Can Child Analysis Prevent Neuroses and Psychoses in Later Life?*

It has been reasonably questioned whether mental hygiene has any larger program for human betterment aside from extending its principles of beneficent care to larger and larger groups of mental patients cared for both privately and by the state. While undoubtedly this policy of mental hygiene has proven a great boon, its first great promise that it hoped to discover the means to perform an even greater service in the prevention of mental disease still remains unfulfilled.

While the present service of mental hygiene naturally leads to this latter aim, still the query is uppermost: Has scientific investigation into the nature and causation of mental disorders led to that degree of mastery of these human ills that internal medicine, for example, has gained over tuberculosis, so that one may state specifically that certain advices and suggestions when followed will decrease or obliterate nervous invalidism? We must frankly admit that it has not, nor is this lack of skill to control the occurrence of mental disease unique in the more precise and exact science of psychiatry itself. The need for definite knowledge of what to do to prevent functional psychoses has become so patent that the question has become hackneyed as to when and what remedies should be applied to avoid them.

It is true we have steadily improved in our facility to detect mental disease in its incipiency from a public to a private recognition of approaching psychoses, but our scientific acumen is still not sufficiently acute as to their earliest apprehension. Even when one is able to detect the Bleuler type of deiristic thinking and the formation of the shut-in character in the adolescent years of a schizophrenic, can such knowledge stay the inevitability of an oncoming psychosis in later life? What, then, can be done or at least be envisaged for the future?