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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    necessary in a great number of cases, in order to be able to apply psychotherapy with success. Reasons of an extremely varied nature, which sometimes are com- pletely foreign to the patient considered by himself, may make it necessary. Here, for example, is a subject who has a very bad family environ- ment, and who has often found the cause of his neurasthenia in this environment itself. There, on the other hand, is a family who treats a neurasthenic like a make-believe invalid, and who consequently ex- aggerates the sufferings of a poor wretch, who often wants to do things, but really cannot, or else, on the other hand,—and this is more apt to be the case,—it is a family who by its too fussy care and perpetual anxiety encourages the patient in his depressing ideas and in his unhealthy point of view. Thus, we see that the psychotherapeutist has many reasons which point out very definitely the need of isolation from one's environment. Let us take the mother of a family who although neurasthenic still keeps up her pride in the appearance of her home. Just as long as she lives there she cannot help but play the part of wife, and attend to her duties as mistress of her home. The education and the health of her children are continually on her mind. What really serious psychotherapeutic action could one practise upon her under these con- ditions? It is very evident that there will always be a continual tendency for her thoughts to turn toward her home and her loved ones. Here isolation and separation from her environment are absolutely in- dicated. It would not be the gravity of the patient's condition that would be the principal reason for her isolation. Let us suppose, on the other hand, that a subject who has been neurasthenic for some years, and more or less phobic, and afflicted with numerous functional manifestations, has always lived in one spot. Can- not one understand that under these conditions his sickness, as it were, hangs on the very walls which surround him ? Each piece of furniture and every little object under his hand has been, as a matter of fact, associated with some distressing moment of his life. It is perfectly clear that, by the common mechanism of the association of ideas, his surroundings will continually recall to the patient his sickness and all his symptoms. Go, under these conditions, and tell him to forget, for that is the last word of psychotherapy concerning functional manifesta- tions, as we shall see later on. Here, again, you will see that isolation, which means isolation from his environment, is obligatory. Take an individual who has become neurasthenic because he has lost one of his family, a wife or a child. Cannot one see that, if he remains in the same environment in which he experienced these sorrows, the emotional cause will have every chance of prolonging its disintegrating action in a way that will be almost indefinite? Until he has completely