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This book consists of a collection of Elizabeth Zetzel's papers dating from 1943 to 1968. These are well put together with introductory chapters, and the book was completed just before she died in 1970.
Elizabeth Zetzel writes from her position as a psychoanalyst who almost completed her analytic training before she was medically qualified and, as she says, ‘approached psychiatry with the underlying assumption that psychoanalytic knowledge was adequate preparation for the evaluation of patients covering the whole range of clinical psychiatry’.
The need to modify this assumption became evident to her while working at the Maudsley Hospital before the war, and was confirmed by her wartime experiences in the Emergency Medical Service. Accordingly, when the war was over, she went back to the Maudsley Hospital, while at the same time working as an active member and subsequently assistant director of the London Clinic of Psychoanalysis.
In 1949 she returned to America and served on the committee for the selection of candidates for analysis at the Boston Institute.
During her work in these various fields she found that there tended to be either a total non-critical acceptance of psychoanalysis or an equally total rejection of it, and that premature attempts to achieve integration between psychoanalysis and psychiatry threatened the integrity of both disciplines. Her attitude is made clear in her statement, ‘In approaching the relationship between psychiatry and psychoanalysis, it is essential to make a clear distinction between psychoanalytic understanding which may be utilized in the evaluation of every psychiatric patient and the selection of those patients who can best profit by psycho-analytic treatment and related insight therapy’.
Her book is an attempt to work out, on a clinical and conceptual basis, criteria for evaluating and selecting patients suitable for psychoanalysis. These criteria are centred on the causes and management of regression and she stresses the need to