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Seishin Shinkeigaku Zasshi. 2003;105(9):1186-205.

[Recovery of intersubjectivity and empathy in schizophrenics: through a characteristic type of friendship "frolicking"].

[Article in Japanese]

Author information

  • Department of Day-Care, Kyoto City Mental Health and Welfare Center.


The author has noticed a characteristic form of close, frolicsome friendship between recovering adolescent schizophrenic patients. It occurs in groups of young patients in a psychiatric clinic and in a day-care institution. Through this type of friendship, their intersubjectivity, ability for empathy and human relations develop, essential changes for the amelioration of schizophrenia. It is characterized by 1 A mutual relationship on equal terms with another schizophrenic patient of the same sex and generation; particularly close friendship between two patients, or sometimes several patients who form a group, spending much time together. 2 Playful, childish behavior, jokes and jests; Patients laugh and make others laugh, playing together. 3 Touching the friends' bodies and coordinated playing such as dancing and singing together. 4 Chatting and having common interests, along with sharing various experiences. 5 Enjoyment with so much energy that sometimes, as in a gang, social norms are contravened. 6 Being a transient phenomenon that ends naturally after a certain period. Through such friendship, the adolescents show mental growth compared with their premorbid state. They come to sympathize with others' feelings and willingly cooperate. Their social relationships and spheres of activity expand, and spontaneity and self-esteem become improved. They come to assert themselves adequately, tolerate stress, and conform to social norms. Moreover, they advance to developing a purpose. e.g. work. To be able to have empathy through friendship with those of the same sex and generation is a basic developmental theme generally seen in childhood and pre-adolescence. Such friendship between the patients studied represents benign regression in such a developmental period. This type of friendship is characterized by a frolicsome and playful atmosphere. Frolicking by means of jokes, jests and body-touching, and play with coordinated acts lead to the sharing of emotions and development of their intersubjectivity, the latter improving the person's empathy, spontaneity and self-esteem. This type of friendship appears in patients in their teens or twenties once a certain period has passed after the disappearance of positive symptoms. Its typical course is seen in teen-agers who show a premorbid personality deviation such as difficulty in establishing social relationships. No particular tendency as to gender or family type was found. Therapists should provide the opportunity and setting for this type of friendship to develop. Adolescent schizophrenics can gather together and are open-mindedly accepted in such a setting, which has an informal component where therapeutic staff may not interfere in this playful atmosphere. Therapists should act as third persons, once friendly play begins, after the introductory period during which the therapists' protection and limits on social stimulation are needed. It is desirable to appreciate patients' friendships and self-help, offering a rehabilitation program and adequate support, as they step forward to the future.

[PubMed - indexed for MEDLINE]
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