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In this book Dr. Ackerman describes the growth of a point of view that germinated some twenty-five years ago. In order to help disturbed patients he feels that it is vital to view the individual disturbances in the larger setting of their meaning to the family. Therefore in his first section he sets out his conceptual framework which enables him to do this. His framework is a synthesis of psycho-analytic personality theory with recent works of American social scientists.
He continually draws attention to the fact that character disorders are seldom found in isolation, and that mental illness limited to a single family member is a rarity. Therefore he sets any sick process as simultaneously occurring intra-psychically, interpersonally, and as a distortion in the social processes of the environment itself. The emphasis he puts on this last form of illness seems to be one of the important messages of the book. He highlights the cumulative effect of mental illness within the primary group where the distortion of the usual social processes adds in a dramatic way to the difficulties of the primary patient. Dr. Ackerman's conceptual framework allows the sick process to be seen and treated inside and outside the primary patient. Equally it can show in detail the health-maintaining processes latent or functioning in and around the primary patient. The play between these two processes he feels to be of considerable diagnostic importance. He shows that it determines how the individual deals with his emotional problems, how the family use them or are crippled by them. Finally he demonstrates the way in which the emotional content of these current family experiences then qualifies the individual's capacity to deal with the original personal conflicts.
Having established his method of approach, Dr. Ackerman uses the following sections to illustrate the clinical advantage that ensues from a wider diagnostic appraisal. The therapist can establish a responsibility to the f