Book Reviews

Contents
DER GESTALTKREIS ( THE CIRCLE OF FORM
GENESIS)
by V, Von Weizsecker
Reviewed by GOTTHARD BOOTH, p.
PSYCHOTHERAPY IN CHILD GUIDANCE
by G. Hamilton
Reviewed by EDWARD A. MASON, p.
of
129
Book Reviews
NURSING FOR THE FUTURE
by Esther Lucile Brown
Reviewed by MARIE REARICK, R.N.,
TAKE OFF YOUR MASK
by Ludwig Eidelberg
Reviewed by STANLEY COBB,
P-
P-
131
132
DER GESTALTKREIS (The Circle of Form
Genesis)
Von Weizsecker, V.
Stuttgart, Georg Thieme, (ed. 3) 7947, 208 pp.
The concepts of this book offer a solution for one of
the theoretical difficulties which have been hampering
the progress of psychosomatic research. So far the so-
matic side has been studied and described in the
quantitative terms of classical physics and chemistry,
the psychologic side in terms which are partly ma-
terialistic (libido, repression, fixation, sublimation),
partly biologic (sex, aggression), partly cultural (e.g.
adjustment, love, hostility, domination). The result is
that "events are alternately described as subjective, as
objective, as physically conditioned or produced, as
psychologically influenced or ordered. Things, so to
speak, change back and forth, and since they do not
always give up dieir names, enormous difficulties of
terminology and communication arise" (pp. 154 ff.)
The theory of the Gestaltkreis is based on quantita-
tive studies of perception and motility which have been
pursued in the laboratories of v.Weizsecker since 1921.
It was found, independently from similar earlier de-
velopments in physics, that in biology, too, experimen-
tation with smallest quantities proves space and time
not to be independent variables. Space and time are
subject to transformations into each other (pp. 8iff.).
Furthermore the thresholds and reactions of the af-
ferent and efferent nervous elements were found to be
functions of biologic situations. The nervous elements
as such did not explain actual perception or motion as
causal effects of quantitative stimuli. Perception of ob-
jects takes place in the objects, motion always involves
self-motion. This viewpoint is contrasted with the the-
ories of classical physiology according to which per-
ception was to be understood as projection of sensory
stimulation, motion not as action, but as re-action. "In
perception ego and object fuse, in this coherence the
distinction between subject and object is not self-under-
stood, but depends on secondary elaboration, e.g. even
within the organism the same pain may appear as 'my
pain' or as 'the pain in my body!'" (p. 121). Since the
MAECH-APRIL, 1949
nervous elements undergo functional transformations
according to the individual subject-object situation,
v.Weizsecher subordinates the principle of nervous func-
tion (Leitungsprinzip) to the principle of biologic ac-
complishment (Leistungsprinzip). For some of those
transformations significant laws are described. Thus per-
ception takes place according to mathematical possibil-
ity, e.g. in stereoscopic vision. The most striking ex-
ample for the "principle of possibility" is provided by
the experiment of Christian (p. 104): in a dark room
one luminous point executing linear motions relative to
a fixed luminous point is perceived as rotating around
the fixed point. In other words, the subject perceives the
two points in the motion two bodies would execute in
empty space according to the laws of astronomy. In the
sphere of motility it was found by Krueger that mo-
tions, e.g. throwing a ball at a target, are executed i
such a way that a minimum of energy is required (p.
186). In me last two examples "the organism behaves,
according to the calculations of an unconscious mind."'
Perception and motion cannot be separated, they are
linked by what the author calls "the principle of the
revolving door: in perception of an object the individual
act through which one perceives is not experienced, in
the experience of one's action, the change of the object
is not perceived. Biologic functioning means mutual ex-
clusion of (conscious) perception and motion" (p. aif)..
The specific forms of biologic acts are described as
based oh a circular process in which simultaneously the
organism acts upon the environment, the environment
upon the organism. "The genesis of forms must be con-
sidered as a closed circle since in it no prius or posterius
can be localized . . . it is termed Gestaltkreis" (pp.
I36ff.). The "coherence" between organism and environ-
ment makes each biologic act a unique meeting of the
subject with his object. According to the theory of the
Gestaltkreis life is a sequence of unique events, all of
them "coming from an unalterable past and moving
into a future which may be either expected or surpris-
ing. Life is not a sequence of cause and effect, but of
decisions" (p. 145). The transition from one situation
to the following is represented by subjective experi-
ence (p. 171). Such transitions may manifest them
130
selves as deep crises of subjective consciousness (pp.
i
74
ff)
The simultaneousness inherent in the Gestaltkreis
makes "coincidence" the basic relationship between sub-
ject and object, the causal processes of material condi-
tions appear as secondary limitations, as restrictions of
individual cognition and will (p. 124). In this theory
time and space lose the primary character they have in
classical physics and in Kantian philosophy. "The world
and the objects do not exist in time and space, but time
and space are in the world as parts of the objects" (pp.
