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Eclectic Psychiatry
BOOK REVIEWS inhihition of cholinesterase may be a factor common to both. The undestroyed acetylcholine does not excite the neurons but produees a synaptic inhihition. This reviewer believes that the concept of synaptic inhibition will reccive increasing attention from molecular hiolo~ists. \\'hile the t'xpt'rimcnts are extremely interestin~, the fact r('mains that normally, pharmacologic agents rt'ach their site of action via the vascular system. Wllt'ther tIlt' resultant activity is equivalent to that induced by the cxperimental routes used by Fddbt'f~ ft'mains to he determincd. These studies cPrtainly warrant further review and application. HEHMAI' C. B. DENIlEII, \I.D., Ph.D.
PSYCHOLOGICAL EVALUATION IN PSYCHOTHERAPY: TEN CASE HISTORIES. LeoT/(Jrd Blallk. Chica.go: AMine PuMishing Co., 1965. 364 pages. $8.95. The author's wish is for his hook to "t'nahle the rt'ader to judge whdll('r psychological t'valuations elucidate the material presented by patients in psychotherapy ... at every point, the writer attt'mpts to ft·lal<' the tlwrapt'utic proct'ss, in detail, to the psychological evaluation and its constituent test elements." The t('n caSt'S were ori~inally refern·d to Dr. Blank for psycholo~ical appraisal and were suhsequently seen hy him in psychotherapy. The value of a psycholo~ical rt'port lies in its ability to clarify the patient's hehavior and provide "cues for intervention." The test battery consisted of the Rorschach, Thematic Apperception Test, Draw-A-Person, Minnesota \fultiphasic Personality Inventory, Interpersonal Check List, Wechsler Adult Intelligence Scale and a Dia~nostic Interview. Eight of the reports were designed for non-psychiatric physicians. Most of the cases were charactt'r disorders of varying types and not all the cases received the complete battery of tests. Each case covers an entire chapter in the book, presented sequentially as follows: figure drawings, dia~nostic interview, the psychological evaluation and the therapy notes. The author instructs the reader to "reconstruct the test data from the therapy notes" or "predict the outcome from the test material." There are It'n appendices that supply, in much greater detail, the interview, the raw test data and interpretative comments. The author also gives abbreviated reports on medical history, the idiosyncracies of his patients and some of their dreams. The author has tried to do too much for one book. He prescnts some very interesting cases but the reader is swamped with material of all kinds. This is an excellent study and practicum book guide. The contcnts could profitably and provocatively be discussed in a workshop or an applied !.rraduate course in methods of evaluation. The author labels his psychotherapy as psychoanalytic but many of his techniques would be rejected by the psychoanalytic schools. The author is awry in his preface when he derogates the value of the very tools that he has laboriously toiled for and thereby undercuts his fine contribuJanuary-Fehruary. 196R
tions. Says the author, "Wht'n next I found myself in a mt'ntal hygiene clinic doing primarily psychotherapy and with ample resources for psychological f('ports I had little inclination to call for them . . .... Later, he states: "another phase was ... my private practice . . . whenever I was puzzled by the therapeutic process, I reread my (evaluation) report and ploughed through the raw test material." HoweVl'r, Ilis hapless introductory rt'mark c1in~s to the reader. RENJA:'>Il!,; KOTKov, Ph.D.
ECLECTIC PSYCHIATRY. Rudolf Kael1Jlin~ al1(l Ral/Jh M. Patterson, Charles C. Tlwma.~: Swin/!field, Illinois, 1966. This book, truly an edectic text, is written for students at all levels of psychiatric orientation, but is especially valuable for those who are non-psychiatrists. Its aim is to reintegrate psychiatry with tht' rest of medicint·; this premise is carried out in 26 chapters which cover the many facets of current psychiatric knowled~e. Tht' authors prt'sent their material in an easily digt'stihle form, free from psychiatric jargon, and are constantly aware of their need to communicate with the ft·adt'r. Both biolo~ical as well as psychodynamic theorit's are well presented in this instructive digest. ~Iany synopses, reviews in table form, as \\,(,11 as an excellent bihliography and a "Cuide to tht' Psychiatric Literature", make this attempt to dost' the gap between medieine and psychiatry most meanin~ful. Of special interest is an t'xcellent chapter dealing with the patient-doctor relationship. Ht're the needs for medical specialization as well as its dan~ers are well documented. The prohlem of set'ondary ~ain through iIInt'ss; the difficulties in differential dia~ nosis hetween malin~ering, conv{'rsion hysteria and psycho-physiolo~ic disorders are thoroughly in\'t'stigated and clarified. The importance of interview techniques also receives excellent handling. The difficulties in learning how to Iistcn are noted as is the development of techniques which utilize "open-ended questions," which permit the patient to tell the doctor morc about "it." Of interest is the sage advice offered on dosin~ the session. The need to do this without abruptness so that the patient do{'s not leave with more anxiety than was present at the he~nning of the interview is underscored. Excellent chapters concern themst'lves with dinical psychiatric syndromes so that the f(·ader can acquaint himself with psychiatric terminolo~, dia~nostic categories, etc. In the chapters on methods of psychiatric treatment, pharmacotherapy as well as pharmacodynamics are intertwined. Psychotherapy, especially the role of the non-psychiatrist in the mana~ement of patients on psychotropic drugs is scen as a natural role for the family physician or internist. This book is warmly recommended to those who function as primary physicians with a need to increase their psychiatric orientation and ahilities. It should also be of value to those who have made the transition from a medical to a psychiatric practice and need a dear picture of the ever-broadening base of psychiatry.-W.D. 61
