On the other hand, the cases reported by Freud were patients whose lot in life had been without the physical strain and stress of the individuals constituting 95 percent of our American citizenship. His patients, according to his reports, knew nothing of physical hardships. They were reared more like "hot house flowers," as his reports clearly show and as he positively assures us, though he uses other words to express it. Moreover, the expense of treatment by methods requiring as long a time as is required by Freud to accomplish results according to his "favorite method" would bar fully 95 percent of the average American psychoneurotics, since we are informed by one of his pupils that Freud devotes an hour each day for from one to three years to effect a cure in some of his cases. Even those effected by him in much shorter time are at a considerable expense to the patient on account of the relatively long time required.

Freud tells us:1 "The process is toilsome and wearisome for the physician; it presumes a profound interest for psychological incidents as well as personal sympathy for the patient. I could not conceive myself entering deeply into the psychic mechanism of a hysteria in a person who appeared to me common and disagreeable, and who would not, on closer acquaintanceship, be able to awaken in me human sympathy; whereas I can well treat a tabetic or a rheumatic patient regardless of such personal liking. Not less are the requisites on the patient's side. The process is especially inapplicable below a certain niveau of intelligence. It is rendered extremely difficult wherever there is the least tinge of weakmindedness. It requires the full consent and attention of the patients - but, above all, their confidence, for the analysis regularly leads to the inmost and most sacredly guarded psychic processes. A large proportion of the patients suitable for such treatment withdraw from the physician as soon as they become cognizant whither his investigations tend; to them the physician remains a stranger.

In others, who have determined to give themselves up to the physician and bestow their confidence upon him - something usually voluntarily given, but never demanded - in all those, I say, it is hardly avoidable that the personal relation to the physician should not become unduly prominent, at least for some time. Indeed, it seems as if such influence exerted by the physician is a condition under which alone a solution of the problem is made possible. I do not believe that it makes any essential difference in this connection whether we make use of hypnosis, or have to avoid or substitute it. Yet fairness demands that we emphasize the fact that, although these inconveniences are inseparable from our method, they nevertheless can not be charged to it. It is much more evident that they are formed in the preliminary neurosis to be cured, and that they attach themselves to every medical activity which intensively concerns itself with the patient, and produce in him a psychic change. I can see no harm or danger in the application of hypnosis even in those cases where it was used excessively.

The causes for the harm produced lay elsewhere and deeper."

1 Hysteria and Other Psychoneuroses. - Translation by Brill, page 84.

So, according to the statements of the originator of psychoanalysis, by the method employed and taught by him, the agent stands condemned, so far as its value to the greater majority of psychoneurotics is concerned.

In reading the latter half of the above quotation from Freud, I could hardly believe the evidence of my own senses, since I had learned from some of his pupils that he regarded the employment of hypnosis as an unjustifiable personal relation between the physician and patient, and, so far as my limited knowledge of the opinions of Freud will warrant, I have found no statement from him to contradict his expressed opinion that he "can see no danger in the application of hypnosis even where it was used excessively."

In the name of common honesty, why do some recent writers make such statements as to convey the idea that the relation between a physician and his patient where psychoanalysis is employed is so essentially different from that where hypnotic suggestion, or any other medical or surgical agency, is employed?

The jealousy exhibited by some neurologists, going so far as to maliciously falsify, in their zeal to limit psychotherapeutic expedients to the small handful of Freud's personal pupils, who are purported to be the only individuals qualified to employ psychoanalysis, is, to say the least, unworthy of scientific men. If they mean to follow their leader, let them learn the a b c of his honesty of purpose and strive to emulate his example.

The reader is now prepared, if he has followed me comprehensively, to understand my reasons for not being so enthusiastic over the employment of psychoanalysis, as an exclusive psychotherapeutic agent, in the treatment of the psychoneuroses, as the Freudians, who would have us believe that this method of treatment is the only psychotherapeutic agency worthy of employment by the "well-trained neurologist."

My relation to the medical profession, in regard to psychotherapeutic methods, is such that I am obliged to stand alone. My efforts have been to help the general practitioner to procure for himself, from the great mass of psychotherapeutic knowledge, the useful and practical, as applied in the treatment of all classes of patients, coming under the domain of the general practice of medicine. All psychotherapeutic methods look alike to me, and I can not afford to give undue prominence to any one procedure until its proven utility warrants its high commendation. The fact remains, however, that the medical profession is indebted to Freud for a most important contribution to the evolution of psychotherapy, particularly his psychology of the psychoneuroses, however much his method of therapeutic application deserves to be improved.

However much his technic may be altered or his theories challenged, the truths that he has set forth will attest his deep comprehension of human nature, and emphasize the importance of a better understanding of the psychogenetic factors contributing to the etiology of the psychoneuroses, just in proportion as his work is studied by the intelligent, open-minded investigator, who holds himself well in hand, with the view of finding the sane, the useful, and the practical contained in his presentation. From the darkness of a comparatively unexplored field of scientific study, Freud has brought to light many beautiful truths, however mixed with the irrational they may be, which are useful and practical.

Without an attempt at discrimination for the time being, let us now see what some of Freud's ideas are, so as to be better equipped to understand the therapeutic application of psychoanalysis, taking, first, a glance into Freud's psychology, upon which the psychoanalytic method of treatment, by whatever modification it may be therapeutically applied, is founded.