ABSTRACT
TWO main phases in the history of the Psychology of Medicine have been dealt with in the preceding pages. The first phase culminated in the work of Pierre Janet and gave us the theory of dissociation which proved so illuminating in our earlier studies of the psychoneuroses; the second phase began when Sigmund Freud formulated the theory of repression. The theory of dissociation helped us to understand what happens to the mind when a neurosis develops; the theory of repression taught us how it happens and why it happens. Study of the neuroses in pre-analytic days showed us that the symptoms were due to a splitting of the mind and to the uncontrolled functioning of the split-off portion; but we found no satisfactory explanation of the occurrence of such a disaster and, consequently, we could not learn how to prevent it. Predisposition to neurosis was ascribed to some hereditary weakness or instability of the mind, some innate defect of mental synthesis, which led to inappropriate reactions when any unusual stress was encountered. The psycho-analytic investigation of the neuroses disclosed the important fact that those events in later life which appear to cause neurotic illness have no such power unless they are associated 162in the patient’s mind with previous experiences of a similar kind which have been repressed. By tracing back the origin of the disorder to events or phantasies of childhood and finding there its explanation, psycho-analysis took away much of the importance previously ascribed to hereditary defect as a causal factor in the production of the neuroses, and freed us, to some extent, in regard to them, from the helpless feeling with which we approach the “prevention” of any disease having such a foundation. Nevertheless, in the ultimate analysis, we must recognize some innate constitutional peculiarity, of a general rather than of a specific kind, predisposing to that type of reaction which characterizes the neurotic.
