Psychotherapy of Psychosis: By Gustav Bychowski. (New York: Grune and Stratton, 1952. Pp. 328.)

It is sometimes assumed among psycho-analysts that extensive hospital experience in clinical psychiatry is not an advantage in the psycho-analytical understanding of the psychoses. This book proves that any such generalization would be mistaken. The author is both a clinical psychiatrist and a psycho-analyst of great experience and erudition. His views on the origin of the psychoses and their treatment are catholic, and he does not adhere to a strictly psychogenic theory. He regards physical treatments as beneficial in certain psychotic states. He is nevertheless firmly convinced of the value of psycho-analytical psychotherapy in the psychoses. The author has a distinguished record as a student of schizophrenia, especially of its regressive features, about which he wrote an excellent monograph in 1923. In his therapeutic approach he stands nearer to Federn than to any other writer. Therapeutic failures in schizophrenia are in his view often due to the indiscriminate use of the method of free association on the one hand, and to the disregard of narcissistic defences on the other hand. Fromm-Reichmann's and Rosen's methods are critically reviewed and Sechehaye's observations are fully and sympathetically discussed. The author believes that in the majority of depressive states we must assume a combination of psychological and biological, i.e. exogenous and endogenous factors. He does not accept Klein's views on mental mechanisms in early infancy. He expects progress in therapy from a combination of biological and psychological methods. This is an unusually well balanced presentation of the state of psycho-analytical psychotherapy of the psychoses. The book can be highly recommended to everybody working in this difficult field.