Eighth annual report to the committee from the medical director : presented 31st December, 1929 / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1930?]
Catalogue details

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Credit: Eighth annual report to the committee from the medical director : presented 31st December, 1929 / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

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    psychoneuroses. Eighty-one improved or became well during their stay in hospital, but of these, six re¬ lapsed, and nine have not been heard of. One of the six who relapsed returned to the Hospital and had again improved when he died of influenza in February of last year. That is 71 patients out of 94 in the psychoneurotic group are known to have remained well for at least one year after discharge. This may be shown in tabular form : Psychoneuroses. No. Improved in Well or improved Not well a Not heard Hospital a year later. year later. from. («) Anxiety States .. 67 60 54 9 4 m Hysteria .. 25 19 15 5 5 (c) Obsessional Compulsive 2 2 2 —— •— Total .. 94 81 71 14 9 Among these patients who have improved axe two with obsessive compulsive symptoms. We have reported very few cases during the years where there has been improvement in this group, and it is therefore interesting to note that these two are the only example of the condition during the year. One was a girl of 20 with washing mania, of not very long duration, who is now described as reasonable in this respect. The other was a very severe case with many elaborate rituals against defilement, which made life almost impossible. They had been present for three years. Under treatment he improved considerably ; his sister with whom he fives wrote that he was much better, and she regretted that we had not kept him much longer. A few months later she wrote to say that he was well; in this letter she stated that he had been to an osteopath, who had rectified some spinal displacements ; she also said that his father had died and that he had to everyone’s surprise displayed great calmness at the funeral and had been well since. The situation is one which emphasizes the difficulty of locating causes of cure. The sister was inclined to share the honour of the cure between us and the osteopath. She felt that we had done a certain amount of good, but that for lack of know¬ ledge of osteopathy, we could not complete the cure. She did not lay any emphasis on the death of the father, and it was obvious that it had not entered her head that it could have any significance. But the investigation at Swaylands had made it abundantly clear that the patient, a man of 48, was living in great fear of his father, and his death cannot be regarded as of no importance with respect to the disappearance of his symptoms. The fears had been because of certain things which he had done of which he felt his father must disapprove, and the ritualistic acts had been partly expiratory, partly to symbolize a reaction against further defilement. Talking this out had led to considerable improve¬ ment, but the presence of his father, to whom he went back had as we thought, prevented complete recovery. If such a scheme is approximately near the truth, the osteopathy had its effect also. It gave a peg on to which he could hang his cure. It is not as a rule difficult for any patient to acknow¬ ledge that his illness has depended on what he considers to be his misdeeds ; it is more difficult for him to acknowledge even to himself the reason that he regards them as misdeeds is chiefly because he is afraid of his father and all that his father represents. Even if he has seen this, it is often difficult for him to give up the idea that he deserves to suffer ; to acknowledge it, would be to own up that he has been punishing himself in a rather silly way. He may do so without acknowledging it if, only when he has seen everything, he is given some quite fresh treatment from another person. He can 3