The Fundamental Conflict with Psycho-Analysis

Psycho-analysis is nearing its fiftieth birthday. Half a century is but a brief moment in the history of a scientific discipline. It is long enough, however, in this age of ultra-rapid developments to perceive the major trends of a new science which indicate, perhaps, its historical destiny. Other therapeutic endeavours saw light in the course of the same period. A number of procedures, more 'sound' than psycho-analysis, came and went with the utmost dispatch. Pyretic therapy, for instance, malarial inoculations by the followers of Wagner-Jauregg, insulin and metrazol, the dental and abdominal surgery of Cotton, the neuro-surgery of Walter Freeman, all were used for the cure of psychoses and neuroses and all have been discarded or are about to be abandoned as soon as the brief and naïvely spectacular claims prove false at the first contacts with the grim realities of clinical psycho-pathology. The precipitate birth, ephemeral life and sudden death of these procedures are primarily due to the fact that they came into existence not as the results of empirical observations based on analytical scientific thinking, but instead were derived from the perennial obsessional belief that 'there must be something anatomical and physiological at the root of this or that'. This 'there must be', persisting in medicine from the days of Hippocrates until now, is the only constant feature of the ad hoc method in medical psychology. Its external manifestations vary with the traditions of the ages. Hippocratic psychiatry inaugurated or authorized the tradition of 'touristic' and pharmacological psycho-therapy: long voyages and hellebore, a potent laxative, and hypnotics. Mediæval psychiatry followed this tradition and elaborated upon it through the development of dietetics and the Dreckapotheke. The age of physics brought the gadget into psycho-therapy, the twirling chair (Drehstuhl, producing vertigo and unconsciousness), the psychiatric 'noyade' (half or almost complete