Wednesday, May 11, 2016

The patient, living in an institution or outside, has come to an arrangement with his illness.  He has adapted himself to the world of his morbid ideas with more or less success, from his own point of view and from that of his environment.  Compared with the experiences during the acute psychosis, his positive symptoms, such as delusions or hallucinations, have become colorless, repetitive, and formalized.  They still have power over him but nothing is added and nothing new or unexpected happens.  Negative symptoms, thought disorder, passivity, catatonic mannerisms and flattening of affect rule the picture, but even they grow habitual with the patient and appear always in the same inveterate pattern in the individual case.  There is a robotlike fixity and petrification of attitude and reactions which are not only due to poverty of ideas but also to a very small choice of modes of behavior.

from "Possible Courses:  30 Years Later" in Surviving Schizophrenia, by E. Fuller Torrey, M.D.

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