ABSTRACT
Considerable interest was aroused before the war, by the methods of Professor Dubois of Berne 1 in his treatment of neurotics. A clear-minded, upright and persuasive individual, he tried to treat these patients by exhorting them to more sensible and rational behaviour. Owing to his own personality he achieved considerable success, but his methods have not obtained similar results in other hands, which shows that a good deal of this therapeutic method depended on suggestion. Déjérine 2 adopted a similar method, but recognized the importance of emotion in the genesis of the neuroses, and tried to work out a method of combining the persuasive rational treatment of Dubois with the investigation and explanation of emotional reaction which Janet 3 practised, but the result was rather confusing and has not led us very much further. These methods are applicable in cases in which the maladjustment to life is a perfectly conscious one or when, if the patient is not conscious of what is wrong, he is perfectly capable of grasping it, directly it is pointed out to him. It is specially applicable to certain mild cases of hysteria, those referred to in Chapter VIII, which depend on a definite suggestion either from the organic illness of the patient himself or from some obvious external agencies such as have been described. Two errors seem to exist in respect of this “persuasive” treatment. In the first place, those who practise and pin their faith to it are apt to expect that all cases of neurosis should yield to it, and think that if they do not, the patients must either be perverse and unwilling to get well, or else of weak intellect, so that they cannot grasp the explanations which are given them. This is of course quite unjust to the patient, who is suffering from more severe forms of neurosis. For example, if a patient is suffering from severe anxiety, it is no use to ask him why he has this unpleasant symptom or to exhort him not to have it. He has not the least idea as to why he has anxiety, what it means or has relation to, and since it is there and he would give everything he has not to have it, it is not of much use to exhort him not to suffer from it. Again, if a patient has a phobia for a dark room, we may exhort him by telling him to pluck up his courage and assure him that there is nothing to be afraid of in the dark room, and we may even persuade him to enter it, but he will not do it naturally and easily, until it is discovered by some analytic method what he is really frightened of, for the dark room is only a symbol of the real trouble.
