368 



SCIENCE 



[N. S. Vol. XLIX. No. 126 



wards the views of tlie psyclioanalj'tic school. 

 Before the war many psychologists were com- 

 ing to see the importance of Freud's work to 

 their science, but within the medical pro- 

 fession, the general attitude was one of un- 

 compromising hostility. This state of affairs 

 has been wholly altered by the war. The 

 partisans of Freud have been led by esj)eri- 

 enee of the war-neurosis to see that sex is 

 not the sole factor in the production of psy- 

 cho-neurosis, but that conflict arising out of 

 the activity of other instincts, and especially 

 that of self-preservation, takes an active if 

 not the leading role. On the other hand, 

 independent students who, partly through lack 

 of opportunity, had not previously committed 

 themselves to either side, have been forced by 

 the facts to see to how great an extent the 

 nature of the psycho-neuroses of warfare sup- 

 port the views of Freud and have made it 

 their business to sift the grain from the chaff 

 and distinguish between the essential and the 

 accidental in his scheme. To such an extent 

 has the reconciliation gone that it has re- 

 cently been possible for the chief adherent of 

 Freud to read a communication before the 

 leading medical society of London without 

 exciting any trace of acrimony and only such 

 opposition as must be expected when dealing 

 with a subject as new and complex as that 

 under discussion. There are many signs that 

 the end of the war will find psychiatrists and 

 psychologists ready to consider dispassionately 

 the value of Freud's scheme as a basis for 

 the study of the psychoses as well as of the 

 psycho-neuroses of civil life, ready to accept 

 the good and reject the false without the igno- 

 rant prejudice and bitter rancor which char- 

 acterized every discussion of the subject be- 

 fore the war. 



Concurrently with the general recognition 

 of the essentially psychical of neurosis, there 

 has taken place a great development on the 

 therapeutical side. As a result of the war 

 psycho-therapy has taken its place among the 

 resources of the physician. There is still far 

 from general agreement concerning the value 

 of different forms of psycho-therapeutic treat- 

 ment, but work is steadily going on in test- 



ing the value of different methods. In the 

 early stages of the war extensive use was made 

 of hypnotism and hypnoidal suggestion, and 

 owing to the striking character of its imme- 

 diate results this mode of treatment still has 

 a considerable vogue. The general trend of 

 opinion, however, has been against its employ- 

 ment as tending to undermine the strength 

 of character which is needed to enable the 

 victim of neurosis to combat the forces which 

 have temporarily overcome him. Many of 

 those who used hypnotism largely in the early 

 days of the war have given it up in favor 

 of other less rapid and dramatic but more 

 efScacious modes of treatment. 



The treatment which has had most success 

 consists of a form of mental analysis which 

 resembles to some extent the psycho-analysis 

 of Freud, but diifers from it in making little 

 attempt to go deeply into the unconscious, 

 except in so far as any dissociation present 

 has been the result of recent shocks of war- 

 fare. Attention is paid especially to those 

 parts of experience which without any special 

 resistance become accessible to the memory 

 of the patient, and to seek by means of the 

 Icaowledge so acquired to demonstrate to the 

 patient the essentially psychical nature of his 

 malady. By a process of reeducation he is 

 then led to adjust himself to the conditions 

 created by his illness. 



The knowledge already gained, and still 

 more that which will become accessible when 

 those at present fully occupied with the needs 

 of the moment have leisure to record their 

 experience, will be of the utmost importance 

 to the future of psychiatry. Already before 

 the war a movement was on foot to bring 

 about reforms in the treatment of mental dis- 

 order, the measures especially favored being 

 the establishment of psychiatric clinics and 

 the removal of curable and slight examples 

 of psychosis from association with more 

 chronic cases. This movement will be greatly 

 assisted by the knowledge and experience 

 gained during the war. Those in the medical 

 profession who are moving towards reform 

 will gain a large body of support from many 

 members of the laity who have come through 



