Research Studies in the Problems of Assessment

I should like to start by quoting Jung. Writing of facts that had impressed themselves most on him during his career as a psychiatrist and psychologist, he says,

… the discovery I made when I began my psychotherapeutic practice: I was amazed at the number of schizophrenics whom we almost never see in psychiatric hospitals. These cases are partially camouflaged as obsessional neuroses, compulsions, phobias, and hysterias, and they are very careful never to go near an asylum. These patients insist upon treatment, and I found myself, Bleuler's loyal disciple, trying my hand on cases we would never dreamed of touching if we had had them in the clinic, cases unmistakably schizophrenic even before treatment—I felt hopelessly unscientific in treating them at all—and after the treatment I was told that they could never have been schizophrenic in the first place. There are numbers of latent psychoses—and quite a few that are not so latent—which, under favourable conditions, can be subjected to psychological analysis, sometimes with quite decent results. Even if I am not very hopeful about a patient, I try to give as much psychology as he can stand, because I have seen plenty of cases where the later attacks were less severe, and the prognosis was better, as a result of increased psychological understanding. At least so it seemed to me. You know how difficult it is to judge these things correctly. In such doubtful matters, when you have to work as a pioneer, you must be able to put some trust in your intuition and to follow your feeling even at the risk of going wrong. To make a correct diagnosis, and to nod your head gravely at a bad prognosis, is the less important aspect of the medical art. It can even cripple your enthusiasm, and in psychology, enthusiasm is the secret of success (JUNG 4, p. 247).

When we start to look at the problems of assessment and to evaluate our criteria in relation to suitability for therapy, and capacity for change and development, it is well straig