Psyche in Nature or the Limits of Psychogenesis1

To-day I am dealing with a current, I may say a burning subject; one that at present is carrying psycho-analysis with it rather like a stream of lava. I propose to speak, first, of the great extension which psychosomatic medicine has undergone.

In the nineteenth century medicine was dominated by emphasis on the organism. The body, and the body alone, seemed to overshadow everything, and the soul, if we may use the word, was considered as merely its subordinate emanation. Yet eventually it had to be admitted that this strictly mechanistic approach was inadequate to take account of many disorders, particularly those that are called nervous. And while the school of Charcot paused at that stage, psychological reactions, such as those expounded by Janet, soon came to the fore.

But the great revolution, which alone was to give mental origins their due place in the genesis of psychoneuroses, was eventually brought about by our common master: Freud.

Psycho-analysis, then, came to birth at the bedside of the neurotic: it was at first a clinical method, and only later gave its name to the body of knowledge, the teaching, which derived from this form of practice. In so far as it is a therapy, it belongs to the art of healing. And medicine, which for so long ignored it, and then derided it, went on—when it had come to acknowledge it wholly or in part—to claim it for itself.

Yet, psycho-analysis is a psychological method; it uses no medicaments or physical means whatever. The psycho-analyst, if his patient becomes physically ill, must call in another physician even if he is himself medically qualified; for analysis does not lend itself to any mingling of mental and physical therapy.

Many apparently organic disorders, however, prove curable by this psychological method, and indeed just where physical means have failed. We need recall only all those symptoms of 'hysterical' origin, although in appearance organic—digestive, intestinal, cardiac, ocular, dermatological, not to m