The Psychotherapeutic Approach to Medicine1

This is an attempt to a new approach to the problem of psychotherapy from the point of view of general medicine. When some patients come in to the practitioner, they show so-called organic signs. Some do not; but still, they complain vividly. These complaints are complaints which concern the body as well as the psychic activities; as for instance, mood and thinking. One is astonished to see that the complaints are not so different, whether so-called organic symptoms are present or not. The suspicion may arise that in the so-called functional case there may be some organic change which we cannot find with our methods, or that the so-called organic case is perhaps not so independent of psychological processes as it may seem in the beginning. At any rate, we are not entitled to say that the organic case should not be treated from a psychological point of view. As a human being, he has his psychological problems, and if there is an organic manifestation, his psychological problems will necessarily find a possibility of the utilization of the organic symptom. The organic symptom removes every individual from work, takes away from him the possibility of the sublimation of his aggressiveness, but a sick person has also the right to expect more consideration and love. He has become worthier. His disease has relieved him also from feelings of guilt, since he is punished anyhow. Organic disease serves, at any rate, a variety of psychological functions. The sick individual cannot help remaining an individual, and according to his psychological structure, the psychological functions of the organic disease will vary. An organic disease may become the source of neurotic behavior, and the psychological function of the organic disease may influence the organic process. The psychotherapeutic approach in medicine should