An introduction to clinical psychology

614 Pages·1948·49.438 MB·English

by  Pennington, Leon Alfred, Berg, Irwin August

AN INTRODUCTION TO
CLINICAL PSYCHOLOGY
Edited by
L. A. PENNINGTON, Ph.D.
ASSOCIATE PROFESSOR OF PSYCHOLOGY, UNIVERSITY OF ILLINOIS;
CONSULTING PSYCHOLOGIST, VETERANS ADMINISTRATION
HOSPITAL, DANVILLE, ILLINOIS
and
IRWIN A. BERG, Ph.D.
ASSOCIATE PROFESSOR OF PSYCHOLOGY, AND
ASSISTANT DEAN FOR STUDENTS
NORTHWESTERN UNIVERSITY
WITH A FOREWORD BY
GEORGE D. STODDARD, PH.D.
PRESIDENT OF THE UNIVERSITY OF ILLINOIS
THE RONALD PRESS COMPANY • NEW YORK
Copyright. 1948, by
THE RONALD PRE^S COMPANY
All Rights Reserved
The text of this publication or any part
thereof may not be reproduced in any
manner whatsoever without permission in
writing from the publisher.
PRINTED IN THE UNITED STATES OF AMERICA
FOREWORD
Once in a foreword to a study by the late Kurt Lewin, I predicted
that "the center of psychology will itself be further shifted from its ana-
tomical, physiological, and biological preoccupation to an acceptance of
social psychology as the focus of all future inquiry into human behavior."
Now, eight years later, I should revise the sentence by changing the
word social to clinical. The world has become more bedridden, and
seems to be so steeped in conflict, aggression, and the licking of wounds
as to demand of psychology a new art and some new scientific procedures.
The new term (the "big magic" if we are not careful) is clinical psy-
chology—a vast area in an applied professional field that stretches from
factor analysis to free association and projection. Outside this area there
is room only for supporting sciences or for activities not given exclusively
to the psychologist as such, as in ethics, political science, philosophy, or
religion. Physics, statistics, animal behavior, and human biology, as em-
ployed by the psychologist, even throughout a lifetime of experimenting,
merely lead up to this all-pervasive, all-demanding question: How shall
we keep our thinking straight, our emotion under control, our anxiety
objectified, our personality unsplit?
The stage is everywhere set for evasive, substitutive, regressive be-
havior patterns. A child, however normal and well adjusted, is potential
grist for the mill of the clinician. Unless he goes wrong, he will rarely be
noticed. Psychology, like the dramatic arts, has little interest in the av-
erage, the normal, the serene, the uneventful. Adjustment, bliss, or resig-
nation bring the play to an end; resolution, integration, or the finality of
deep depression close the psychological study. Man at ease, like man
asleep, has precipitated scarcely a flurry of scientific reports. Famous
last words are "and they lived happily ever after—finis."
This ancient preference for the struggle—high-lighted in Homer and
long before him in the Sumerian tablets—is what makes clinical psychol-
ogy the darling of the social sciences. It is, indeed, about to bring not
only the individual, but also the whole family, community, or nation into
the sick ward for extensive study. And not a moment too soon!
The present volume is studded with distinguished names. The ap-
proach is varied, but this able company shares a common interest—the
desire to be helpful to the reader by applying to some immensely diffi-
cult problems of human behavior a vast amount of research and firsthand
experience. It is a book without pretense. It is characterized by a
straightforward approach. Its references appear well selected; if tracked
down, they would enliven the use of this book as a text or a base of op-
erations.
Perhaps I should mention what the reader will soon discover, namely,
iii
iv FOREWORD
that the authors have been allowed much freedom as to style and general
treatment of the subject matter. On the whole this does not detract from
the value of the symposium. Few persons will try to read the book in one
sitting. Its yield is better, it seems to me, when it is read as a series of
related but separately organized contributions. The change in pace, in
compactness, as one moves from author to author, is not unwelcome: it
is better far than the foolish reduction to a single style—an amorphous
style—that characterizes the work of most committees.
Here, in short, is a work on clinical psychology packed with useful ma-
terial, case history, and philosophical insight. It offers both to students
and to general readers a many-sided approach to the biggest field in the
whole wide domain of psychology.
GEORGE D. STODDARD
University of Illinois
December 1, 1947
EDITORS* PREFACE
The purpose of this book is to describe eclectically at the introduc-
tory level what clinical psychologists do. Of course no single clinician
deals regularly with all varieties of problems nor with all clinical methods
considered here; yet every clinical psychologist is professionally con-
cerned with some of them and, as explained later, the editors feel that
for a first course in clinical psychology such an eclectic survey is a basic
need. Thus the scope of this volume is represented in varying proportion
in the daily, collective activities of clinical psychologists.
