Psychoanalysis and Brain Disease: (Observations of Juvenile Paretic Patients)

The pathological findings in the brain of general paralysis patients can not be explained by psychoanalytic methods and no psychoanalyst would try to do so, but some of the same psychoanalysts might be content with the hypothesis that the psychotic symptoms of general paretics can be explained by the syphilitic process in the central nervous system. The reason why the psychoanalyst might be so easily satisfied with the somatic explanation of the psychotic picture in the organic brain disease is that the psychiatrists are so busily engaged in wrestling with the problem of functional mental disease that they are prone to be grateful for those pathological changes in the anatomy of the central nervous system which offer a seemingly causal explanation for the psychic changes in patients with organic brain disease. Furthermore, the organic cause of an illness can be seen and touched. It is a psychical reality and not psychological “only.” However, even Kraepelin, who attached so much importance to the organic explanation of mental disease, made the statement that the organic findings in general paresis have solved none of the psychological problems involved. This statement has also been made by Jelliffe when correlating the somatic disease process with the attendant mental symptoms and psychiatric sequelae of the 1918 epidemic of encephalitis lethargica.

It is a well known fact that a corn on a toe may change the behavior of the person afflicted. However, it should not be said that the change takes place because the behavior is localized in the toe;