Traumatic neuroses; War neuroses; World War, 1914-1918 -- Health aspects; World War, 1914-1918 -- Veterans -- Mental health
But while the contributions of anatomy, physiology and pathology to
the treatment of psychoneuroses have not yet gone beyond theoretical
and mutually conflicting suggestions, the psychological method of
investigation and treatment on the other hand has proved itself of
practical use in restoring patients to a normal state of mental health.
What scientific justification therefore have we, when considering
the action of heredity, for lumping together the organic and the
functional mental disorders? The psychoneurosis is often simply a
progressive state of mal-adaptation to environment; a mental twist
which can be corrected if treated suitably at a sufficiently early
stage. Its specific nature is frequently explicable almost entirely
in terms of the peculiar educational, family or social relations of
the patient’s environment. The war has shown us one indisputable fact,
that a psychoneurosis may be produced in almost anyone if only his
environment be made “difficult” enough for him.[59] It has warned us
that the pessimistic, helpless appeal to heredity, so common in the
case of insanity, must go the same way as its lugubrious homologue
which formerly did duty in the case of tuberculosis. In the causation
of the psychoneuroses, heredity undoubtedly counts, but social and
material environment count infinitely more.
To some readers the above argument may seem so obvious as to be
superfluous. To ascribe a patient’s entangled state of mind to heredity
without attempting to discover how far his own personal experiences
have tended to bring about that mental condition, would seem as
fatuous as attributing to heredity the financial muddles of a son who
has inherited from his unbusinesslike father a badly managed estate.
The trade-adviser called in to help might for a moment consider the
possibility that the son may have inherited his father’s unpractical
character, but surely his first serious efforts would be to discover
where the business methods were wrong or antiquated and to improve
on them. So it is with the mental patient; his own history is the
important desideratum. That of his parents may cast valuable light
upon his trouble, but even then it is often just because their own
difficulties have contributed to the making of his environment.
Public-domain text, read in full here on John Shaqi.
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