The variation in what clinical workers individually do probably ac-
counts for the marked differences in the content of courses labeled clin-
ical psychology. Several state certification laws which define the training
and activities of clinicians require that the applicant shall have academic
credit for a course in clinical psychology. Yet students meeting this re-
quirement would secure widely different training in different institutions.
In one university the course in clinical psychology is essentially "ad-
vanced abnormal psychology" in that it deals in detail with the psycho-
neuroses and the psychoses. At a second institution the clinical psychol-
ogy course is concerned exclusively with psychological tests, mostly those
of intelligence. At a third, the same course title is used for teaching
counseling and psychotherapeutic techniques, while a fourth course at
still another university seems to be concerned with personality develop-
ment. Careful investigation would undoubtedly reveal even further di-
versity of course content under the selfsame title.
This, of course, is not to assert that content such as that just men-
tioned does not belong in a curriculum described as clinical. All such
material is obviously appropriate and essential. But for the first course
in clinical psychology we hold firmly to the conviction that an eclectic
survey of the field is a basic need. Broad familiarity with the clinical
problems and methods will provide a convenient springboard for subse-
quent more specialized courses. And more important still, it will help
establish a common background of familiarity in the field among clini-
cians, since all would have been exposed to the same core of clinical
knowledge. As almost any supervisor of neophyte clinicians can testify,
there are holders of advanced degrees in clinical psychology who know
the Stmford-Binet Examination well indeed, but who know virtually
nothing of the Wechsler-Bellevue Scale. Others are quite competent
in administering all widely used intelligence tests, but have only "heard"
of the various projective techniques for personality evaluation. The
present book does not aspire to do more than to give a description of
clinical problems and methods in psychology. Yet in so aspiring it of-
fers one operational definition of the field; for it deals with what clini-
v
vi EDITORS' PREFACE
cians do. Of course there are shifts in emphasis in clinical activities;
and different clinical jobs require more of certain activities than of others.
The clinician who is starting to work on an assignment requiring con-
siderable emphasis upon intelligence testing, for example, may wish for
more extensive treatment of the subject, while another assigned to an out-
patient clinic may feel that the single chapter on the currently omnipres-
ent problem of emotional tension is all too introductory.
But the aim of this book is not to make a student master of any special
area. The aim is indeed one of introduction—a first course in clinical
psychology. This, we believe, is apparent in the plan of the volume.
Part I first defines this clinical branch of psychology and indicates for
the student who first encounters the field the nature of the training
needed, as well as those fields most closely related. Part I is also con-
cerned with the question of the meaningfulness of such concepts as nor-
mality, adjustment, and maladjustment. Inasmuch as the practicing clin-
ical psychologist is always concerned with his client's attainment and
maintainment of adjustment to the environment, it is essential for the
student early to encounter these concepts. Once these issues have been
clarified, and once the signs by which maladjustment is suspected have
been considered, one is then ready to investigate the several phases of
specific maladjustment which the practitioner encounters, regardless of
whether he is employed in industry, the hospital, the community clinic,
or the university counseling center. Part II, accordingly, provides a sur-
vey and a discussion of those behavior problems with which the clinician
frequently works. Thus, because the qualified professional psychologist
is concerned with children exhibiting behavioral deviations, with the
mentally defective, with the physically and educationally handicapped,
with the delinquent, the criminal, the psychopathic personality, with sex
problems, with tension states, with the psychoneurotic and psychotic de-
viations, these receive here major attention. As a part of practically all
these discussions, a satisfactory array of case histories is presented in ade-
quate detail. Following the discussion of these problems, Part III con-
siders those tools with which the psychologist works—psychological tests
of several types, the use of the clinical interview in the arrival at a diag-
nostic impression and at a choice of the most appropriate psychothera-
peutic procedures. Part IV provides a description of selected procedures
by which behavior disorders can be alleviated. In addition, the use of
medical techniques as far as they are related to the psychologist's thera-
peutic function is summarized (Chapter 21). Part V raises the question
of professional relationships with those of the psychiatric profession,
and points out areas in which the clinical psychologist, the psychiatrist,
and the case worker—working together—can be of mutual assistance.
Throughout, the editors have intended to stress the similarity of prob-
lems encountered in the field of clinical behavior, regardless of the oc-
cupational placement of the practicing psychologist. It is our opinion that
the problems remain much the same, although the purposes for which clin-
ical procedures are applied may vary. The editors also assume, as sug-
EDITORS' PREFACE vii
gested earlier, that training in the administration and interpretation of
the numerous clinical techniques is beyond the scope of this volume.
The sole aim operative during the arrangement for and editing of this
text has been to present an introductory description of the problems en-
countered, of the more frequently met diagnostic and therapeutic tech-
niques used by the qualified clinician at work. Accordingly, detailed ex-
amination of all available clinical methods is not specifically provided.
