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By Herbert A. Rosenfeld. New York: International Universities Press, Inc., 1965. 263 pp.
STUDIES ON PSYCHOSIS. Descriptive, Psychoanalytic, and Psychological Aspects. By Thomas Freeman, M.D. with John L. Cameron and Andrew McGhie, Ph.D. New York: International Universities Press, Inc., 1966. 245 pp.
During a decade in which 'tranquillizer' and 'psychedelic' have become common parlance and physicians and public alike have shown an increasing fascination with the effects of a rapidly widening spectrum of experimental psycho-pharmacological agents, it is heartening to find that in some quarters there remains a sustained interest in studying and treating the psychotic process in a state unaltered by drugs. These two books, though divergent in point of view, are products of such sustained interest.
In Psychotic States, Rosenfeld has brought together thirteen papers, many of which have previously appeared in The International Journal of Psychoanalysis. His devotion to Melanie Klein and her point of view is never in doubt. Although there are lengthy theoretical discussions this is essentially a compilation of clinical papers in which the author describes his technique of treating severely disturbed psychotic patients, many of whom are hallucinated and delusional, some even assaultive. This technique takes personal courage, dogged determination, patience, and a sustained interest in a most difficult task. All of this comes through indirectly in Rosenfeld's descriptions of his clinical work. Initially he does not hesitate to see an acutely disturbed patient six times a week, often for ninety minutes at a stretch. If necessary this is done in a hospital or in the patient's home. Reassurance or other direct supportive measures are staunchly avoided. When the patient improves and feels more comfortable he is seen in the examining room where he may choose to use the couch.