Psychosis as a Disorder of Reduced Cathectic Capacity: Freud's Analysis of the Schreber Case Revisited

Approximately 100 years ago, a prominent German public figure name Daniel Schreber wrote memoirs of his experiences in asylums. His case was diagnosed Dementia Praecox at times and Paranoia at others by his treaters. Freud analyzed Schreber''s memoirs from the perspective of his “libido” theory of developmentally organized mental “cathexes” or ideational/emotional investments in self and others. Revisiting Freud''s analysis of the Schreber case suggests that it may represent the first theoretical articulation that the pathophysiologic core of psychosis is one of deficit, i.e., of diminished (organic) cathectic capacity for normal mental and affective investments in life.