Traumatic neuroses; War neuroses; World War, 1914-1918 -- Health aspects; World War, 1914-1918 -- Veterans -- Mental health
To assume that one can make the patient forget such worries as these
without first discovering what they are, is obviously fatuity at its
grossest. Moreover, as we have seen, it is quite insufficient merely
to discover that the patient is “suffering from hallucinations” or
delusions and then to tell him to dismiss them from his mind. To
suppose that, without understanding the nature of and the specific
reasons for the development of a particular hallucination, one can
“make the patient forget” his interpretation of a real experience which
has appealed to him night and day for weeks, or banish a delusion which
is gradually becoming systematised and rationalised—_i.e._, intimately
interwoven into the tissues of the whole of his experience—is an
assumption which has no foundation in fact.
The point cannot be too much emphasised that many of these patients are
quite sane, if conduct be regarded as the criterion of sanity; but
they are growing afraid of the appearance of these abnormal phenomena,
and take them for signs of incipient—or, more usually perhaps, of
established—insanity. Hence follows the important corollary that while
treatment by isolation has obvious advantages in certain cases, in the
particular group of patients which we are now discussing it is often
dangerous, for the reasons already emphasised in the last chapter. The
presence of such mental phenomena is usually confided to the physician
only after great hesitation, and such worrying experiences are common
in cases of insomnia and other disorders, which, though troublesome,
do not appear to be grave. It is therefore possible that isolation may
have serious effects in many cases in which its net result seems merely
to be that the patient is no better.
It is granted then that in some instances (by no means all), the
patient may be temporarily pained by the dragging into daylight of the
causes of his worry, but it is usually a case of _reculer pour mieux
sauter_. This procedure is often inevitable in the medical treatment of
many disorders which have become complicated to any considerable extent.
Public-domain text, read in full here on John Shaqi.
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