Читать книгу The Essential Jung: Selected Writings - Anthony Storr - Страница 14

Two facts have impressed themselves on me during my career as a psychiatrist and psychotherapist. One is the enormous change that the average mental hospital has undergone in my lifetime. That whole desperate crowd of utterly degenerate catatonics has practically disappeared, simply because they have been given something to do. The other fact that impressed me is the discovery I made when I began my psychotherapeutic practice: I was amazed at the number of schizophrenics whom we almost never see in psychiatric hospitals. These cases are partially camouflaged as obsessional neuroses, compulsions, phobias, and hysterias, and they are very careful never to go near an asylum. These patients insist upon treatment, and I found myself, Bleuler’s loyal disciple, trying my hand on cases we never would have dreamed of touching if we had had them in the clinic, cases unmistakably schizophrenic even before treatment – I felt hopelessly unscientific in treating them at all – and after the treatment I was told that they could never have been schizophrenic in the first place. There are numbers of latent psychoses – and quite a few that are not so latent – which, under favourable conditions, can be subjected to psychological analysis, sometimes with quite decent results. Even if I am not very hopeful about a patient, I try to give him as much psychology as he can stand, because I have seen plenty of cases where the later attacks were less severe, and the prognosis was better, as a result of increased psychological understanding. At least so it seemed to me. You know how difficult it is to judge these things correctly. In such doubtful matters, where you have to work as a pioneer, you must be able to put some trust in your intuition and to follow your feeling even at the risk of going wrong. To make a correct diagnosis, and to nod your head gravely at a bad prognosis, is the less important aspect of the medical art. It can even cripple your enthusiasm, and in psychotherapy enthusiasm is the secret of success.

The results of occupational therapy in mental hospitals have clearly shown that the status of hopeless cases can be enormously improved. And the much milder cases not in hospitals sometimes show encouraging results under psychotherapeutic treatment. I do not want to appear overoptimistic. Often enough one can do little or nothing at all; or again, one can have unexpected results. For about fourteen years I have been seeing a woman, who is now sixty-four years of age. I never see her more than fifteen times in the course of a year. She is a schizophrenic and has twice spent a number of months in hospital with an acute psychosis. She suffers from numberless voices distributed all over her body. I found one voice which was fairly reasonable and helpful. I tried to cultivate that voice, with the result that for about two years the right side of the body has been free of voices. Only the left side is still under the domination of the unconscious. No further attacks have occurred. Unfortunately, the patient is not intelligent. Her mentality is early medieval, and I was able to establish a fairly good rapport with her only by adapting my terminology to that of the early Middle Ages. There were no hallucinations then; it was all devils and witchcraft.

^*Alfred Binet, Alterations of Personality, tr. Helen Green Baldwin, London: 1896, p. 147.