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In Western Europe and in the United States of America there has been a great change in attitude towards the long-stay mental hospital patient since the Second World War. Formerly, although there may well have been a good deal of custodial kindness, the problem of personal and social rehabilitation had scarcely been faced at all. This book, an American product, consists of chapters which describe the different methods of tackling the problem which appropriately is called remotivation, as it consists of something more than rehabilitation, more than welfare, but can be summarized as the subjecting of a group of patients to modified and appropriate forms of social 'pressure cooking' within the mental hospital. The sort of work which is described by the authors is being carried out in many mental hospitals in the United Kingdom and Western Europe as well as in America, and it is interesting to see how close is the resemblance between the facets of the therapeutic community in the several countries where such projects are now in operation.
Hitherto patients who suffer from personal or social failure of a gross kind have been herded into large wards, and in this impersonal milieu further regression has been facilitated, so that there has been either gross withdrawal or a reduction to the lowest common denominator of performance and adaptation. This process of human degradation can be reversed, so that a vicious spiral of pessimism and decline, of devaluation and degeneration can be converted into a favourable spiral of progress and revaluation which often continues to the point of fitness for discharge into the outside community. Basically the principles are simple, and consist of enlightened love and care given by trained personnel who do not cordon themselves off from the patient but are prepared to involve themselves in the project of remotivation. At the same time, less ill patients are encouraged to take an active part in rehabilitating and remotivating more ill