Also, no effort has been made to teach through the medium of the printed
page, for example, the actual techniques of projective and concept-level
testing. References, it is believed, are sufficiently numerous to pro-
vide the teacher with additional material in the amplification of points
discussed within the chapters. It is fully realized that further detailed
study at the graduate level with appropriate intervals of internship is es-
sential for the mastery of detailed information and for the acquisition of
specific skills. For this arrangement and plan of the volume the editors
take responsibility.
We are indebted to the contributors to this work for their helpful sug-
gestions and cooperative effort, to all others who, in moments of advise-
ment, have materially improved the volume as a teaching instrument for
the beginning student of clinical psychology. We are grateful to those
editors of scientific journals and to those authors of texts who have as-
sisted in the preparation of the volume.
L. A. PENNINGTON
IRWIN A. BERG
Urbana, Illinois
Claremont, California
January, 1948

CONTENTS
PARTI
INTRODUCTION
CHAPTER PAGE
1 THE MEANING OF CLINICAL PSYCHOLOGY . . .. 3
By RAYMOND B. CATTELL, Ph.D., D.Sc, Research Professor
of Psychology, University of Illinois
2 WHAT IS NORMAL BEHAVIOR? 17
By O. H. MOWRER, Ph.D., Associate Professor of Education,
Graduate School of Education, Harvard University
PART II
CLINICAL PROBLEMS
3 SIGNS OF PERSONALITY DISINTEGRATION . . .. 49
By D. W. DYSINGER, Ph.D., Associate Professor of Psychol-
ogy and Chairman of the Department, University of Nebraska
4 BEHAVIOR PROBLEMS OF CHILDREN 66
By GLADYS LOWE ANDERSON, Ph.D., Chief, Clinical Psy-
chology, Veterans Administration Hospital, Fort Custer,
Michigan; and HAROLD H. ANDERSON, Ph.D., Professor of
Psychology and Head of the Department, Michigan State
College
5 THE MENTAL DEFECTIVE 89
By MANDEL SHERMAN, Ph.D., M.D., Professor of Educational
Psychology, University of Chicago
6 THE PHYSICALLY HANDICAPPFD 107
By STANLEY S. MARZOLF, Ph.D., Professor of Psychology
and Head of the Psychological Counseling Service, Illinois
State Normal University
7 THE EDUCATIONALLY BACKWARD 138
By ROBERT M. BEAR, Ph.D., Professor of Psychology and
Director of the Reading Clinic, Dartmouth College
8 SPEECH AND PERSONALITY 157
By FILLMORE H. SANFORD, Ph.D., Assistant Professor of
Psychology, University of Maryland
ix
x CONTENTS
CHAPTER PAGE
9 TENSION STATES 178
By ANNETTE C. WASHBURNE, M.D., Associate Professor of
Neuropsychiatry, Associate Professor of Preventive Medicine,
and Senior Consultant in Neuropsychiatry, Department of
Student Health, University of Wisconsin
10 PSYCHOSEXUAL BEHAVIOR 200
By JOSEPHINE BALL, Ph.D., Psychologist, Rockland State
Hospital, Orangeburg, New York
11 PSYCHOLOGICAL TRENDS AND PROBLEMS IN LATER MA-
TURITY 218
By RAYMOND G. KUHLEN, Ph.D., Associate Professor of Edu-
cational Psychology and Chairman of the Department, School
of Education, Syracuse University
12 ANTISOCIAL PERSONALITIES 249
By HERVEY CLECKLEY, M.D., Professor of Psychiatry and
Neurology, University of Georgia College of Medicine at
Augusta
13 THE PSYCHOSES AND THE PSYCHONEUROSES . . . 265
By R. M. DORCUS, Ph.D., Professor of Psychology and Chair-
man of the Department, The University of California at Los
Angeles
PART III
CLINICAL METHODS
14 THE MEASUREMENT OF ACHIEVEMENT AND APTITUDE . 325
By JOHN E. HORROCKS, Ph.D., Associate Professor of Psy-
chology, Ohio State University
15 INTELLIGENCE TESTING AND CLINICAL PRACTICE . . . 353
By ANN MAGARET, Ph.D., Associate Professor of Psychology,
University of Wisconsin
16 INTEREST AND PERSONALITY TESTS 380
By WILMA T. DONAHUE, Ph.D., Director of the Bureau of
Psychological Services, Institute of Human Adjustment, Uni-
versity of Michigan
17 PROTECTIVE METHODS 416
By HELEN SARGENT, Ph.D., Lecturer in Psychology, North-
western University, and Consulting Psychologist, Evanston,
Illinois