Failures in Psychiatric Treatment: Edited by Paul H. Hoch. (New York: Grune and Stratton, 1948. Pp. 241. 27 s.

This book consists of fifteen papers on failures in different fields of psychiatric treatment presented at a symposium held at the 37th Annual Meeting of the American Psychopathological Association in 1947.

Failures in psycho-analytic treatment are described by Dr. C. P. Oberndorf (pp. 10–20). He discusses the effects of unfavourable external conditions, the difficulties in applying psycho-analytic technique usually due to counter-transference problems, the effect of initial symptoms masking a psychiatric condition for which psycho-analytic treatment is not usually considered suitable, and finally the occasional patients whose personalities and symptoms justify psycho-analytic treatment which nevertheless is ineffective. He ends by making an appeal for research by psycho-analysts into the causes of failures and repeats the plea he made in 1942 (Amer. J. Psychiatry, 99, 374) that psycho-analysts make use of consultations with colleagues more frequently than is usual after, for instance, a period of unsuccessful treatment of 300 hours. S. Rado, in discussion, regretted that psycho-analysts had not yet developed definite criteria and prolonged follow-up in order to allow adequate statistical analysis of results.