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Every psychiatrist is familiar with cases in which pyschoanalysis or psychotherapeutic interviews would be highly desirable but prove to be unattainable in practice. I refer chiefly to certain schizophrenic patients, and those bordering on schizophrenia, as well as some deep depressives, or the extremely uncommunicative types of patients. Those patients of low intelligence who cannot understand, even after trying hard, what the psychiatrist means when he wants them to tell their thoughts freely. Lastly come those who chronically take sedatives, barbituric acid, etc., morphine, or alcohol, who for some reason must be treated as out-patients, and who are quite simply in a stupor during their interviews.
There are constant efforts and experiments to make the patients accessible to psychotherapy. Hypnosis, hypnotics, shock therapy, all serve the purpose of breaking in the patient, and subduing his resistance against the therapeutic approach. The present paper deals with psychoanalyses and psychotherapies in which not sedatives but central stimulants were used in order to win the patient's cooperation and to make him accessible to psychoanalytic treatment or psychotherapeutic interviews in spite of his deep resistance, not by weakening his consciousness but, on the contrary, by increasing his awareness, his self-confidence, and his strength.
In the first case I administered thyroid. When the thyroid unexpectedly rendered the patient excellently accessible to psychotherapy, it gave me the idea that perhaps central stimulants might help to bring about the accessibility of certain cases.
Consequently I began to experiment with average stimulating doses of caffeine, theophyllin, and metrazol, and later with benzedrine sulfate. My experiments seemed very promising in certain cases. Without wishing to form final and decisive judgments on the basis of my small number of experiments, I should like, in the present paper, to give an account of the experiences I have gained so far.