Symptoms and Illness Configurations

In Section II (see Chapter 5), I have described the patient sample in terms of the criteria that governed their selection as research subjects (basically a series of exclusion criteria) and then have specified the characteristics of the patient group along the usual demographic identifying lines. As noted there, the population was reasonably homogeneous but very far from representative of the population at large, and probably also systematically somewhat different from that subset of the population at large who come (or are brought) to psychiatric treatment.

The sample, to recapitulate, consisted of 21 men and 21 women. The age range was restricted to the young adult to middle adult years. Not quite half were married, and those who were (or had been) married averaged not quite 2 children per family. They came from sibships that averaged about 2½ children per family. Their religious affiliation was overwhelmingly Protestant. They were all white. About half came from affluent families (with a small handful of very wealthy ones) and half from much more modest backgrounds. There was a surprising amount of severe alcoholism in the family backgrounds—in about one-third of them. The patients' own occupational and social status was at a somewhat lower level than that of their families of origin. Intellectually, they were in a clearly superior range, with a mean IQ of 124. Most of them came to The Menninger Foundation in the context of failed psychiatric treatment efforts in their home communities of varying kinds and varying intensities.

Both the nature of the institution in which the patients were treated (The Menninger Foundation) and the exclusion criteria that we used in the selection process served also to restrict the range of the sample. Coming to Topeka mostly on the basis of failed outpatient treatment efforts in other communities excluded the usual moderately neurotically ill psychiatric outpatient population; the patients had to be “sick” enough to come to The Menn