THE PRACTICE OF THE TOTAL PUSH METHOD IN THE TREATMENT OF CHRONIC SCHIZOPHRENIA

The foregoing group of 11 deteriorated patients, suffering from chronic schizophrenia, who have been ill an average of 12.1 years and whose average hospitalization is over ten years, have shown the changes as recorded after three months' treatment with the total push method. The larger group of 22 patients in a shorter period of time are making similar improvement in their social conduct and general reaction. They can be described as slightly improved, much improved and markedly improved. In none of these patients has the condition become worse. This improvement is shown in better contact with reality, in social responsiveness, increased activities, skill and coordination, sociability, improved mood and æstheticism with some degree of improvement in physical status. There has been a response to competitive games and to the reward-punishment and praise-blame concepts in accordance with the theories and principles advanced by Dr. Myerson. One of our patients, Patient 2, has improved to such an extent in his social status that a program of re-education has begun and he is already making satisfactory progress. It is our hope that such a program of re-education and an increasing program of psychotherapy may be applied to a considerable number of these patients.

We believe that if the insulin and metrazol therapy are used, the total push method should be instituted in its fullest sense as an important adjunct. We are offering it, however, as a distinct method of organized, intensive, individual activation in chronic schizophrenia. Such an intensive method of treatment has not only improved the mental and physical status of these patients, but since its success depends upon the thoroughly coordinated efforts of nurses, physicians, physiotherapists, physical instructors and occupational therapists, it has been stimulating to the entire personnel and has added much to the hospital morale.