It is not easy for the therapist to discern when, in the patient's communicating, an introject has appeared and is holding sway.
One learns to become alert to changes in his vocal tone -- to his voice's suddenly shifting to a quality not like his usual one, a quality which sounds somehow artificial or, in some instances, parrot-like.
The content of his words may lapse back into monotonous repetition, as if a phonograph needle were stuck in one groove;
only seldom is it so simple as to be a matter of his obviously parroting some timeworn axiom, common to our culture, which he has evidently heard, over and over, from a parent until he experiences it as part of him.

One hebephrenic woman often became submerged in what felt to me like a somehow phony experience of pseudo-emotion, during which, despite her wracking sobs and streaming cheeks, I felt only a cold annoyance with her.
Eventually such incidents became more sporadic, and more sharply demarcated from her day-after-day behavior, and in one particular session, after several minutes of such behavior -- which, as usual, went on without any accompanying words from her -- she asked, eagerly, "Did you see Granny"?
At first I did not know what she meant;
I thought she must be seeing me as some one who had just come from seeing her grandmother, in their distant home-city.
Then I realized that she had been deliberately showing me, this time, what Granny was like;
and when I replied in this spirit, she corroborated my hunch.

At another phase in the therapy, when a pathogenic mother-introject began to emerge more and more upon the investigative scene, she muttered in a low but intense voice, to herself, "I hate that woman inside me"!
I could evoke no further elaboration from her about this;
but a few seconds later she was standing directly across the room from me, looking me in the eyes and saying in a scathingly condemnatory tone, "Your father despises you"!
Again, I at first misconstrued this disconcertingly intense communication, and I quickly cast through my mind to account for her being able to speak, with such utter conviction, of an opinion held by my father, now several years deceased.
Then I replied, coldly, "If you despise me, why don't you say so, directly"?
She looked confused at this, and I felt sure it had been a wrong response for me to make.
It then occurred to me to ask, "Is that what that woman told you"?
She clearly agreed that this had been the case.
I realized, now, that she had been showing me, in what impressed me as being a very accurate way, something her mother had once said to her;
it was as if she was showing me one of the reasons why she hated that woman inside her.
What had been an unmanageably powerful introject was now, despite its continuing charge of energy disconcerting to me, sufficiently within control of her ego that she could use it to show me what this introjected mother was like.

Earlier, this woman had been so filled with a chaotic variety of introjects that at times, when she was in her room alone, it would sound to a passerby as though there were several different persons in the room, as she would vocalize in various kinds of voice.
A somewhat less fragmented hebephrenic patient of mine, who used to often seclude herself in her room, often sounded through the closed door -- as I would find on passing by, between our sessions -- for all the world like two persons, a scolding mother and a defensive child.

Particularly hard for the therapist to grasp are those instances in which the patient is manifesting an introject traceable to something in the therapist, some aspect of the therapist of which the latter is himself only poorly aware, and the recognition of which, as a part of himself, he finds distinctly unwelcome.
I have found, time and again, that some bit of particularly annoying and intractable behavior on the part of a patient rests, in the final analysis, on this basis;
and only when I can acknowledge this, to myself, as being indeed an aspect of my personality, does it cease to be a prominently troublesome aspect of the patient's behavior.
For example, one hebephrenic man used to annoy me, month after month, by saying, whenever I got up to leave and made my fairly steoreotyped comment that I would be seeing him on the following day, or whenever, "You're welcome", in a notably condescending fashion -- as though it were his due for me to thank him for the privilege of spending the hour with him, and he were thus pointing up my failure to utter a humbly grateful, "thank you" to him at the end of each session.
Eventually it became clear to me, partly with the aid of another schizophrenic patient who could point out my condescension to me somewhat more directly, that this man, with his condescending, "You're welcome", was very accurately personifying an element of obnoxious condescension which had been present in my own demeanor, over these months, on each of these occasions when I had bid him good-bye with the consoling note, each time, that the healing Christ would be stooping to dispense this succor to the poor sufferer again on the morrow.

Another patient, a paranoid woman, for many months infuriated not only me but the ward-personnel and her fellow patients by arrogantly behaving as though she owned the whole building, as though she were the only person in it whose needs were to be met.
This behavior on her part subsided only after I had come to see the uncomfortably close similarity between, on the one hand, her arranging the ventilation of the common living room to her own liking, or turning the television off or on without regard to the wishes of the others, and on the other hand, my own coming stolidly into her room despite her persistent and vociferous objections, bringing my big easy chair with me, usually shutting the windows of her room which she preferred to keep in a very cold state, and plunking myself down in my chair -- in short, behaving as if I owned her room.

4.

Condensation.

