What, I think, is clearly established, is that a man's actions and
beliefs may be wholly dominated by a desire of which he is quite
unconscious, and which he indignantly repudiates when it is suggested
to him. Such a desire is generally, in morbid cases, of a sort which
the patient would consider wicked; if he had to admit that he had the
desire, he would loathe himself. Yet it is so strong that it must force
an outlet for itself; hence it becomes necessary to entertain whole
systems of false beliefs in order to hide the nature of what is desired.
The resulting delusions in very many cases disappear if the hysteric or
lunatic can be made to face the facts about himself. The consequence
of this is that the treatment of many forms of insanity has grown more
psychological and less physiological than it used to be. Instead of
looking for a physical defect in the brain, those who treat delusions
look for the repressed desire which has found this contorted mode
of expression. For those who do not wish to plunge into the somewhat
repulsive and often rather wild theories of psychoanalytic pioneers, it
will be worth while to read a little book by Dr. Bernard Hart on "The
Psychology of Insanity."* On this question of the mental as opposed to
the physiological study of the causes of insanity, Dr. Hart says:
* Cambridge, 1912; 2nd edition, 1914. The following
references are to the second edition.
"The psychological conception [of insanity] is based on the view that
mental processes can be directly studied without any reference to the
accompanying changes which are presumed to take place in the brain, and
that insanity may therefore be properly attacked from the standpoint of
psychology"(p. 9).
Public-domain text, read in full here on John Shaqi.
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