Selected papers on hysteria and other psychoneurosesFreud, Sigmund
Science
Selected papers on hysteria and other psychoneuroses
Freud, Sigmund
Hysteria; Neuroses; Psychoanalysis
I can not say the same thing about the therapeutic procedure which we
have proposed to our colleagues together with our theory. It still
struggles for recognition. This may have its special reasons. The
technique of the procedure was at that time still rudimentary. I was
unable to give those indications to the medical reader of the book which
would enable him to perform such a treatment. But surely there were
other causes of a general nature. To many physicians psychotherapy even
today appears as a product of modern mysticism, and in comparison to our
physico-chemical remedies the application of which is based on
physiological insight, psychotherapy appears quite unscientific and
unworthy of the interest of a natural philosopher. You will therefore
allow me to present to you the subject of psychotherapy, and to point
out to you what part of this verdict can be designated as unjust or
erroneous.
In the first place let me remind you that psychotherapy is not a modern
therapeutic procedure. On the contrary it is one of the oldest remedies
used in medicine. In Lëwenfeld’s instructive work (Lehrbuch der gesamten
Psychotherapie) you can find the methods employed in primitive and
ancient medicine. Most of them were of a psychotherapeutic nature. In
order to cure a patient he was transferred into a state of “credulous
expectation” which acts in a similar manner even today. Even after the
doctors found other remedial agents psychotherapeutic endeavors never
disappeared from this or that branch of medicine.
Secondly, I call your attention to the fact that we doctors really can
not abandon psychotherapy if only because another very much to be
considered party in the treatment—namely the patient—has no intention of
abandoning it. You know how much we owe to the Nancy school (Liébault,
Bernheim) for these explanations. Without our intention, an independent
factor from the patient’s psychic disposition enters into the activity
of every remedial agent introduced by the doctor, acting mostly in a
favorable sense but often also in an inhibiting sense. We have learned
to apply to this factor the word “suggestion,” and Moebius taught us
that the failures of some of our remedies are to be ascribed to the
disturbing influences of this very powerful moment. You doctors, all of
you, constantly practice psychotherapy, even when you do not know it, or
do not intend it, but it has one disadvantage, you leave entirely to the
patient the psychic factor of your influence. It then becomes
uncontrollable, it can not be divided into doses and can not be
increased. Is it not a justified endeavor of the doctor to become master
of this factor, to make use of it intentionally, to direct and enforce
it? It is nothing other than that, that scientific psychotherapy expects
of you.
Public-domain text, read in full here on John Shaqi.
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