An 'Interpretative Diagnosis', essentially the psycho-analytic summary of the available data, is worked out from the patient's history and examination. The next step is to determine a therapeutic aim (e.g. devising means for the patient to express aggressive feelings), and this is carried out by nurses and therapists, apparently with the help of an artificially produced environmental situation. Contact fostered in this way may become stable enough to warrant an analytic technique modified to fit the patient. The analyst must not be impersonal but must approach the patient on his own ground, as by using grunts to answer the patient's grunts. In this way the patient's ego is built up sufficiently to gras the relationship between himself and the analyst. If after a period there seems to be no change, shock treatment is considered, but the other measures are continued.