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Dr. Emanuel Miller in opening the discussion declared his belief in the validity of Freudian psycho-dynamics but felt himself free in treatment to use such ancillary methods as occasion demanded. He gave notes from a series of case records to illustrate the complex nature of the condition, for not only did they present a very wide variety of symptoms but their psychopathology ranged from the later stages of mental organization to those disorders which are mainly psychotic in character. He emphasized that choice of treatment rested on this distinction, and for the clarification of this diagnosis personality studies were essential. He felt there is a very real danger in lightly undertaking analysis where obsessional compulsive states screen a larval schizophrenia. He disapproved of leucotomy being practised in any child before puberty. On the other hand no one should object to leucotomy in extreme cases.
Dr. Karin Stephen gave a concise account of the accepted psycho-analytic views concerning the nature and treatment of obsessional neuroses. She also stressed the fact that severe obsessional neurosis may mask a psychosis, but did not consider this danger was necessarily a bar to the analytic approach, as it would be possible to change over to a supportive type of therapy.
Dr. William Sargant and Dr. Eliot Slater regretted that there were no clear-cut indications for the various forms of treatment which were in vogue to-day. They lamented that personal bias and rule of thumb played such a prominent part in the choice of treatment. They gave a short account of their experiences with the physical methods of treatment. Sleep