117 ff.) "They are put in the service of the organism
as its sense organs mediate its fitting into a world, not
the knowledge of an objective world without subjects;"
(p. 119). The consequences of the concept of time and
space as moved by the organism instead of being pri-
mary elements of life lead not to complete indeter-
minism, but time and space of the organism are found
to be related to each other by certain biologic con-
stants: e.g. a specific time is associated with the act of
describing a circle in the air. "Motor figures either
differ in space, but are alike when enacted in the same
time, or they differ in form, if the space is the same,
but the time of execution is made different" (pp. 146s.).
A typical biologic example is the change of form which
the motions of a horse undergo as it changes its speed
from pace to canter to gallop. This constant "figure
time" involves another departure from the causal time
sequence of classical physics and physiology: in the
above example of describing circles of different diam-
eter in the air it is to be noted that the speed of the
beginning circular motion is determined by the circum-
ference of the circle intended. This phenomenon is
called "prolepsis" and is defined as "the anticipation of
the result through a motion, perception or act, which
does not contain the result as possible effect, but actually
achieves it" (p. 207).
The motor and sensory coherence between organism
and environment is illustrated particularly by examples
involving the accomplishment of equilibrium. Either in
rotating the subject on Barany's chair or in rotating a
screen around the subject the speed of the rotation can
be experienced in various ways: either the subject or
the environment may be seen as rotating at full speed,
or the experience may be divided between subject and
environment in such a way that the total sum of
both speeds is kept constant. Furthermore the percep-
tion of motion as well as nystagmus can be eliminated
by rotating both subject and screen at the same speed
and in the same direction. This last phenomenon can-
not be explained on the basis of nervous reflexes, but
only in biologic terms: "Equilibrium means the con-
servation of the biologic identity of the organism in his
environment" (p. 169). As a specific consequence of
the interlocking between perception and motion, equi-
librium can be achieved either by substituting the per-
ception of motion for self-motion, or self-motion can be
substituted for the perception of motion.' Those inter-
relationships are connected with clinical observations of
BOOK REVIEWS
affect being acted out in motor attacks, motor impulses
being experienced as emotions (p. 165).
The new concepts of space and time appear of
particular interest for the following reason which is not
mentioned in the book. All the data were obtained in
exact experimentation with unselected individuals, but
they bear striking characteristics of phenomena which
so far have been treated as "psychic" and associated with
selected individuals. Thus the principle of coincidence
in the Gestaltkreis agrees with what Jung described as
the principle of synchronicity which plays in oriental
thinking the role causality plays in western thinking.
Prolepsis has a formal resemblance with the phe-
nomenon of precognition in dreams, as described by
Dunne. The specific coherence between subject and ob-
ject gives a general physiologic background to the
theory of paranoia proposed by Ehrenwald.
Despite its revolutionary dealings with the concepts
of classical physiology the present work seems to be ob-
scure partly because it confines itself explicitly to the
time-space concept of the conscious mind and of classi-
cal physics. In the opinion of this reviewer it would be
an advantage for communication if biology would use
the tendimensional concept of the world as developed in
modern physics. This was brought to the attention of
psychiatry first by P. Jordan, the physicist (Positivistic
remarks on parapsychological phenomena, Zentralbl. f.
Psychotherap. 93.1936) Such extra dimensions are im-
plied in such remarks of v.Weizsecher as "the specific
quality of the perception includes a transsensual sphere
which cannot be derived from (conscious) perception"
(p. 122) or: "The physical conditions are only one of
the various elements on which biologic phenomena are
based" (p. 123).
The main purpose of the book is the introduction of
the subject into physiologic thinking, but it develops
around the central theme a general philosophy of life
and of medicine which are close to the philosophy of
existentialism, particularly of Sartre. Contrary to the
purely negative attitude of rationalistic science re-
garding suffering and death, the author finds that "the
pathic character of life is an essential character of life,
it is not only active but also passive" (p. 186); "Death
is not the antithesis of life, but the counterpart to con-
ception and birth, birth and death are like back and
front of life, they are not mutually exclusive." As in
politics this scientific existentialism emphasizes action..
V.Weizsecher criticizes the static character of classical
science which had resulted from the sensualism of the
era. "The task of sciences is not to explain phenomena,
but to create realities in a connection of man and
nature" (p. 153). "An emancipated century has ex-
cluded creation from the sciences as a dangerous idea.
