In deference to Freud's methods, I must repeat again, the reader can never fairly appreciate the value of his contributions to the evolution of psychotherapy, particularly his psychology as applied to the better understanding of the psychoneuroses, without a careful study of the methods and theories as presented by Freud himself, nor will he be able to fairly estimate the theories of Freud and other foreign investigators without a careful- study of the writings of Prince, Munsterberg, and Sidis, to say nothing of Putnam, Meyer, Brill, and other well-known American writers, whose names are mentioned in the preface of the present edition of this book. The more thoroughly one studies this subject from the writings of all who have contributed to its development, the better will he be able to judge of the practicability and soundness of the methods which the writer has given to the profession, and which stand unscathed and unreproached by all of these scholarly investigators. In the hewing out of the crude, coherent mass our conception of rational psychotherapy, let us adhere to the line of truth, letting the chips fall where they will.

As to Freud's sexual theories and their relation to the psycho-genetic origin of the psychoneuroses, I am not prepared to indorse them. On the other hand, I am free to say that more and more have I become convinced of the importance of the guidance of the sexual instinct in the earliest years of infancy and childhood, construing the "sexual instinct" in the broad manner indicated in the foregoing chapter on this subject. As unpopular as is the sexual subject in America, I have dared to express my convictions freely, however much the personal sacrifice may prove. The change of a single word in Freud's sexual theories and their relation to hysteria would make them very nearly harmonize with my individual opinions on this subject.

Freud tells that "he who understands the language of hysteria can understand that the neurosis deals only with the repressed sexuality. One should, however, understand the sexual function in its proper sphere as circumscribed by the infantile predisposition. Where a banal emotion has to be added to the causation of the disease, the analysis regularly shows that the sexual components of the traumatic experience, which are never missing, have exercised the pathogenic effect."

I would transpose his statement as follows: He who understands the language of hysteria can understand that the neurosis deals only with a repressed personality. One should, however, understand that sexuality is one of the component elements of every normal human being, and that all the elements going to make up the development of the personality are influenced by hereditary predisposition, and that where a banal emotion has been added to the causation of the disease the analysis regularly shows that the environing influences of early childhood have been the determining factors in contributing to the development of the neurosis, and the sexual component may or may not have entered into the traumatic experience exercising the pathogenic effect.

As long back as 1897 I had frequently removed hysterical symptoms by employing suggestion in the hypnotic state to detect the forgotten painful experience contributing to the development of the symptoms manifested, discussed the incidents which were painful and objectionable to the conscious ego, and again hypnotized my patient for the purpose of removing the hysterical symptoms manifested, with complete and permanent success. By this means I not only brought into the consciousness of the patient memories of painful experiences which were responsible for the feelings of depression - nervousness, insomnia, and other neurotic manifestations - but by the clearer understanding of the gross psychogenetic factors, or "psychic traumas," contributing to the development of the symptoms with which I had to deal, I was better enabled to re-educate my patient, after I had obtained this new insight into his relations to his life's problems, so as to equip him for readaptation to his present and future environment.

In many of these patients the irritating subconscious factor, or series of factors, which was responsible for the repression and retardation of the development of the patient's personality had so interfered with the functions of the physiological machinery as to markedly lessen the mental and physical capacities of the patient, and he was unfit to take up the duties and responsibilities incident to the strain and stress of his occupation until his physiological machinery could re-establish the lessened physical resistance which had resulted as a consequence of the disturbing psychogenetic factor or factors. In such eases, detecting the psychogenetic factors was only the beginning of the treatment by other means. Until the physiological machinery of the patient could be qualified to meet the, duties and responsibilities incident to his struggle for existence, hypnotic suggestion, suggestion without hypnotism, reasoning, persuasion, re-education, exercise, gymnastics, and dietetic and hygienic instruction were all essential to the qualification of the patient for obtaining a sufficiently stable mental and physical condition commensurate with a happy, useful existence.

These patients were taken from every department of life.