Page:The Modern Treatment of Mental and Nervous Disorders.djvu/24

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wrong with the patient, technical psychological knowledge is necessary, a knowledge of the mechanisms of the mind, and of the ways in which its various elements may express themselves on its surface. We must be able to judge, from the surface picture, which is all that the patient can give, what causes are at work underneath, and how they have acted to produce the picture before us, just as the physician estimates, from the signs he can examine on the surface of the chest, what the condition of the lung is underneath. Moreover, when the first stage has been achieved, and the erring elements have been discovered, they have to be rearranged and fitted into place, and here again technical knowledge is required. Nevertheless, in spite of all these difficulties, much can be done, and there is every reason to hope that with the added knowledge that should result from organised investigation and research much more will be able to be done in the future.

What is meant by the process of rearranging and fitting into place may be illustrated with reference to the example of the "shell-shock" soldier described above. The patient must be made to understand what is going on in his mind, and to see how the civil war waged therein is sapping his energies and producing the symptoms from which he suffers so greatly. He must be taught that the memories he fears gain their injurious effects because they are dislocated and out of perspective, that they are constituents of his mind which he cannot abolish but only impotently struggle against, and that once they are properly fitted into the structure of the mind