The problem of treating the “back ward” chronic schizophrenic is likely to remain for some years to come, and with it the problem of establishing the genuine effectiveness of particular treatments. Disentangling effective from non-effective therapeutic techniques in “total-push” programmes is particularly complicated. What precisely is responsible for the minimal improvements observed: some subtle change in “ward climate”, the altered medication or the new music therapist? Writers who view mental illness primarily as a breakdown in normal interactional relationships with other persons have stressed the therapeutic importance of certain types of social milieu (e.g. Martin, 1962). Others (e.g. Greenblatt et al., 1955) have suggested that the success of even the physical treatments can be explained in terms of the optimism and enthusiasm with which they are carried out. However, there are few systematic research attempts to disentangle the physiological from the psychological variables.