PSYCHOLOGY.*
Ways we view the wreckage of the Great War, it is a pleasing diversion to seek amidst the ruin evidence of human progress.
The search is indeed an arduous one, for on the material side there has been little but loss, while on the spiritual side there would seem to be increasing darkness, but we may hope that it is the darkness preceding the dawn. Too long, perhaps, has man concentrated his energies on the material side of life, and medicine had not escaped the influence of such an outlook. As Dr. Rivers says, Army medical officers were prepared to combat bodily disease, to reduce to a minimum the dread effects of the weapons of war, but they were almost wholly unprepared to deal with the effects of a great modern war on the minds of the soldier. Even for these a physical explanation was first sought, as indicated by the term " shell-shock," which continued to be used even when experience had shown that the majority of cases of mental disorder could not be connected with physical injuries to the brain. It is true that similar mental conditions met with in civil life had in the years immediately preceding the outbreak of the war been carefully studied psychologically by Freud and Jung and their followers, but the number of these was small, and they had been able to make but a slight impression on medical opinion owing partly to the ignorance and prejudice of the profession, but mainly because of Freud's insistence on the psycho-sexual basis of the conditions met with in these cases. The war provided an almost limitless field of investiga- tion, and medical men, mostly quite unprepared by a previous training in which the study of psychology played no part, had perforce to reconsider their position and in their extremity to study afresh the despised work of Freud and his co-workers. Without accepting his views in their entirety, these fresh workers found that Freud's theories provided a sound working basis for their treatment of many nervous conditions, and that by such treatment they were frequently able to obtain results which seemed little less than marvellous. To the domain of psycho- therapeutics the war has certainly brought benefits, but at what a cost of human suffering !
For the moment there seems great danger of the pendulum swinging too far in the opposite direction, impelled thither by the extraordinary success that has been obtained in certain cases. Whereas but a few years ago a material explanation was sought for all our ailments, there is now a tendency to seek a psychical origin of many of our ills. No longer are we to cure dyspepsia by diet and drugs, no longer shall we seek a toxic cause for the sickness of the expectant mother ; these, we are told, have their origin in a disturbance of the psyche, and can be cured by suggestion or other psycho-therapeutic measure. There may be much truth in all this. The training of the older practitioners hardly qualifies them to express an opinion, but we shall be well advised to hurry slowly and not to take the plunge until we more fully understand the forces, with which we propose to deal. If disturbances of the mind, and by these we do not mean insanity, can produce such manifold and strange physical disturbances, it behoves us to be very careful how we attempt to interfere with such potent energy, and the public should at least be able to satisfy itself that the practice of psycho-therapeutics is in the hands of practitioners with an up-to-date knowledge of their subject. Perusal of the two books under review should convince the reader of the extraordinary complexity of the subject and the necessity of the warning we have given.
The first thing that strikes the reader of these books is the important part the subconscious plays in our mental life. To
* (1) Psychology and Psychotherapy. By William Brown, M.A.; M.D. (Oxon), DSo. (Loud.). London : Edward Arnold. Re. net.]---(2) end the Unconscious. By W. H. B. Rivers, M.D., D.Sc., LL.D.. Cambridge : at the University Press. 11th. not.]-
the subconscious are relegated all memories which by the painful thoughts they give rise to or in other ways would interfere with our normal activities. Such memories may be wittingly or unwittingly suppressed. In either case they pass out of and are lost to consciousness. But although out of consciousness they may still exert an influence on our mental processes and in certain cases a very harmful one. To cure these harmful results it is necessary to bring the discarded memory back into consciousness. At first sight this may not seem a very useful proceeding, seeing that at one time in the individual's life it seemed advisable to repress it, but the mind is unable to deal with an unconscious influence, whereas it can deal with a conscious one which, moreover, no longer causes such painful emotions as it did originally. Whether this be the true explanation, it is by this process of bringing the memories from the subconscious to the conscious that so many of these cases are permanently cured. The work is a lengthy one, requiring much patienoe and no little intelligence. How it is carried out by suggestion, hypnosis and psycho-analysis, including the study of dreams, is clearly and succinctly set out in Dr. Brown's book,' wherein is also found a very readable exposition of Freud's views. The book is one that can be recom- mended to all students of the subject. Many such students, possibly the majority, will be found outside the ranks of the medical profession, and to them a word of warning is necessary. Unacquainted with what had already been achieved for cases of nervous disorder before the present era of psycho-analysis, they will be prone to exaggerate the value of psycho-therapy. Such exaggeration will almost inevitably result in a reaction which may sweep aside or relegate to oblivion the work of the patient investigator. Feetina lente /
Dr. Rivers states in his introduction x that his purpose in writing is " to bring functional disorders of the mind and nervous system into relation with the concepts concerning their normal mode of working which are held by the biologist and physiologist." He writes clearly, being always most careful to explain the sense in which he uses any special term, a most necessary precaution in dealing with a little studied subject. What is meant, for instance, by " the unconscious " as applied to experience is stated to be such experience as is not capable of being brought into the field of consciousness by any of the ordinary processes of memory or association. This is illustrated by the remarkable case of claustrophobia, or fear of confined spaces, in an army doctor originating from a terrifying experience in childhood, an experience which could only be recalled to consciousness by psycho-analysis and the study of dreams. For thirty years the memory had been suppressed, but although inaccessible to consciousness it had remained in the subconscious, and until again brought into consciousness adversely affected the individual's life.
But the interest of the book lies in its insistence on the necessity of suppression for the building up of the mind as we know it. Even our ordinary sensations are the product of suppression and synthesis, and in the dovelopment of instinct, which is not confined to the lower animals, suppression plays an important part. The life of such animals as at one time lead an aquatic, existence, at another dwell on land, would, as the author suggests, be full of difficulties were it not for the power of suppressing unsuitable experiences or instincts.
The manner of approaching the subject will be novel to most readers, but the book is an important contribution to the study of a difficult subject.
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