The psychoneuroses and their treatment by psychotherapy / by Professor J. Dejerine and Dr. E. Gauckler, authorized translation by Smith Ely Jelliffe.

  • Dejerine, J. (Jules), 1849-1917.
Date:
[1913], [©1913]
Catalogue details

Licence: Public Domain Mark

Credit: The psychoneuroses and their treatment by psychotherapy / by Professor J. Dejerine and Dr. E. Gauckler, authorized translation by Smith Ely Jelliffe. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    chondriac is the only one who has imaginary manifestations which are the pure fabrications of his mind, although sometimes due to medical questioning. The symptoms of a neurasthenic are legitimate sufferings, quite as legitimate as if they were due to some affected organ; only,- instead of having had a peripherical origin, they have had a central starting-point,—that is, a psychic starting-point. It is quite under- stood that the neurasthenic is apt to exaggerate his sufferings, and one must always remember this fact, which is true even for patients who are organically afflicted, that the pain which is a purely subjective phenomenon is felt in proportion to the attention that is brought to bear upon it. But to tell a neurasthenic that what he feels is merely an idea shows a very poor comprehension of the exact mechanisms of the troubles from which he is suffering. It is, therefore, very wise to make the patient grasp the fact that psychic phenomena and organic phenomena are by no means independent of one another, but that their reciprocal action is felt in a double sense, either by an organic trouble created by a psychic impression, or else, which is true in this particular case, that a previous psychic impression may disturb an organic function. The functional disturbance of psychic origin thus realized is itself sus- ceptible of having a psychic expression, and of strengthening the pathological convictions for the patient, which in their turn become factors of a still more marked disturbance. Thus is formed the vicious circle into which psychotherapy must penetrate. The patient, from the moment that he finds that you are not going to treat him like an invalid who is making believe, is quite disposed to admit the very reassuring mechanism which you explain to him. It will be proper thenceforward to show him just what is the exact and precise origin of his auto- or hetero-suggestions, and what is the influence which emotional causes exert upon him. It will be necessary to demonstrate to him the role played by all associations of ideas, and memories which bound by ties of succession or causality to the pathological idea are apt to recall it and with it all the disturbances which depend upon it. In this way you will be able to explain to him the apparent regularity of certain manifesta- tions which always spring up at a given moment, because following the ordinary psychological mechanism, which one can easily understand, it is at the very moment that the psychism of the patient finds itself directed toward the manifestation which it presents. The role of association of ideas and the awakening of the patho- logical idea through memory has always seemed to us of very great importance. It is in this way we feel that a great number of functional manifestations are prolonged and complicated and exaggerated. It is also by reason of not taking this fact into account that so many thera- peutic procedures based on the re-education of a will, which moreover is often by no means deficient, only leads to very uncertain results. The essential thing for a neurasthenic is, first of all, not to struggle, but