Psychiatry at a Time of Crisis

A visit to the occupational therapy department of a military psychiatric hospital during the early part of the war convinced me that, in the methods employed to deal with neurosis, some sort of equilibrium of insincerity had been achieved by patients, doctors and community alike. The nature of this equilibrium was not understood or even observed; I concluded that the only occupation that could be therapeutic was the study by the group of the nature of the affliction from which they individually and collectively suffered.

When I had the opportunity some years later of putting this idea into practice the result was a powerful release of emotion which showed itself chiefly in heightened morale amongst the patients, acts of indiscipline by two warrant officers of the staff – ex officio stable personalities – and minor but persistent obstruction of obscure origin. The experiment was brought to a close by the authorities, and since it has not proved possible to investigate their state of mind I cannot suggest a cause of failure.

Subsequent developments, in particular the Civilian Resettlement Units set up by the War Office, have persuaded me that this experiment had the characteristics of a chain reaction and so had the requisites for growth. But it showed, too, that something in the dynamics of unconscious tendencies in a group made the group peculiarly sensitive to any investigation of its emotional tensions. This sensitiveness manifested itself particularly in the class that Arnold Toynbee calls ‘the dominant minority’ (A Study of History, Vol. 3, p. 77). “The ailing civilization”, he says, “pays the penalty for its failing vitality by being disintegrated into a dominant minority, which rules with increasing oppressiveness but no longer leads, and a proletariat (internal and external) which responds to this challenge by becoming conscious

that it has a soul of its own and by making up its mind to save its soul alive.“ I shall have more to say of the dominant minority l