Traumatic neuroses; War neuroses; World War, 1914-1918 -- Health aspects; World War, 1914-1918 -- Veterans -- Mental health
It would be rash to deny that up to a certain point this convention
is susceptible of defence. But, carried too far, it is productive
of disastrous results. Moreover, it is impossible for a doctor to
treat many varieties even of physical disease without becoming to a
great extent the confidant not only of the patient but often of his
family. And there is no doubt that the present unwritten law that the
doctor should confine himself to the patient’s physical ills is often
judiciously disobeyed by very many successful practitioners. Yet it
must be recognised that the convention exists, and like all social
usages is extremely tenacious.
The chief medical objection, which we shall now consider, is usually
expressed in some such form as the assertion that “it makes the
patient worse to talk about his worries” and that one should rather
“try to make him forget them.” Let us examine these statements, both
of which contain a certain amount of truth, but if applied without
qualification to serious cases of incipient mental disorder can by
their respective negative and positive tendencies do an incalculable
amount of harm. They are often the result of applying experience
acquired by the successful reassuring of a certain type of “malade
imaginaire,” to the consideration of far more complicated cases in
which such easy and straightforward treatment is impossible. A man,
let us say, visits a doctor and confesses to him his fear that he is
suffering from some organic disease. The physician after a careful
examination proves to the patient by objective means that there is
nothing the matter with him; the sufferer is reassured and returns to
his daily business and in due course forgets about this worry or ceases
to be troubled by the memory of it. Here the diagnosis, treatment,
and cure may be uncomplicated and “on the surface.” But even here it
should be emphasised that in one sense, far from “making the patient
worse” to talk about his trouble, the talking about it was the _sine
quâ non_ of cure; otherwise the doctor would never have known of the
fear. In another sense, however, talking about the trouble did make the
sufferer worse—but for a short time only, during a confession of his
apprehensions, or perhaps even for a few days, if more than one visit
to the consulting room were necessary before the doctor’s verdict could
be obtained.
Public-domain text, read in full here on John Shaqi.
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