Therapeutic Studies on Psychotics: By Julius I. Steinfeld, M.D. Des Plaines, Illinois: Forest Press, 1951. 262 pp.

Dr. Steinfeld ranges over a wide field. Of chief interest in these studies is the first section on psychoanalytically oriented psychotherapy. The rest of the book is a report of therapy among psychotics with such 'somatic aids to therapy' as multiple electroshocks, ketogenic diets, the administration of testosterone to certain psychotic women.

In psychotherapy Dr. Steinfeld's emphasis is on what he calls the therapist's countertransference: open expressions of sympathy, attentiveness, stern criticism and hostility are all necessary in meeting the patient's needs at the patient's level and assisting him to further maturation; the therapist must be capable of 'instinctive shifting in response to the needs and demands of the id, ego and superego'. The methods are unorthodox, Dr. Steinfeld says, but justified, he feels, by the results. The case reports are vivid and convey the flavor of Dr. Steinfeld's working atmosphere: 'While adequately satisfying the essential regressive needs of the patient, which does not exclude proper frustration of others within this context, the therapist also sets an immediate model for the patient's subsequent integration, adaption, and sublimation'.

One may differ with Dr. Steinfeld's definition of countertransference, but he succeeds admirably in communicating what he means by it. The illustrations of his spontaneous and intuitive responses to patients suggest he is willing impulsively to risk acting out whatever may occur to him for the sake of spontaneity. How many therapists can be consistently themselves as 'a person doing psychotherapy' in the manner outlined by Dr. Steinfeld? Whether permissive and sympathetic, or showing controlled hostility and restrictiveness, this is an authoritarian approach to the patient that for many, if not most, would be role-playing and not role-taking.

The statistics on remissions and 'recovery' among psychotic