It was classical physics which, inhibited biologic in-
determinism. One cannot have two contradictory con-
cepts of nature simultaneously. Now biology can start
to elaborate methodically and logically its indeter-
minism. It appears that it is not a milder, but even a
more severe law than determinism" (p. 154).
VOL. XI, NO. 2
BOOK REVIEWS
Although this book is difficult to follow, it is full of
factual observations and of theoretical considerations
which make it rewarding reading. In the opinion of
this reviewer it is of fundamental significance for the
development of psychosomatic theory on account of
its critical analysis of the role of causal and material
conditions in physiology.
GOTTHARD BOOTH
PSYCHOTHERAPY IN CHILD GUIDANCE
Hamilton, G.
New Yorl^: Columbia University Press, 194J.
Pp. 362,, $4.00.
This book, written primarily for social workers, has a
good deal to offer to psychiatrists and psychologists
concerned with child guidance. Professor Hamilton of
the New York School of Social Work has studied the
material from the Jewish Board of Guardians, and
presents a dynamically oriented discussion of its diag-
nostic and therapeutic efforts with children of all age
groups. There is considerable emphasis on clarification
of diagnostic terms, such as the distinction between
habit and conduct disorders. This is necessary not only
for developing a common language among workers in
the field, but also as a basis for determining how and
by whom a child should be treated.
Psychotherapy, as done at the Jewish Board of Guard-
ians by social workers with the psychiatrists for con-
sultation, is described with careful attention to the
therapist's role. There are dangers involved in the
management of therapy by other than physicians; re-
gardless of the fact that the need for therapists is
great and the functions of the caseworker and psy-
chiatrist often overlap, the feasibility of caseworkers
carrying major responsibility in psychotherapy is ques-
tioned by many. The author, as well as Dr. Nathan
Ackerman in the Foreword and Herschel Alt in the
Introduction, discusses thoroughly the reasons for this
practice.
The book is clear and interesting, and uses well-
chosen case histories for examples. The author encour-
ages a greater realization that a consideration of the
patient as well as his environment is necessary. He
gives intelligent and understanding comments on all
aspects of child guidance and has contributed to the
knowledge and progress of the field.
EDWARD A. MASON
NURSING FOR THE FUTURE
A Report Prepared for the National Nursing
Council by Esther Lucile Brown
New Yor\, Russell Sage Foundation, 1948, 198
pp., $2,oo.
This report is the result of a study with a three-fold
purpose: first, to view nursing service and nursing edu-
cation in terms of what is best for society; secondly, to
determine by extensive field trips the current condi-
tions of nursing service and of nursing education; and
MARCH-APRIL, 1949
thirdly, to make recommendations concerning the or-
ganization, administration and financial support of
professional schools of nursing based on a knowledge
of the following:
1. The health services evolving in the second half
of this century;
2. The nursing services demanded by these health
services;
3. The kinds of training and of academic and pro-
fessional education necessary for the essential
nursing services.
Health services have been greatly extended since the
First World War. The trend has been toward the goal
of maintenance of health rather than emphasis on or-
ganic disease. It is evident in the growtii of guidance
clinics and nursery schools for children. It has'been
made evident by die plans for hospitals to serve as
community health centers, to act as diagnostic clinics
for the community medical profession, and to be a re-
lated part of other community health agencies. This
trend has brought form the question as to the financing
of such projects with several plans proposedcompul-
sory health insurance bills, federal grants, and voluntary
health insurance.
This focus on positive health has been demonstrated
in the medical profession by the developments in pre-
ventive psychiatry with the changes in emphasis in
psychiatric teaching in the medical school and the ex-
periments in brief post-graduate courses for the prac-
titioner in the field. Concomitant have been the "new"
pediatrics and the "new" obstetrics with their emphases
on the healthy, happy growth of the child and the posi-
tive conditioning of the parents for birth.
But if health services are extended in this fashion
with more hospitals and public health agencies, with
industry widening its scope of activity in the main-
tenance of health, the implication for nursing of the
future is clearly that more nursing service will be
needed and a better preparation of the graduate nurse,
if she is to understand and work with the doctor in
this new approach to the patient.
The shortage during the Second World War led to
the advent of much non-nursing personnel (ward help-
ers, attendants, orderlies, and secretaries) to relieve the
nursing load. This in itself has created many prob-
lems which remain for solution, namely the differen-
tiation of functions for the various groups, the need
for in-service training of a standard quality, and the
establishment of better interpersonal relationships
within the hospital of all concerned with the care of
the patient.
If, as has been proposed, many of the current nursing
services can be allocated to the auxiliary nursing per-
sonnel, such as the nursing aide or attendant and the
practical nurse, what then is the role of the "profes-
sional" nurse in the future? This assumes that she has
a truly professional education and the facilities for
functioning thus.