It is clear to every thinking person that, in analysing a mental state the physician should use every legitimate means at his disposal. If these means include, as they do, the valuable assistance derived from the study of the patient’s dreams, his “associations” whether free or constrained,[49] and other mental phenomena, the doctor may use them freely without thereby subscribing to any one “doctrine of psychoanalysis.”
The term psychoanalysis has been widely applied, not only to the diagnostic method, but also to the theories which underlie and determine the subsequent process of re-education. This seems to be a misuse of the useful word “analysis.” It may be objected that in all scientific analysis there is some directive hypothesis to be confirmed or disproved, and that in this sense all analysis is based on theory. This is true, but it seems inadvisable to confuse the analytic process with the theory which directs one form of it.
When we come to consider the theoretical presuppositions which underlie the different methods of re-education adopted by various physicians, it is not surprising, at this early stage of our knowledge, to discover differences of opinion. The physician will find at every step that in “tidying up” the disentangled functions of the patient’s mentality he will need not one theory but many, for his problem is life itself.
All his own human sympathy, with its indispensable basis, a knowledge of his own strength and weaknesses, all his learning in physical science and psychology, all his knowledge of morality and religion must be available for immediate and efficient use. In one interview he may have to lay down the law for the benefit of some ignorant and distressed patient who is desperately anxious to follow his advice unquestioningly; in the next he may be at close grips with a mind more flexible and independent than his own, knowing well that his every little victory must be consolidated, and that every position won may be subsequently counter-attacked by his patient. He must be ready to suggest, discuss, persuade as the time and the conditions indicate.
While, therefore, the ultimate lines on which an ideal diagnostic analysis and curative re-education will be possible are as yet undefined, it would serve no good purpose in a book of this length to raise discussion on the question of psychoanalysis. Its future will be settled, not in the heated atmosphere of the debate, not in the acrid polemics of the correspondence columns, but in the calm, careful examination by the individual worker of his own actual findings and the honest comparison of them with those of others.
FOOTNOTES:
[37] Such development involves a complicated set of processes the nature of which is by no means obvious to unaided common sense.
[38] “... for example, a patient may maintain that he is the king, but that an organised conspiracy exists to deprive him of his birthright. In this way delusions are sometimes elaborated into an extraordinarily complicated system and every fact of the patient’s experience is distorted until it is capable of taking its place in the delusional scheme.” Bernard Hart, The Psychology of Insanity, Cambridge, 1914, p. 32.
[39] Cf. p. 15f.
[40] Cf. Hart, op. cit., p. 66f.