1564

In the first place, let me remind you that psychotherapy is in no way a modern method of treatment. On the contrary, it is the most ancient form of therapy in medicine. In Löwenfeld’s instructive Lehrbuch der gesamten Psychotherapie many of the methods of primitive and ancient medical science are described. The majority of them must be classed under the head of psychotherapy; in order to effect a cure a condition of ‘expectation coloured by faith’ was induced in sick persons - a condition which answers a similar purpose for us to-day. Even since physicians have come upon other remedies, psychotherapeutic endeavours of one kind or another have never completely disappeared from medicine.

Secondly, let me draw your attention to the fact that we physicians cannot discard psychotherapy, if only because another person intimately concerned in the process of recovery - the patient - has no intention of discarding it. You will know of the increase in knowledge on this subject that we owe to the Nancy school, to Liébeault and Bernheim. A factor dependent on the psychical disposition of the patient contributes, without any intention on our part, to the effect of every therapeutic process initiated by a physician; most frequently it is favourable to recovery, but often it acts as an inhibition. We have learned to use the word ‘suggestion’ for this phenomenon, and Möbius has taught us that the unreliability which we deplore in so many of our therapeutic measures may be traced back to the disturbing influence of this very powerful factor. All physicians, therefore, yourselves included, are continually practising psychotherapy, even when you have no intention of doing so and are not aware of it; it is a disadvantage, however, to leave the mental factor in your treatment so completely in the patient’s hands. Thus it is impossible to keep a check on it, to administer it in doses or to intensify it. Is it not then a justifiable endeavour on the part of a physician to seek to obtain command of this factor, to use it with a purpose, and to direct and strengthen it? This and nothing else is what scientific psychotherapy proposes.