DR. TOM A. WILLIAMS, Washington, D. C.: My remarks do not apply to the
contents of the delusions, of course, but to the cerebral capacities merely
which were susceptible of the formation of such delusions.
DR. SMITH ELY JELLIFFE, New York: Dr. MacCurdy's paper fascinated me a
great deal. There is so much material that one is in a maze. I am sorry,
moreover, that he had to mutilate his conclusions by being forced by lack of
time to condense them. It strikes me he gives us a very important
contribution to the mechanism of the cure of some psychoses. That mechanism
of cure, may be stated as follows: How can one take the split off libido
which results from the analytic technique and apply it to a better
constructive synthesis? It would seem that these constructive delusions
really correspond to interpretative schemes whereby a certain amount of the
split off libido becomes synthesized. In that sense these delusions are
constructive and are, therefore, helpful to the patient. They represent
partial curative processes.
DR. JOHN T. MACCURDY, New York: I would like to refer briefly, first, to
the point made by Dr. White to the effect that these ideas were interesting
in so far as they were archaic. That is true and it is one of the
profoundest truths we have to offer. At the same time it is of psychological
and not strictly speaking of psychiatric value. The purpose of my paper was
essentially psychiatric, to point out that there is a prognostic value in
such delusion as I have tried to outline. Now one can get archaic delusions
in patients very much deteriorated. The point of this paper is rather to
show, as the discussion brought out, that it is the constructive tendency
operating in the insane as it has historically in the race. The second point
as to the cycle in his attacks, to follow the inference of Dr. White, I
presume he meant to imply that there may have been some organic swing
corresponding to the psychotic swing. That of course is quite possible. At
the same time the analysis of this case showed that purely psychic factors
had a great deal to do with it. His monthly attacks seemed to represent a
break in the balance. He was always in unstable equilibrium and the factor
that seemed to decide the issue finally between relative sanity and a
markedly deteriorated state, was a purely psychological one. When his father
died, when he was released from that bondage, the relief seemed just enough
to decide the issue. So the organic factors here seem to be the general,
underlying inability to adapt himself. One of the hardest situations to
adapt himself to was his relations with his father. If he could not free
himself he was going to be very insane. When that factor was removed he
became relatively insane.
DR. TOM A. WILLIAMS, Washington, D. C., read a paper entitled, "The origin
of Supernatural Explanations."[*]
[*] Published in this number of the Journal, p. 236.
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