Here a variety of meanings and emotions are concentrated, or reduced, in their communicative expression, to some comparatively simple-seeming verbal or nonverbal statement.

One finds, for example, that a terse and stereotyped verbal expression, seeming at first to be a mere hollow convention, reveals itself over the months of therapy as the vehicle for expressing the most varied and intense feelings, and the most unconventional of meanings.
More than anything, it is the therapist's intuitive sensing of these latent meanings in the stereotype which helps these meanings to become revealed, something like a spread-out deck of cards, on sporadic occasions over the passage of the patient's and his months of work together.
One cannot assume, of course, that all these accumulated meanings were inherent in the stereotype at the beginning of the therapy, or at any one time later on when the stereotype was uttered;
probably it is correct to think of it as a matter of a well-grooved, stereotyped mode of expression -- and no, or but a few, other communicational grooves, as yet -- being there, available for the patient's use, as newly-emerging emotions and ideas well up in him over the course of months.
But it is true that the therapist can sense, when he hears this stereotype, that there are at this moment many emotional determinants at work in it, a blurred babel of indistinct voices which have yet to become clearly delineated from one another.

Sometimes it is not a verbal stereotype -- a "How are you now"?
Or an "I want to go home", or whatever -- but a nonverbal one which reveals itself, gradually, as the condensed expression of more than one latent meaning.
A hebephrenic man used to give a repetitious wave of his hand a number of times during his largely-silent hours with his therapist.
When the therapist came to feel on sufficiently sure ground with him to ask him, "What is that, Bill -- hello or farewell"?
, the patient replied, "Both, Dearie -- two in one".

Of all the possible forms of nonverbal expression, that which seems best to give release, and communicational expression, to complex and undifferentiated feelings is laughter.
It is no coincidence that the hebephrenic patient, the most severely dedifferentiated of all schizophrenic patients, shows, as one of his characteristic symptoms, laughter -- laughter which now makes one feel scorned or hated, which now makes one feel like weeping, or which now gives one a glimpse of the bleak and empty expanse of man's despair;
and which, more often than all these, conveys a welter of feelings which could in no way be conveyed by any number of words, words which are so unlike this welter in being formed and discrete from one another.
To a much less full extent, the hebephrenic person's belching or flatus has a comparable communicative function;
in working with these patients the therapist eventually gets to do some at least private mulling over of the possible meaning of a belch, or the passage of flatus, not only because he is reduced to this for lack of anything else to analyze, but also because he learns that even these animal-like sounds constitute forms of communication in which, from time to time, quite different things are being said, long before the patient can become sufficiently aware of these, as distinct feelings and concepts, to say them in words.

As I have been intimating, in the schizophrenic -- and perhaps also in the dreams of the neurotic;
this is a question which I have no wish to take up -- condensation is a phenomenon in which one finds not a condensed expression of various feelings and ideas which are, at an unconscious level, well sorted out, but rather a condensed expression of feelings and ideas which, even in the unconscious, have yet to become well differentiated from one another.
Freeman, Cameron and McGhie, in their description of the disturbances of thinking found in chronic schizophrenic patients, say, in regard to condensation, that "the lack of adequate discrimination between the self and the environment, and the objects contained therein in itself is the prototypical condensation".

In my experience, a great many of the patient's more puzzling verbal communications are so for the reason that concrete meanings have not become differentiated from figurative meanings in his subjective experience.
Thus he may be referring to some concrete thing, or incident, in his immediate environment by some symbolic-sounding, hyperbolic reference to transcendental events on the global scene.
Recently, for example, a paranoid woman's large-scale philosophizing, in the session, about the intrusive curiosity which has become, in her opinion, a deplorable characteristic of mid-twentieth-century human culture, developed itself, before the end of the session, into a suspicion that I was surreptitiously peeking at her partially exposed breast, as indeed I was.
Or, equally often, a concretistic-seeming, particularistic-seeming statement may consist, with its mundane exterior, in a form of poetry -- may be full of meaning and emotion when interpreted as a figurative expression: a metaphor, a smile, an allegory, or some other symbolic mode of speaking.

Of such hidden meanings the patient himself is, more often than not, entirely unaware.
His subjective experience may be a remarkably concretistic one.
One hebephrenic women confided to me, "I live in a world of words", as if, to her, words were fully concrete objects;
Burnham, in his excellent article (1955) concerning schizophrenic communication, includes mention of similar clinical material.
A borderline schizophrenic young man told me that to him the various theoretical concepts about which he had been expounding, in a most articulate fashion, during session after session with me, were like great cubes of almost tangibly solid matter up in the air above him;
as he spoke I was reminded of the great bales of cargo which are swung, high in the air, from a docked steamship.