Learning Psychotherapy: Rationale and Ground Rules. By Hilde Bruch. Cambridge, Mass.:  Harvard University Press, 1974.

Dr. Bruch has dedicated her book to her teachers, among them Freida Fromm-Reichmann and Harry Stack Sullivan. Apparently they transmitted their interest in treating severely disturbed patients to Dr. Bruch because she devoted considerable space to the management and treatment of schizophrenics. She tries to provide an understanding of the schizophrenic patient by emphasizing that his problems differ in degree rather than kind from those of less disturbed patients. Thus she is able to convey to the reader that although many problems that patients present may seem insurmountable at first, they are not actually so and that, with diligent and careful work, the mantle of obscurity that cloaks the patient and the therapeutic process can be removed.

Dr. Bruch points out several ways this can be done. For example, when treating some patients, it is necessary to involve the family in the treatment process. She also suggests that, at times, judicious use of medication is appropriate and that factors other than the analytic process per se can have therapeutic value. The latter emphasis is particularly welcome in the context of treating in-patients, where many other factors that impinge on the patient's day-to-day activity can, if properly