DR. SMITH ELY JELLIFFE, New York: Dr. MacCurdy's paper fascinated me a great deal. There is so much material that one is in a maze. I am sorry, moreover, that he had to mutilate his conclusions by being forced by lack of time to condense them. It strikes me he gives us a very important contribution to the mechanism of the cure of some psychoses. That mechanism of cure, may be stated as follows: How can one take the split off libido which results from the analytic technique and apply it to a better constructive synthesis? It would seem that these constructive delusions really correspond to interpretative schemes whereby a certain amount of the split off libido becomes synthesized. In that sense these delusions are constructive and are, therefore, helpful to the patient. They represent partial curative processes.
DR. JOHN T. MACCURDY, New York: I would like to refer briefly, first, to the point made by Dr. White to the effect that these ideas were interesting in so far as they were archaic. That is true and it is one of the profoundest truths we have to offer. At the same time it is of psychological and not strictly speaking of psychiatric value. The purpose of my paper was essentially psychiatric, to point out that there is a prognostic value in such delusion as I have tried to outline. Now one can get archaic delusions in patients very much deteriorated. The point of this paper is rather to show, as the discussion brought out, that it is the constructive tendency operating in the insane as it has historically in the race. The second point as to the cycle in his attacks, to follow the inference of Dr. White, I presume he meant to imply that there may have been some organic swing corresponding to the psychotic swing. That of course is quite possible. At the same time the analysis of this case showed that purely psychic factors had a great deal to do with it. His monthly attacks seemed to represent a break in the balance. He was always in unstable equilibrium and the factor that seemed to decide the issue finally between relative sanity and a markedly deteriorated state, was a purely psychological one. When his father died, when he was released from that bondage, the relief seemed just enough to decide the issue. So the organic factors here seem to be the general, underlying inability to adapt himself. One of the hardest situations to adapt himself to was his relations with his father. If he could not free himself he was going to be very insane. When that factor was removed he became relatively insane.
DR. TOM A. WILLIAMS, Washington, D. C., read a paper entitled, "The origin of Supernatural Explanations."[*]
[*] Published in this number of the Journal, p. 236.
DISCUSSION
DR. E. E. SOUTHARD, Boston: Are all these somatic explanations of metaphysics?
DR. WILLIAMS: Largely.
DR. SMITH ELY JELLIFFE, New York: I recall a note in one of Dr. Jones' papers in which he says "that in the future our reason will be used to explain things. Heretofore it has been used to explain them away."
DR. TOM A. WILLIAMS, Washington, D. C.: I am not prepared to make any predictions about a thousand years from now, that is in the air. I mention not the levels at all, nor do I speak of "decerebrate metaphysics." Nor do I speak of metaphysics at all unless one would imply that what I have called supernatural explanations needs must be metaphysical. I do not speak of cerebral functions per se. I was simply speaking of states of feelings. The source and origin I did not go into. I simply made an attempt to imply that such states of feeling were responsible for the discomfort and feeling of inadequacy of the patient, and as Dr. Jelliffe has well repeated that the victim attempts to rationalize this in supernatural fashion and that this may be not at all dependent upon the notion of the supernatural universe he has imbibed as a child. It is a construing of natural means for getting out of a difficulty.
Dr. L. E. Emerson, Boston, read a paper entitled "The Psycho-Analytic
Treatment of Hystero-Epilepsy."[*]