consistent with theory and these research findings to maintain that the primitiveness of the latter group is not a result of regres— sion as much as an essential failure in true development out of the autistic position, 113'! an essential fixation rather than the essential regression that characterizes the reac- tive schizophrenic. This conceptualization of the reactive schizophrenic as seeking autism could add to ideas such as those of Freeman (1959), in which schizophrenic regression is viewed as an 44 ego directed activity. Consequently, we might View this regression as an escape rather than as a structural break- down of ego processes. Further Integration of Conceptions of Nostalgia and Schizophrenia Werman (1977), following Geahchan (1968) conceived of nostalgia as an insufficient resolution of the loss of the early object. It is a failure to completely mourn. The in— ability to abandon these early experience-states and objects results in "an inability to love new objects, a depreciation of objects in one's current life, and an endless pursuit of nostalgic memories for themselves at the expense of an inhibition in many areas of existence" (Werman, 1977, p. 396). Thus, as conceptualized, the reactive schiZOphrenic has never wholly emerged from earliest experience. As a result he is insufficiently invested in reality and cannot appropriately cathect its positive qualities. He is there— fore prone to regression. The nostalgic feeling would be the experience of maintained ties with the autistic while exist- ing in the real. It would seem then that the essential nos- talgic position would be a defining characteristic of the regressive reactive schizophrenic. The dangers of precipi- tous regression are not as great for the normal individual, nostalgic or not, because there would seem to be insufficient investment in the autistic world (as evidenced by low M-) for it to exert its regressive power. 45 Further Areas for Research As proposed in this paper, regression may be conceptu- alized in terms of two dimensions, that of a reality-unreal— ity pleasantness gradient (the Rorschach measures) and that of a level of urge to regress (the Nostalgia measure). These two dimensions, in turn, may be viewed in terms of: the pleasantness of "unreality," the unpleasantness of "reality," and the inclination to leave the "present," "real world." A study of the interactions between these variables might yield valuable information about the "regression in- service of the ego," a concept considered crucial in compre— hending creativity. The creative individual might therefore be viewed as nostalgic, in ways similar to the reactive schizophrenic, but without ascribing greater pleasantness to the unreal world in contrast to the relatively unpleasant "reality." Alternatively, the evaluative disequilibrium between the "real" and the "unreal" might be as severe but lacking the active involvement with the autistic (M-) that characterizes the schizophrenic. Thus the creative individ- ual can rebound from the contact with the unreal having re- solved the momentary disequilibrium by allowing the brief flow from the fantastic to the existing (Jung, 1960). The lack of bond to the autistic might also allow the creative individual greater opportunity to integrate positive experi- ences in reality than is possible for the schizophrenic. 46 These issues may be analyzable by using the TAT and Rorschach factors introduced in this paper. The area of psychopathology, too, presents research opportunity. Spitzer, Endicott, and Gibbon (1979) have shown the borderline disorder to be separable into two dis- crete entities. One, the "schizotypal personality" is marked by inadequate rapport and social isolation (among other characteristics). The other, the "unstable personal- ity" is marked by instability, feelings of emptiness, lone- liness, and intensity of affect. The sterile existence of the former as contrasted to the instability of the latter might present a parallel to the process-reactive distinction. The unstable personality might correspond to the reactive schizophrenic, while the schizotypal personality appears more closely related to the process schizophrenic. Thus an investigation of these subtypes of borderline disorder might reveal relationships to the autistic world similar in quality to that of the subtypes of schizophrenia. S UMMARY Reviews of the literature on schizophrenia, the process-reactive dichotomy, regression, and nostalgia led to the speculation that nostalgia and potential for regres- sion are related and would differentiate reactive from pro- cess schizophrenics. This is a consequence of the idea that for "reactives," in contrast to the more "fixed" "process" patients regression is an escape into the remembered grati— fication of the earliest stages of development. Based on this understanding predictions were made that more "reac- tives" than "processes" would tell nostalgic stories on the TAT, that more "reactives" would evaluate interactive autistic Rorschach percepts positively and interactive realistic percepts negatively, that more "reactives" than normal subjects would evaluate interactive autistic Rorschach percepts positively and interactive realistic per cepts negatively; that this difference would not occur in contrasting "processes" and "normals," and that more nostal- gic than non-nostalgic schizophrenics would evaluate inter- active autistic Rorschach percepts positively and interactive realistic Rorschach percepts negatively. The TAT's and Rorschachs of 36 reactive and 18 pro— cess schizophrenics were compared. Also Rorschachs of 28 47 48 normal individuals were compared to the protocols of the schizophrenics. Based on a statistical analysis of the material obtained, the following were the results: 1. Significantly more "reactives" than "processes" told nostalgic TAT stories. 2. Significantly more "reactives" than "processes" evalu- ated interactive autistic Rorschach percepts positively and there was a strong tendency for more "reactives" than "pro- cesses" to evaluate interactive realistic Rorschach percepts negatively. 3. There was a strong tendency for more "reactives" than "normals" to evaluate interactive autistic Rorschach per- cepts positively; also there was a trend for more "reactives" than "normals" to evaluate interactive realistic Rorschach percepts negatively. 4. "Processes" did not evaluate autistic interactive Rorschach percepts more positively than "normals" nor did they evaluate realistic interactive percepts more negatively than "normals." 5. Significantly more nostalgic than non-nostalgic schizo- phrenics evaluated interactive autistic Rorschach percepts positively and interactive realistic Rorschach percepts negatively. The results were interpreted as consistent with the hypothesized relationships between nostalgia, regression, and the process—reactive dichotomy. APPENDIX A SUMMARY OF SAMPLE CHARACTERISTICS APPENDIX A SUMMARY OF SAMPLE CHARACTERISTICS Reactives: N = 36, Mean Age = 24.7, Mean VIQ = 115.2 (S.D. = 13.17) Mean R = 23.1 (S.D. = 10.8), Mean TAT story length = 65. (S.D. = 25.2) Number of individuals with: nostalgic TAT stories = 11, no nostalgic stories = 7 benevolent M- Rorschach percepts = 9 no benevolent M— malevolent M+ percepts = 18, no malevolent M+ = 18 malevolent M- percepts = 5, no malevolent M- = 31 Processes: N = 18, Mean Age = 23.0, Mean VIQ = 118.7 (S.D. = 18.0), Mean R = 23.7 (S.D. = 11.28), Mean TAT story length = 98.6 (S.D. = 72.7) Number of individuals with: nostalgic TAT stories = 1, no nostalgic stories = 13 benevolent M- percepts 1, no benevolent M- percepts malevolent M+ percepts = 3, no malevolent M+ percepts malevolent M- percepts = 4, no malevolent M- percepts Normals: N = 28, Mean Age = 25.6, Mean VIQ = 123.7 (S.D. = 10.67) Mean R = 38.7 (S.D. = 28.0) Number of individuals with: benevolent M- percepts = , no benevolent M— percepts ‘ 2 malevolent M+ percepts = 9 no malevolent M+ percepts 1 malevolent M- percepts = , no malevolent M- percepts 49 I 2 27 17 15 14 26 19 27 APPENDIX B SUMMARY TABLE OF RORSCHACH AND TAT RESULTS mm mm ma mm Ao.mmn.o.mvh.mm mHmEHoz vH va ma 5H ma As.meu.o.mve.mm 1m.aeu.n.mvo.mm mommmooum Am.mmn.n.mvm. 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