Christopher Bollas’s New York Times essay “A Conversation on the Edge of Human Perception” portrays schizophrenia as a nonspecific, imaginative, debatable diagnosis.

Bollas, a psychoanalyst, says that psychiatrists are wrong to emphasize medication as the mainstay of treatment for people with schizophrenia. Bollas says, “Talking to an empathetic other is curative. We all know that.”

As an example, he says that Lucy, a 55-year-old writer, phoned him from thousands of miles away to ask if he wanted to psychoanalyze her, long-distance. He agreed. So they had therapy sessions by phone at 8 o’clock in the evening, five nights a week. “By the end of the fifth year of our work, Lucy was no longer hallucinating and she was no longer dwelling in past memories…”

Here is a link for the essay, to read it yourself:

http://opinionator.blogs.nytimes.com/2015/10/17/a-conversation-on-the-edge-of-human-perception/?_r=0

Now, it may be that if I knew more about Lucy, I would agree with Bollas’s diagnosis, but based on what is in the essay, I would hesitate to diagnose Lucy as having schizophrenia. In my opinion, just having hallucinations, especially about mythical figures, and more especially if the hallucinations are affected by the power of suggestion, and even more especially if they occur in a writer, do not confirm a diagnosis of schizophrenia. But the diagnostic criteria for schizophrenia are so nonspecific that I can see how Lucy could be misdiagnosed.

Oct 21, 2015: I should add that Bollas's whole scenario for Lucy is inconsistent with what most psychiatrists would call "schizophrenia." You would not expect a person who truly has schizophrenia to seek someone out with a request to be analyzed, and then stick with that for five-plus years. One of the main things impaired in schizophrenia is interpersonal relatedness, and persons with schizophrenia don't seek to increase interpersonal relations and have someone intrude into their issues. Moreover, true schizophrenic hallucinations and delusions tend to be nonsensical or bizarre, not metaphorical or amusing, no matter how empathic the therapist is.