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The aim of all psychotherapeutic treatment is to impel or induce the patient through influencing his mental processes to convert symptoms which may be reflected in mental or physical sickness into a state contemporaneously regarded as healthy. The psychic methods by which this can be accomplished are extremely numerous, diversiform, and are not necessarily limited to verbal communication. Like other procedures in healing, it is offered by the physician and accepted by the patient with the implication and hope that it will relieve him of his suffering. Until the latter part of the nineteenth century there had been little scientific basis for many of the psychological methods which have been therapeutically effective. Generally speaking no systematic or consistent approach had been made up to the time of psychoanalytic investigation of psychic determinism and it is such psychoanalytic discoveries that have made possible the concepts and comments which follow.
The clinical elements entering into all forms of medical psychotherapy, whether it be brief, superficial or penetrating, and whether the condition for which it is applied be mild, severe or chronic, and upon which its efficacy depends are roughly five. They are: (1) who undertakes to perform it; (2) what is said or done; (3) the time when it is undertaken; (4) how (and even where) it is done or said; and finally, (5) the susceptibility of the person upon whom the psychotherapy is practiced. The overlapping of each of these factors and their mutually supportive interaction are obviously highly variable and complex.