But it obviously does not follow that the fact of a man having for very sufficient reasons, admitted the physician into his confidence, must necessarily bring as a consequence a diminution in his self-respect. On the contrary, he often emerges from such an examination with increased confidence and a better opinion of himself, especially if, as so often happens, his self-reproaches have been unfounded. The civilised world contains a relatively large proportion of people who habitually confess their shortcomings to priests. One may recognise that the confessional has its defects, but the assumption that to have recourse to it inevitably promotes mental flabbiness is obviously unfounded. The business man who, when faced with the necessity of successfully meeting an entirely new situation, consults his legal adviser, is not usually blamed for his lack of self-reliance. Conducting one’s own legal transactions, like doctoring oneself, may appear (to the vulgar) to show independence, but its results are not always happy.
It is therefore perfectly fair to claim that none of the arguments against the use of psychological analysis have any very great significance. In some cases, however, they express valuable reminders that this delicate and powerful instrument, like all others with these attributes, must be used with care and discretion.
We may now proceed to take stock of our present position and briefly to summarise the contents of the foregoing remarks. Many cases of “functional nervous disorder” or “neurosis” exhibit as their most important characteristics symptoms, the underlying factors of which are demonstrably mental. A neurosis may be regarded as the failure of an act of adaptation.[45] The resultant mental disturbances do not seriously affect the “reason” or the “intellect” as was formerly supposed, but are in character predominantly instinctive and emotional. The neurotic’s behaviour in the face of an insurmountable difficulty presents a considerable resemblance to that of a child. The reasons why this analogy is not always obvious (though often it is quite plain) is that while in the child one can usually appreciate the cause of the emotional disturbance and watch its progress, these possibilities are often excluded in the case of the civilised neurotic adult. Both his insurmountable difficulty and the historical circumstances which have made it unconquerable may (they do not always) lie within his inmost mental life. Further, the child’s difficulty usually is caused simply by his inability to adjust himself to his environment; or perhaps more often to adjust his environment to himself. The adult neurotic, on the other hand, adds to these difficulties the further significant one of a lack of inner harmony. There are warring elements inside as well as outside him: he is trying to fight the enemy with an army which has mutinied.
It follows then that any attempt to restore equilibrium between himself and his social environment must be accompanied by a similar endeavour to bring about his inner harmony. Therefore, in such cases, a certain amount of psychological analysis is indispensable. Without such investigation the application of physical or psychical methods of treatment must inevitably be a shot in the dark.
The task of psychological analysis is rendered difficult by the fact that not all the motives of the patient’s present beliefs, attitudes and actions are conscious; the entry into consciousness of some of the unacceptable motives and memories is obstructed by various mental processes. When the action of these shielding mechanisms has been subverted by various means the real significance and history of the patient’s present mental condition becomes clear to him. In the light of this new self-knowledge he begins to cure himself. In a few cases he may require little or no subsequent assistance, but usually a process of re-education[46] is necessary. He may still require to be helped over some of the obstacles which he meets, and he may need more or less frequent encouragement and advice to an extent determined by his disposition, temperament, and character. By these means he is “freed from himself,” liberated from the exaggerated emotional tone which has become attached to so many of his memories, and so enabled to face life anew with a harmonious and integrated mind.
The procedure which we have discussed is precisely that which the sensible mother adopts towards a child who exhibits sudden and unreasonable fear, anger, or any socially undesirable emotion. The same method is adopted towards the man who, having muddled his financial affairs, appeals for advice to an experienced and judicious business friend. “Firmness”—of the unsympathetic and unintelligent order—may occasionally produce good results in both these instances, but usually it only makes matters worse. Paying for the commercial muddler a few of his chief debts may remove his embarrassment for the time, but if unaccompanied by an attempt to reform his business methods, the result will usually be merely that such a treatment will enable him to incur fresh liabilities. So it is when a symptom or set of symptoms in a neurosis is unintelligently removed: new troubles frequently break out in fresh places.
We believe that there exist and can exist no serious arguments against the procedure of psychological analysis and re-education which we have just described. But now we come to speak of a procedure introduced during the last few years which has certainly not escaped criticism both of the most flattering and the most hostile kind. This is the method of “psychoanalysis” which we owe to Professor Sigmund Freud, of Vienna, who developed it as an extension and elaboration of the pioneer work of his former master, Professor Pierre Janet[47], of Paris.
Perhaps few terms in medicine have aroused so much misunderstanding, so much criticism, well-informed and ill-informed—and so much enmity as this word “psychoanalysis.” This latter fact alone, however, should not prejudice the reader for or against it. He will probably remember that it is the exception, rather than the rule, for an innovation to be received without hostility, not only from the general public, but also from experts who work in provinces bordering upon the field in which the new method is introduced.
It should be pointed out that much of the heated discussion which has raged around this word psychoanalysis is due to the fact that the term has different meanings, as used, not only by its enemies, but by its friends. Psychoanalysis, according to Dr. Jung, is a method; “a method which makes possible the analytic reduction of the psychic content to its simplest expression, and the discovery of the line of least resistance in the development of a harmonious personality.”[48]
Psychoanalysis is therefore a method of psychological analysis. Why, then, have we not used the term psychoanalysis in the earlier part of the book? It was purely to avoid unnecessary and acrimonious discussion on any particular doctrinal aspect of the question which this term may be taken to imply.