PSYCHOLOGY AND NEURASTHENIA
[To the Editor of the SPECTATOR.] Sin,—The article of " Crusader " on the " Psychology of Neurasthenia " clearly shows the necessity for raising the study of psychological medicine to the same level as that of public health, and the advantages to be derived by medical men and laymen in joining the National Council for Mental Hygiene so as to ensure a better understanding of the many intricate medical and social problems connected with mental health. So far as the position of psychological medicine is concerned at present, no special medical qualification is required for what is after all the most difficult and most intricate of all medical subjects.
In France medical men are required, before they are pro- moted to serious and responsible positions in psychological medicine, to study for at least four years, pass certain specified examinations and spend that time in actual working among those who are mentally affected,• and it is only a question of time in this country until a Diploma of Psychological Medicine or a Certificate of special qualifications for dealing with mental affections will be required of all medical men who !onVider themselves competent to deal with mental problems. It is through the experiments that " Crusader " cites,.namely, the researches of such men as Ferrier and Horsley that scientific knowledge of psychological medicine will advance. The still more recent, works of Flechsig and Shaw Bolton
are ample evidence of this. .
Neurasthenia is as much a mental disorder as General Paralysis and here I join issue with " Crusader " for I consider the conception of any mental disorder, however mild, not based on some physical change in the nerve cells of the cortex of the brain to be an unscientific conception. It has been put forward only by those who practise psycho-therapy and psycho-analysis. Psycho-therapy and psycho-analysis have, I venture to state, thrown no light on the problems of psycho- logical medicine. Indeed, they have been Will-o'-the-wisps. which have led many medical men from the straight and arduous path which alone leads, and is still leading, to scientific knowledge of the pathology of the mind. Neither the psycho-analysis of Jung nor that of Freud reveals the true causes of neurasthenia and hysteria. On the contrary, there is evidence that their practice has done much harm in confirming the obsessions that often prevail in these con- ditions and in several cases have actually transformed the obsession into possession or delusion.
Early in the War and for several years psycho-therapy and psycho-analysis were considered sure and potent remedies for the cure of neurasthenia and hysteria but the lapse of years has reduced their importance and shown that they are only after all twin children of Aeolus, born of the wind, and swollen with words. It is only by the use of the despised physical means which " Crusader " holds are of no account in these conditions that permanent and useful results have been obtained, and all who wish to contribute to the develop- ment and progress of psychological medicine and the pre- servation of mental health will find ample scope on the lines of a purely physical basis of mental disorder to explore that unknown territory of mind, still amounting to almost three- fourths of the area of the surface or " bark " of the brain referred to by " Crusader."—I am, Sir, &e.,
• EXPLORER.
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