To enter into the full richness of this whole, large field of course
lies entirely beyond the scope of our short discussion, which seeks as
its only aim a clear recognition of the principles. Yet it seems
essential to illustrate at least this sketch of the field by a more
detailed account of actual developments. Various ways of procedure might
appear in order and the most natural one would be, of course, to pass
down from disease to disease and sketch special cases from diagnosis to
cure. We might go through the various stages of neurasthenia and then
through psychasthenia and then through hysteria and so on. And if we had
to write a handbook for physicians, it would certainly be the desirable
way, in spite of the too frequent repetitions which would become
necessary. But as our aim is only a discussion of principles of
psychotherapy, we have no right to use this method. Moreover, such a
method would suggest the misleading view that the psychotherapist is
called and is able to treat diseases. All that he treats are symptoms
and he ought not to pretend that he can do more, as long as he abstracts
from all other therapeutic agencies. Psychotherapeutic influence may
remove the phobia of a psychasthenic or the obsession of a neurasthenic
or the emotion of a hysteric, and thus may bring not only momentary
relief but a change which may be favorable for general improvement, but
certainly the neurasthenia and psychasthenia and hysteria are not really
removed by it. Of course, even the treatment of symptoms demands a
constant reference to the whole background of the disease. The
depression of the neurasthenic must not be treated like the depression
of the melancholic, the obsession of the psychasthenic must not be
mixed with the fixed ideas of a paranoiac, the hysteric inability to
walk must not be confused with an injury of the motor nerves; in short,
each symptom has to be treated as part of a complete situation. The
efforts of the psychotherapist will move over as large a part of the
disease as possible and cover, perhaps, the causes of the disturbance as
far as they are of psychical origin. Yet it would remain dilettanteism
if we were to accept the popular view that the mere psychotherapeutic
aid is a sufficient treatment of the whole disease. The physician has to
be much more than a psychotherapist. Our discussion only seeks to point
out that whatever else he may be, he must be also a psychotherapist.
Public-domain text, read in full here on John Shaqi.
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