The object of this paper is to set out some of the difficulties experienced in early training in Psychotherapy.

The tendency of anorexic patients to overestimate their own body size was one element of Bruch's (1962) concept of body image disorder. The first experimental validation of this tendency was reported by Slade and Russell (1973), who also demonstrated that overestimation was directly related to a poor prognosis and that patients tended to become more accurate with therapeutically induced weight gain.

The views I express in this paper are my personal views and not those of either the Department of Health and Social Security or the National Development Group, but they are, nevertheless, based on established services and views expressed to me by colleagues in various parts of the country.

Consultation-liaison psychiatry has emerged as a significant area of special interest within clinical psychiatry in recent years. It seeks to enhance the quality of psycho-social care of medically ill patients and of their psychological reactions to illness; to provide effective consultations not only with regard to patient management, but also to the complex problems arising where serious medical and psychiatric illness overlap, and to deal with the personal difficulties arising in members of the clinical team caring for the patient. It has an essential contribution to make to the actual practice of holistic, comprehensive health care; rather than just to the airy rhetoric by which whole-person medicine exists in the medical school's prospectus and objectives but not in its wards. We do not teach mere vapid sympathy, but competent psycho-physiological understanding of the patient, and sound communication skills.

In response to a widespread demand within the College, Council has approved a scheme for granting formal recognition to individuals appointed as Psychiatric Tutors, Specialty Tutors and Organizers in the field of postgraduate education. The College is not concerned in the creation of such posts or in the appointment of individuals to them but in making the tutors' position more formal by providing criteria for their recognition and establishing standards by which they are chosen, and in doing this in a way that will be both acceptable to and welcomed by Universities, Postgraduate Committees, Health Authorities and other appointing bodies.

Studies of West Indian and West African immigrants have consistently shown high rates of diagnosed schizophrenia, although they differ in the extent to which the illness is seen as atypical. A retrospective examination of hospital notes at an East London Psychiatric Unit showed that although total admissions were similar in different ethnic groups there was an excess of schizophrenia in Caribbean and West African migrants similar to that found previously. These patients also showed an increase in two pathoplastic features, religious and paranoid flavour and an increased proportion of women, formal admissions and short admissions.