Forty Years of Psycho-Analytic Psychiatry1

It is a very gratifying honour for me to have been selected to give the Schilder Memorial Lecture, because my acquaintance with and friendship for Dr. Paul Schilder, while not progressing to an intimate personal relationship, had been of long duration. It so happened when I went to Vienna for study in 1921 that Paul Schilder, barely ten years after his graduation from medical school in 1909, was already recognized as one of the outstanding minds in neuropathology, neurology and psychiatry, having published important work in each of these fields. Of these early contributions I will mention only his discovery and description of encephalitis periaxialis diffusa, a syndrome which bears his name, and his book on Consciousness of One's Self and One's Personality, a theme in which his interest continued up to his untimely death in 1940. In Vienna I attended briefly a clinical course he gave at the Allgemeines Krankenhaus.

Dr. Schilder, in addition to his clinical flair for neurology and psychiatry, early appreciated the importance of the Freudian theories, but because of the disapproval of psycho-analysis by his chief, Wagner von Jauregg, could not give them undivided support. Nevertheless, he dared to risk the favour of his chief by becoming a member of the Vienna Psycho-Analytic Society in 1919. When he settled in America in 1929 we immediately renewed our contact, and from then on had frequent discussions over a cup of coffee which he enjoyed after a scientific meeting. These talks often concerned questions of depersonalization and dual personality and the flexible adaptation of psycho-analysis to therapy in lesser and major mental disturbances. On these occasions Schilder's originality of approach, incredible memory, utter frankness and quick, pungent wit showed even more brilliantly than in forums of scientific discussion where he excelled. Vitally interested as he was in psycho-analytic psychiatry, he joined the New York Psychoanalytic Society, but his tendenc