Requisites for the treatment of the psycho-neuroses : psychopathological ignorance, and the misuse of psychotherapy by the novice / by Tom A. Williams.

  • Williams, Tom A. (Tom Alfred), 1870-
Date:
1909
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Licence: In copyright

Credit: Requisites for the treatment of the psycho-neuroses : psychopathological ignorance, and the misuse of psychotherapy by the novice / by Tom A. Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted from Monthly Cyclopedia and Medical Bulletin August, 1909. ] REQUISITES FOR THE TREATMENT OF THE PSYCHO-NEUROSES: PSYCH0PATH0L0GICAL IGNORANCE, AND THE MISUSE OF PSYCHOTHERAPY BY THE NOVICE.* By TOM A. WILLIAMS, M.B., C.M. (Edin.), WASHINGTON, D. 0. We hear much about the neuroticism of modern days, the popular belief being that neurasthenia,1 as it is loosely called, hardly existed until the latter end of the 19th century. It is supposed that this state of matters is due to the fatigue to the nerves of the modern strenuous life. As a matter of fact, confessions, memoirs,2 and the pictures of the time show that neurotic states occurred in the Middle Ages even more widely than they do to-day. Again, the “vapours” so often alluded to in the literature of Queen Anne’s time, would nowadays be called nervous prostration, and a “rest-cure” would be prescribed; but in that less enlightened age, they were appraised, empirically it is true, at their real value—mental vacuity, discontent or failure of adjustment to environment. The last factor is shown by a close analysis to be the real cause of most cases of so-called nervous prostration3; and the indiscriminate administration of the rest-cure without a clear psycho-diagnosis will in the future be relegated to the limbo of such other medical superstitions as blood-letting and anti- pyretics. Of course, adjustment fails when the nerve cells are poisoned, injured, receive insufficient oxygen or irregular supply of blood; but these are not psychic difficulties, and'can be provided against by the internist and the patho- logical chemist. He succeeds in virtue of the precision with which he estimates the derangements in a body whose normal functions he has spent years in studying. Similarly, the psychiatrist can succeed only by an understanding of normal mental reactions, and by a profound study of the data of morbid psy- chology. It must be recollected that the patients referred to him are those in whom empirical methods have failed. For example, they are “suggestioned” ad nauseam; one patient told me how thankful she was that I did not tell her she was better or minimize her mental suffering; for she hated the sight of a doctor; as each in turn made light of her state, and said she would soon be bet- * Read by invitation at the Symposium on Psychotherapy before the Washington Therapeutic Association, April 10, 1909.