174 SECTIONAL ADDRESSES. 



the trenches showed a two-fold dissociation, namely (1) a dissociation of 

 the memory of events immediately following upon the shell explosion 

 from memories of earlier and later parts of the patient's life ; and (2) a 

 dissociation of these memories, as mere intellectual awareness, from the 

 accompanying emotional reaction of fear — tremors, sweating, mutism, 

 paralysis, &c. — which are of a physiological nature. The physical 

 reaction of fear, thus dissociated from its psychical counterpart, had 

 become relatively permanent instead of being transitory. The patient 

 no longer felt the emotion of fear — at least, of just that fear which the shell 

 explosion had aroused — but did show its physical manifestations in the 

 form of hysterical symptoms. By re-arousing the whole of the lost 

 experience in all its emotional vividness I overcame both dissociations. 

 The physical manifestations became linked up with their psychical 

 counterpart, and this in its turn was linked up with earlier and later 

 memories of the patient's life. In this way the mind was completely 

 resynthesised, and the physical symptoms came once more under the 

 sway of the entire mind (the complete personality) and could disappear. 



In addition to ab-reaction, I advocate the thorough thinking out of 

 the whole psychological situation by the patient, so that he may be 

 brought eventually to understand himself adequately. This is the 

 process of autognosis, or self-knowledge. The patient is encouraged to 

 obtain as objective a view of his entire mental condition as is possible. 



C. G. Jung 4 has explained the beneficial effects of ab-reaction in terms 

 of ' transference.' By transference is meant the emotional rapport 

 (conscious and unconscious) which springs up between patient and 

 physician, and which enables the patient to live again, in the course of an 

 analysis, through earlier experiences of his life in relation to the physician, 

 and thus become freed from their harmful effects. The following case 

 illustrates how ab-reaction can bring benefit without the factor of trans- 

 ference coming in. It is a case of a man of considerable education, who 

 had for some years suffered from obsessive fear, the origin of which he 

 could not fathom. He would wake up in the morning with this fear 

 weighing upon his mind. After reading about the method of ab-reaction, 

 as used in treating shell-shock patients, he thought that he would try to 

 cure himself by a similar method. He endeavoured to recall earlier and 

 earlier memories of his past life, using the method of concentration — to 

 all intents and purposes producing a light degree of self-hypnosis. At 

 length he seemed to get this memory : it was half a memory, half a 

 waking vision. He seemed to be in a sort of native compound in India. 

 He experienced intense heat, such heat as he never remembered 

 experiencing in his life before, and seemed to see a black kid lying on 

 the ground with its throat cut and blood pouring out of the wound. He 

 felt intense terror as he went through this experience. This terror grew 

 and grew ' like a bubble.' It got bigger and bigger and at last burst, 

 and all at once the fear began to subside again and eventually disappeared, 

 and he remained free of it afterwards. So far as one could make out — he 

 came and told me of it afterwards ; I had not treated him at the times — 

 he had cured himself of the fear by bringing up this memory. He could 



4 He writes : ' It must, above all, be emphasised that it is not merely the rehearsal 

 of experience that possesses an unconditional curative effect, but the rehearsal of 

 experience in the presence of the physician.'— Brit. Journ. Med. Psych., vol. ii, 1921. 



