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This small volume is one of the most scholarly and stimulating pieces of research in psychology to come to this reviewer's attention in a long time.
Dr. Zucker has investigated a problem that has been baffling psychologists and psychiatrists for many years, namely, the difference between the hospitalized and the ambulatory schizophrenic. Specifically puzzling to the diagnostician is the fact that test records of ambulatory schizophrenics who maintain themselves extramurally
frequently show that they are more overtly disturbed than hospitalized patients. So far it has been assumed that the difference between these two groups does not lie in the patients themselves so much as in their environment, i.e., in their families' ability to tolerate the patients' deviant behavior.
Dissatisfied with this type of ad hoc explanation, the author hypothesized that the difference between these two groups of schizophrenics lies in a particular aspect of the patients' ego strength, namely, fluidity of ego boundaries. While projective techniques have previously been used as indicators of ego boundaries, we lacked precise instruments for measuring this ego deficiency. Dr. Zucker selected three established projective techniques—the Rorschach, the Mosaic Test, and Figure Drawings—as particularly suited for revealing degree of impairment of ego boundaries and devised a technique by which hitherto unscorable response 'facets' of these three techniques became units of measurement. With this equipment she examined two groups, each of thirty schizophrenic patients, one of them hospitalized, the other ambulatory. Her hypothesis was confirmed. The extent of impairment of ego boundaries was indeed much greater in the hospitalized group, whereas the ambulatory group, while showing more bizarre ideation, autism, and other overt indications of a schizophrenic process, revealed more stable ego boundaries or, to put it differently, could marshal more defenses to forestall ego disintegration.
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