There is a body of opinion which regards psychiatrically ill individuals, or at least one great class or subdivision of them, as suffering primarily from disturbances in personal relationships and social interaction processes generally. Sullivan, Horney and Fromm have made the most significant theoretical contributions to this subject, and empirical applications have been reported by Balint (1957), Maxwell Jones (1968), Rapoport (1960) and Laing (1961). These writers have at least this in common, that they take the point of view that since the pathology of the illness lies in social relationships the fundamental treatment process must lie there also—must, in fact, consist of re-experiencing social interaction within a therapeutic re-educative framework. In the past attention has been directed principally to the doctor-patient relationship as a heuristic model of social interaction, but Rapoport has extended the operational range of significant interaction to include all staff-patient, staff-staff and patient-patient encounters. As the recent Subcommittee of the Central Health Services Council has pointed out (1968), little has been written of the nurse as therapist, but a considerable literature has accumulated concerning the role of the social worker or caseworker or counsellor (e.g. Halmos, 1965). Halmos investigates the nature of such relationships, and finds therapeutic utility to be unrelated to intellectual skills. The therapeutic process is adjudged to lie in the relationship, true enough, but the essential qualities have more to do with the interpersonal styles of the therapist, than with his analytical expertise. Such is his conclusion. Apparently social skills are necessary for the professional worker, but intellectual skills for the problems to be unravelled are of little importance, and are largely irrelevant.
One has to admit that the treatment of the mentally ill by psychological methods only leaves something to be desired, for even in the neuroses the long term results of psychotherapy are at times disappointing. Shorter methods of treatment, more economical of time and surer of outcome are constantly sought and, of course, there remains the very considerable problem of how to treat the not over-intelligent neurotic who can never hope to achieve profound self knowledge or insight.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.