PSYCHOLOGICAL EVALUATION IN PSYCHOTHERAPY: TEN CASE HISTORIES. LeoT/(Jrd Blallk. Chica.go: AMine PuMishing Co., 1965. 364 pages. $8.95. The author's wish is for his hook to "t'nahle the rt'ader to judge whdll('r psychological t'valuations elucidate the material presented by patients in psychotherapy ... at every point, the writer attt'mpts to ft·lal<' the tlwrapt'utic proct'ss, in detail, to the psychological evaluation and its constituent test elements." The t('n caSt'S were ori~inally refern·d to Dr. Blank for psycholo~ical appraisal and were suhsequently seen hy him in psychotherapy. The value of a psycholo~ical rt'port lies in its ability to clarify the patient's hehavior and provide "cues for intervention." The test battery consisted of the Rorschach, Thematic Apperception Test, Draw-A-Person, Minnesota \fultiphasic Personality Inventory, Interpersonal Check List, Wechsler Adult Intelligence Scale and a Dia~nostic Interview. Eight of the reports were designed for non-psychiatric physicians. Most of the cases were charactt'r disorders of varying types and not all the cases received the complete battery of tests. Each case covers an entire chapter in the book, presented sequentially as follows: figure drawings, dia~nostic interview, the psychological evaluation and the therapy notes. The author instructs the reader to "reconstruct the test data from the therapy notes" or "predict the outcome from the test material." There are It'n appendices that supply, in much greater detail, the interview, the raw test data and interpretative comments. The author also gives abbreviated reports on medical history, the idiosyncracies of his patients and some of their dreams. The author has tried to do too much for one book. He prescnts some very interesting cases but the reader is swamped with material of all kinds. This is an excellent study and practicum book guide. The contcnts could profitably and provocatively be discussed in a workshop or an applied !.rraduate course in methods of evaluation. The author labels his psychotherapy as psychoanalytic but many of his techniques would be rejected by the psychoanalytic schools. The author is awry in his preface when he derogates the value of the very tools that he has laboriously toiled for and thereby undercuts his fine contribuJanuary-Fehruary. 196R
tions. Says the author, "Wht'n next I found myself in a mt'ntal hygiene clinic doing primarily psychotherapy and with ample resources for psychological f('ports I had little inclination to call for them . . .... Later, he states: "another phase was ... my private practice . . . whenever I was puzzled by the therapeutic process, I reread my (evaluation) report and ploughed through the raw test material." HoweVl'r, Ilis hapless introductory rt'mark c1in~s to the reader. RENJA:'>Il!,; KOTKov, Ph.D.
ECLECTIC PSYCHIATRY. Rudolf Kael1Jlin~ al1(l Ral/Jh M. Patterson, Charles C. Tlwma.~: Swin/!field, Illinois, 1966. This book, truly an edectic text, is written for students at all levels of psychiatric orientation, but is especially valuable for those who are non-psychiatrists. Its aim is to reintegrate psychiatry with tht' rest of medicint·; this premise is carried out in 26 chapters which cover the many facets of current psychiatric knowled~e. Tht' authors prt'sent their material in an easily digt'stihle form, free from psychiatric jargon, and are constantly aware of their need to communicate with the ft·adt'r. Both biolo~ical as well as psychodynamic theorit's are well presented in this instructive digest. ~Iany synopses, reviews in table form, as \\,(,11 as an excellent bihliography and a "Cuide to tht' Psychiatric Literature", make this attempt to dost' the gap between medieine and psychiatry most meanin~ful. Of special interest is an t'xcellent chapter dealing with the patient-doctor relationship. Ht're the needs for medical specialization as well as its dan~ers are well documented. The prohlem of set'ondary ~ain through iIInt'ss; the difficulties in differential dia~ nosis hetween malin~ering, conv{'rsion hysteria and psycho-physiolo~ic disorders are thoroughly in\'t'stigated and clarified. The importance of interview techniques also receives excellent handling. The difficulties in learning how to Iistcn are noted as is the development of techniques which utilize "open-ended questions," which permit the patient to tell the doctor morc about "it." Of interest is the sage advice offered on dosin~ the session. The need to do this without abruptness so that the patient do{'s not leave with more anxiety than was present at the he~nning of the interview is underscored. Excellent chapters concern themst'lves with dinical psychiatric syndromes so that the f(·ader can acquaint himself with psychiatric terminolo~, dia~nostic categories, etc. In the chapters on methods of psychiatric treatment, pharmacotherapy as well as pharmacodynamics are intertwined. Psychotherapy, especially the role of the non-psychiatrist in the mana~ement of patients on psychotropic drugs is scen as a natural role for the family physician or internist. This book is warmly recommended to those who function as primary physicians with a need to increase their psychiatric orientation and ahilities. It should also be of value to those who have made the transition from a medical to a psychiatric practice and need a dear picture of the ever-broadening base of psychiatry.-W.D. 61