1568

(c) From certain of my remarks you will have gathered that there are many characteristics in the analytic method which prevent it from being an ideal form of therapy. Tuto, cito, jucunde: investigation and probing do not indicate speedy results, and the resistance I have mentioned would prepare you to expect unpleasantness of various kinds. Psycho-analytic treatment certainly makes great demands upon the patient as well as upon the physician. From the patient it requires perfect sincerity - a sacrifice in itself; it absorbs time and is therefore also costly; for the physician it is no less time-absorbing, and the technique which he must study and practise is fairly laborious. I consider it quite justifiable to resort to more convenient methods of treatment as long as there is any prospect of achieving anything by their means. That, after all, is the only point at issue. If the more difficult and lengthy method accomplishes considerably more than the short and easy one, then, in spite of everything, the use of the former is justified. Only consider, Gentlemen, how much more inconvenient and costly is the Finsen therapy of lupus than the method of cauterizing and scraping previously employed; and yet the use of the former signifies a great advance, for it performs a radical cure. Although I do not wish to carry this comparison to extremes, the psycho-analytic method may claim a similar privilege. Actually, I have been able to elaborate and to test my therapeutic method only on severe, indeed on the severest cases; at first my material consisted entirely of patients who had tried everything else without success, and had spent long years in sanatoria. I have scarcely been able to bring together sufficient material to enable me to say how my method works with those slighter, episodic cases which we see recovering under all kinds of influences and even spontaneously. Psycho-analytic therapy was created through and for the treatment of patients permanently unfit for existence, and its triumph has been that it has made a satisfactorily large number of these permanently fit for existence. In the face of such an achievement all the effort expended seems trivial. We cannot conceal from ourselves what, as physicians, we are in the habit of denying to our patients, namely, that a severe neurosis is no less serious for the sufferer than any cachexia or any of the dreaded major diseases.