The neuroses were the first subject of analysis and for a long time they
were the only one. No analyst could doubt that medical practice was
wrong in separating those disorders from the psychoses and in attaching
them to the organic nervous diseases. The theory of the neuroses belongs
to psychiatry and is indispensable as an introduction to it. It would
seem, however, that the analytical study of the psychoses is
impracticable owing to its lack of therapeutic results. Mental patients
are, as a rule, without the capacity for forming a positive
transference, so that the principal instrument of analytic technique is
inapplicable to them. There are, nevertheless, a number of methods of
approach to be found. Transference is often not so completely absent but
that it can be used to a certain extent; and analysis has achieved
undoubted successes with cyclical depressions, light paranoic
modifications and partial schizophrenias. It has at least been a benefit
to science that in many cases the diagnosis can oscillate for quite a
long time between assuming the presence of a psychoneurosis or of a
dementia præcox; for therapeutic attempts initiated in such cases have
resulted in valuable discoveries before they have had to be broken off.
But the chief consideration in this connection is that so many things
that, in the neuroses, have to be laboriously fetched up from the
depths, are found in the psychoses upon the surface, visible to every
eye. So that the best subjects for the demonstration of many of the
assertions of analysis are provided by the psychiatric clinic. It was
thus bound to happen before long that analysis would find its way to the
objects of psychiatric observation. At a very early date (1896) I was
able to establish, in a case of paranoid dementia, the presence of the
same ætiological factors and the same emotional complexes as in the
neuroses. Jung explained some most puzzling stereotypes in dements by
bringing them into relation with the patients’ life histories; Bleuler
demonstrated the existence in various psychoses of mechanisms like those
which analysis had discovered in neurotics. Since then analysts have
never relaxed their efforts to come to an understanding of the
psychoses. Especially since it has been possible to work with the
concept of narcissism, they have managed, now in this place and now in
that, to get a glimpse beyond the wall. Most of all, no doubt, was
achieved by Abraham in his elucidation of melancholia. It is true that
in this sphere all our knowledge is not yet converted into therapeutic
power; but the mere theoretical gain is not to be despised, and we may
be content to wait for its practical application. In the long run even
the psychiatrists have been unable to resist the convincing force of
their own clinical material. At the present time German psychiatry is
undergoing a kind of “peaceful penetration” by analytic views. While
they continually declare that they will never be psychoanalysts, that
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