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Thorner, H.A. (1965). Die Psychosomatische Klinik Und Ihre Patienten: By C. de Boor and E. Künzler. (Bern and Stuttgart: Huber and Klett, 1963. Pp. 274.). Int. J. Psycho-Anal., 46:277.

(1965). International Journal of Psycho-Analysis, 46:277

Die Psychosomatische Klinik Und Ihre Patienten: By C. de Boor and E. Künzler. (Bern and Stuttgart: Huber and Klett, 1963. Pp. 274.)

Review by:
H. A. Thorner

This is a statistical report on the first ten years' work (to 1959) of the Psychosomatic Clinic at Heidelberg University which is directed by Professor A. Mitscherlich. The report is of interest to the psycho-analyst because the majority of cases have been treated by psychoanalysis; only in the last five years of the report have about half the patients been treated by brief therapy on analytical lines as used at the Tavistock Clinic and described in the book by Malan (reviewed on pp. 261–265 above). The authors are aware of the difficulties in the statistical treatment of analytical data and they restrict themselves to such data which are sufficiently definable to be used for statistical treatment, such as the routes by which patients come to treatment (about twenty per cent come on their own initiative and are not sent by doctors or clinics); social elements, such as age, education, sex, distance of residence from the treatment centre, etc. Twenty per cent of the patients are classed as 'refugees' which is roughly the same percentage as in the population as a whole—a sign of our times.

The selection of patients for treatment is carried out in stages: initial interview (including psychological tests), probational treatment, and, finally, proper analysis. A patient may be rejected at any of these stages. In the first five years of the report 69% of all patients are rejected, in the second five years 74%. In actual figures, 70% fewer patients were accepted in the period 1955–59 than in the period 1950–54. The most frequent reasons for rejection were (in order of frequency): psychoses, patients stayed away for no known reason, primitivity of personality (lack of means of communication), geographical. After the probational period the rejection for psychoses is less frequent but lack of insight appears as another reason. The results of treatment are broken down under the headings: clinical, social, analytical (with or without structural changes). With awareness of its limited aim I find the book very valuable and it may serve as a model for the statistical treatment of the work of any analytical clinic.

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