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We are met to consider the application of psycho-analytical principles to hospital in-patients. Before we consider the applications it would be well to consider briefly, and have some agreement on, what those principles are.
First, the whole fifty years of psycho-analytical experience shows that one cannot separate research from therapy in this field of work. The technical aim of the therapy is to enable the patient to disclose as fully and as freely as possible the history of his development, including not least that of which he has been unconscious. This disclosure the doctor must meet with sincerity of purpose and dispassionateness, and he must not lose patience in the face of failure. These qualities are among those which are prerequisites in the research worker. The discovery of the causes and the solving of the problems of mental pain are not possible unless the patient experiences relief of that suffering in the course of his treatment; then he will co-operate in the research and in the therapy. This can be briefly summarized by saying ‘No research without therapy; no therapy without research’, i.e., the patient's personal and particular difficulty has to be the subject of a special and personal investigation, personal both to the patient and to the doctor treating him.
The second point is that there is invariably a strong but unconscious defence set up against the resurgence of the past emotionally-toned experiences, and these defence processes operate both in the patient and in the doctor treating him; if the latter has not worked through his own past experience he will unwittingly co-operate with the patient's defences in greater or lesser degree, and this will nullify both the investigating