The treatment of schizotypy spectrum disorders has a long tradition in psychanalysis. Their description and view on positive therapeutic change encompass a broad range of clinical states on the one hand and psychoanalysts and their schools on the other hand. In the psychoanalytic conception, the basis of knowledge is a therapeutic relationship and the observed events within it. It is also the basis for a description, concepts and a therapeutic approach for many of these conditions. One of them is the concept of mental disintegration or mental fragmentation in schizophrenic conditions, which begins with Freud's idea of de-cathexis or primary process of thinking or Bleuler's autistic thinking. Melanie Klein and her successors have developed the area of schizoid mechanisms in their patients' cases and subsequent theories, which cover a wider range of patients from persons with psychotic states to patients with personality psychopathology. Wilfred Bion developed Klein's theory of psychic splitting the object and the ego, in the concept of which splitting disrupts the continuity of thought connections and creates dissociated parts within the personality. Another understanding of the mental states of schizotypy was brought about by another successor of the Kleinian tradition Matte-Blanco, especially in the theory of the principle of symmetry. The varying degrees of expression of psychic symmetry corresponds to the depth of pathology that we find in schizotypy. An understanding of the features of withdrawal and emotional flattening was best provided by a group of psychoanalytic authors who dealt with autistic phenomena in various mental conditions (Anzieu, Bleger, Ogden, Tustin) and looked for therapeutic solutions in these conditions.
In this chapter, authors present different theoretical conceptualizations based on their clinical experience and discuss their use for current psychotherapeutic practice.