Mental Therapy Studies in Fifty Cases
- Author:
Louis S. London, M.D. 2 Vols.
Covici Friede, New York. $12.50.
Students of Medical Psychology, and especially intending therapists, suffer from a handicap which does not restrict those, who study other branches of medicine, namely that the material which they study is only partially accessible to them.
The full clinical picture of a psychoneurosis can only be observed at first hand by the analyst who is treating the patient, since much of the picture only becomes visible during the course of the analysis. Even the direct clinical experience of the analyst himself is limited, in comparison with other medical specialists, by the large amount of time which must be devoted to each patient.
This restriction of direct access to clinical material can only be made good by the reading of reported case histories and analyses. The publication of such reports is, therefore, of peculiar importance both for students and for practitioners of the speciality.
Dr Louis London’s book consists of fifty case reports, with a short introductory section surveying the development of psycho-analysis, dreams, the psychic development of the child, and the pathology of the sexual instinct. In the chapter on this last subject, the author expounds his own theory of the “traumatisation of the libido”. These early chapters seem less valuable than they might be. They are too condensed to be an adequate summary of psychopathology for the student and too superficial to interest the specialist. They serve, nevertheless, one useful purpose?namely, to indicate the type of technique employed by the author. That a collection of case histories should include some indication of the technique by which the analytic material was elicited, is most desirable, and from Dr London’s introductory chapters we gather that his technique is modelled on that of Wilhelm Stekel.
The case histories themselves are grouped under the headings of ” The Neuroses”, ” The Paraphiliac Neuroses ” The Borderline Neuroses”, “Schizophrenia” and ” CyclothymiaOf the fifty case reports, twenty-two describe the borderline neuroses and the psychoses, while seventeen are devoted to sexual perversions. Of the remaining eleven case reports of psychoneurotics, five are hysterics, three are classed as anxiety neuroses, and three are obsessionals.
This very unrepresentative allocation of numbers reflects one fault which pervades the whole book. It attempts to reach too wide an audience. It is most certainly desirable that the rarer forms of psychic illness should be adequately recorded. It is equally important that the student and general practitioner should have access to series of case histories of each common psychic illness, for only thus can they appreciate those origins and mechanisms which are common to all cases of that particular illness.
To attempt to do both, as this book does, is to fail. The cases of sexual perversion which in the book so far outnumber the much commoner psychoneuroses, give the student a completely false impression of their clinical frequency and importance, while the case reports are too superficial to interest the specialist.
The case reports themselves are naturally influenced by the author’s technique, in which dream interpretation plays a large part. The history of each patient is given in some detail, but the descriptions of the analyses are less satisfactory, sometimes even being condensed to a short series of dreams and their interpretation.
To summarise?Dr London appears to have attempted a double task : to write an analytical successor to Havelock Ellis’s ” Studies in the Psychology of Sex and on the other hand to provide the student and general practitioner with case material with which they may supplement their clinical experience. His book shows that these two aims are incompatible. R. H.
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