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Updated: June 25, 2025
As it is entirely impossible to determine all those factors by any sufficient inquiry, most of the adjustment of method must be left to the instinct of the physician, in which wide experience, solid knowledge, tact, and sympathy ought to be blended. Even the way in which the patient reacts on the method will often guide the instinct of the well-trained psychotherapist.
From a long experience I have to confess that I have seen that this unsentimental remedy is the safest and most important prescription in the prescription book of the psychotherapist. There is one more feature of general treatment which seems almost a matter of course, and yet which is perhaps the most difficult to apply because it cannot simply be prescribed: the sympathy of the psychotherapist.
In the same way it is indirectly most important to stir up, for instance, the sensations and feelings of appetite and thus to make normal nutrition possible. Also in cases of anæmia or tuberculosis, such indirect assistance can produce some beneficial consequences. The same holds true of the power of the psychotherapist to secure sleep.
And finally it may be said that we abstain from everything which is exceptional or even unusual, and confine ourselves to the routine observations with which the psychotherapist comes in contact every day and the simplest country physician surely every week. Thus I turn from systematic objectivity to my unsystematic reminiscences of many years.
We recognized that mental disturbances were often the result of suppressed emotion and repressed wishes. For the cure the psychotherapist has to aim toward the cathartic result. The suppressed ideas had to be brought to consciousness again and then to be discharged through vivid expression.
A well-conducted psychotherapeutic treatment as a scientific physician ought to carry it out, is entirely different in meaning and appearance, from the first step of diagnosis to the last treatment of after-effects, from every unscientific faith cure. It is also in no way necessary that the psychotherapist ever leave the path of complete sincerity.
The psychotherapist wants to produce effects inasmuch as he wants to cure disease. He is therefore obliged to adjust his work as such entirely to the causal aspect of man, as soon as he wants to seek the means by which he can reach the end.
Another and for the psychotherapist much more important group is that in which the impairment results from toxic influences. Alcohol, morphine, cocaine, tobacco, and many other drugs may have been misused and may have produced a most marked alteration in the mind-brain system.
The psychotherapist must always somehow set levers of the mind in motion and work through them towards the removal of the sufferer's ailment; but the disturbances to be treated may show the greatest possible variety and may belong to mind or body. Treatment of diseases by influence on the mind is as old as human history, but it has attained at various times very different degrees of importance.
But no psychotherapist can doubt that the havoc which secret sexual thoughts may bring to the neural life, especially of the unbalanced, is tremendous.
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