Psychological Stress. Psychoanalytic and Behavioral Studies of Surgical Patients: By Irving L. Janis. New York: John Wiley & Sons, Inc., 1958. 439 pp.

Dr. Janis, whose studies of group responses to disaster are well known, continues his line of investigation in this new work. In it he focuses primarily on the reactions of the individual and uses the surgical operation as the paradigm of the disaster experience. A supervised study of an analytic patient, who underwent a surgical procedure in the course of her analysis, makes up the first part of the book. In the second part, the reactions of surgical patients are explored by means of intensive interviews and questionnaires. The theoretical discussion of methodology which precedes the clinical data is excellent. The book represents much work; a large body of data is set forth with painstaking care and what emerges is often an impressive validation of basic psychoanalytic theory. There are many points on which one might take issue with the author's own theoretical formulations. However, the great virtue of the book lies in the fact that the data are there and one is free to argue with the author as to their significance.

With the growth of psychiatric services in general hospitals psychoanalysts are increasingly called upon to understand and to contribute to the care of the physically ill. This study helps to show how exciting a place the general hospital can be for the psychoanalyst with an investigative bent. It should also provide interesting data for discussion in residents' training seminars.