If, however, as is likely to be the case, you are a more or less feminine person, instinctively unwilling to exhibit your mind in déshabille, and fatuously intent with a persistency worthy of a better cause on making a good impression on the only person present, you learn to use these opportunities to tell him everything to your credit that you can think of, and by carefully working out, preferably in advance, a chain of passable associations, to present yourself, your character, and your career in the most favorable light. The wide range of possibilities in this process that are open to the designing patient seems to be scarce dreamt of in the philosophy of the gross masculine mind.
This brings me by easy and inevitable stages to the important topic of the “transference.” To the unenlightened this may be defined as the mock modest and deceptive designation invented by the psychoanalyst for the more or less ardent affection for himself that he cold-bloodedly sets out to inspire in his victim. The doctor, for the benefit of his patient, temporarily transfers to himself and appropriates the devotion which normally belongs to father, brother, husband, son or lover. To be sure, it is to remembered that as there is no such word as friendship in the psychoanalytic vocabulary, an attitude of confidence or admiration must be represented in terms of a deeper sentiment.
Of course what happens is that the patient mistakes for an attachment of the heart what is in reality only an intimacy of the mind, because such an abandon of reserve is indissolubly associated in the feminine mind with the ties of affection. According to the true Jamesian psychology, she loves because she confides, instead of confiding because she loves. How a poor man patient manages can only be surmised, but there are indications that the knowing of the sex furtively seek the ministrations of a woman analyst.
Apparently the theory on which all the varied forms of this treatment are based is that the catharsis of the mind is essential to mental health, the emptying of all that is in it, the expulsion of dead matter. The nausea of the soul is relieved like its physical analogue by freeing it from the undigested matter, the “repressions,” that lie so heavily upon it. The self-contained nature that refrains from spilling over and strives to maintain itself without recourse to the safety valve of confidence must in the end unload its burden.
After the destructive process is completed and the ground cleared for the constructive measures that are to rear the temple of the “mens sana in corpore sano,” the heavier half of the work remains to be done; for the gigantic task to which the practitioner of the new prophylaxis sets himself is nothing less than the reconstruction of the character of the patient. Indeed, a recent work on psychoanalysis has for its title The Mechanisms of Character Formation. The conversions that the Rev. Mr. Sunday and his less notable peers are wont to accomplish in an hour, these painstaking scientists patiently bring about in from some scores to some thousands of hours of equally strenuous labor. I am informed that the cure of the first case of a certain type undertaken by one of these under-studies of the Eternal, actually consumed two thousand hours, and that the cure of the specific disease required the entire reconstruction of the character of the sufferer. Presumably the bill for “professional services” involved in this beatification was $20,000. One wonders whether the character that resulted was worth the price. The consulting room of the psychoanalyst is the new Beauty Parlor where those dissatisfied with their mental and moral physiognomy may have the lines of stress and strain smoothed away, and may gain the roses and lilies of a rejuvenated spiritual complexion. Unhappily I am unable to speak at length and with authority on this phase of the treatment; for I am at present only just entering upon the period of metamorphosis. I see dimly, “as through a glass darkly,” my own apotheosis looming ahead, but the road to that celestial height looks a long and weary and appallingly expensive journey.
It is the time element that perhaps most impresses and depresses the student of the new prophylaxis. In a recent paper by a competent psychiatrist the writer refers as follows to the impracticability of studying a group of cases in a public hospital on the plan of getting the patients to understand and explain their own difficulties:
At the rate at which the best of the psychoanalysts work, it would not be possible properly to study in the course of the year more than a dozen cases. Furthermore, the results of such work are of importance purely for the individual, and no generalization can be drawn therefrom…. Also, no generalization being possible, it is a matter of piece work; to study one hundred cases according to this method would require the efforts of fifteen to twenty psychologists on full time for many months.
In the opinion of the faithful, Freud, the inventor of psychoanalysis, is to psychiatry what Darwin was to biology, but as Darwin’s theory of evolution required more aeons than the geologists were able to oblige him with, so Freud’s method requires more time than the calendar affords. Darwin’s theory of the variation of species had to be modified by the theory of mutations or sports. Freud’s methods, to be workable, must be adapted in some way to the indisputable fact that there are only twenty-four hours in the day, and only three hundred and sixty-five days in the year.