This provides. 'ome circumstantial support for the associa- ... high compared with the 4 g./100 ml. recom- .... three months since the withdrawal of the contra-.
~~~~~~BRITISH 1c~~~~~~~~~~~~~~~~~~~~~~~~~~~ Correspondence COctober 1967 this sign makes assessment difficult. There was, however, a distinct difference between the mean concentrations of plasma protein in the two groups. Fourteen (55 ) of the anaemic" children had plasma protein levels of below 4 g./100 ml., whereas only § (18°I ) of the " not anaemic " ones had .uch low levels (P- ,nsible to use, in addition, fantasy and desired hehlviour, particularly in the Labsence o' overt behaviour. As we pointed out in our paper, the five patients who w-ere havNin_Jsexual intercourse with their wives prior to treatment had to use homosexual fantasy in order to do so. If wc look at sexual behaviour as ai ballance between heterosexual and homosexual components it seems reasonible to state that nearly 60°,h of our series were towards the heterosexual end of the continuum post-treatrnent. Even if the outcome of treatment x\-a >imilar in the tswo series aversion therapy sWOUld be the treatment of choice. Our patients received an average of 18 to 20 sessions, each lasting 20 to 25 minutes. Of Dr. Bieber's patients 78 75 ') had 150 sessions (hours) of treatment or more, and of these 38 (36',',) had 350 sessions or more. WXith two exceptions improvement xvas confined to those receiving 150 sessions or more. Of the 24 cases in our series wsho had been practising homosexuality for 10 years or more six became Kinsey 0 after treatment alnd four IKinsey 1. None of these 10 cases displayed overt homosexual behaviour post-treatment, six of them were having heterosexual intercourse, aind txvo displayed overt heterosexual behaviour short of intercourse. The term abnormal psychogenic developmnent *was used by Schneider2 to describe personality aberrations which xx'ere not dependent on the patient's sexual status and which when present indicated a severely damaged personality, usually of the self-insecure or attention-secking types. Non-psychoanarlytic workers such as ourselves cannot hope to explore our patients' pcr>nrialities in sery great detail, although xse are aware that i is possible to detect abnorm-nal psychogenic dcxvcopnmcnts in relation to relatively insignific snt c cnts. W e must concede that the personslits classification is crude. Hovever, it ilS the micrits oif xworking at a clinical level, and of being usWd bx thc World Health Organization.. In reply to Dr. Kalcev, 10 out of the 18 of our series of cases xho presented in connexion xith a court appearance shoxwed an improvement after treiltment. Hence, rcferral by court is not neI2cssarily a contraindicarit for success. Ho)vever, irresectirve of success xxe agree that there is indecd a moral issue here. It is certainly wcronL: to imnpo-se treatni-t on a-invsneo, anTd a1 choice of beine sent to prison~ or receivine trealtmuent is halrdly an adequate test of free xx'ill. The term personality disorder is u:sed to describe a serious problenm of pnersonal function-
