The modern psychiatrist has
many strings to his bow for treating both mild and severe mental illness. The
oldest is hydrotherapy (water treatment, of which bathing in warm springs and
the "ducking stool" are ancient examples) The latest are the new
drugs, the ataraxics. introduced in the 1950's. The most disputed is
psychoanalysis, which took root in the 1900's.
The type of treatment
selected, or attempted, depends on specific diagnosis, length and severity of
the illness, and the personality structure of the particular patient
Central to all types of
treatment is psycho therapy, which
essentially means purposeful conversation between the patient and his
therapist. This includes directive and non-directive counseling, reassurance,
group therapy, hypnosis, confession, orthodox Freudian psychoanalysis, and
theoretical or practical ("short-cut") modifications of it.
Most of the short-range
methods of psychotherapy are called suppressive;
they attempt to drive conflicts so deep into the unconscious mind that
they are no longer troublesome. Many so-called "miracles" and faith
cures are suppressive psychotherapy. They are usually most effective in caset
of conversion hysteria. For example, in hysterical paralysis, a lame patient
may visit a famous shrine or get a great shock, throw away his crutches, and
walk again.
The power of
suggestion can also be a powerful force in legitimate mental healing. (It is
often employed by quacks too.) Suggestion is sometimes so effectively used in
treatment (e.g. of hysterical paralyses) that the results seem
"miraculous."
Expressive psychotherapy is something else again. Here the patient is encouraged to
talk about himself, his problems, his thoughts, feelings, dreams, and inner
conflicts to the extent that he is or becomes aware of them. The goal here is
re-education of the patient, particularly to help him find a changed perspective toward
himself and other people.
Psychoanalysis
Psychoanalysis
is the
prototype of all forms of expressive psychotherapy, but it is only one of many
kinds of psychotherapy. Pioneered in theory and practice by Freud, it
established the vital importance of the unconscious mind and its anxious conflicts. It remains
the basis of all psychodynamic psychology despite modifications by Adler, Jung,
Rank, Horney, Sullivan, and many others.
,
In directive counseling, which attacks primarily the patient's
conscious worries about his immediate real-life situations, the counselor does
most of the talking. He often tells the patient directly what he thinks the patient
ought to do. In non-directive
counseling, at the same conscious level, the patient is left much more
to his own devices to determine what steps he must take to shed his apparent
difficulties.
In group therapy, under a skilled discussion leader, patients are
encouraged to talk about themselves and share experiences in such a way that
they get better insight into their problems and recognize, at the very least,
that they are not alone in facing and striving to meet particular human
troubles.
Hypnosis
has some
limited uses in treating neuroses but only in the hands of a well-qualified
practitioner. Hypnotism can be dangerous when practiced by parlor amateurs or
unscrupulous quacks. Approximately three out of four people can be hypnotized
to some extent, but only one in five deeply. Women succumb to it more readily
than men.
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