erest the average practitioner. The most widely diffused psychiatric
reports of our time are the sensational news items of the daily press.

(5) The overemphasis of psychogenetic factors to the apparent neglect of
important somatogenic factors by some psychiatrists has tended to arouse
suspicion regarding the soundness of the opinions and methods of
psychiatric workers in the minds of men thoroughly imbued with
mechanistic conceptions and impressed with the results of medical
researches based upon them. The ardor of the psychoanalysts, also,
though in part doubtless justified by experience, has, it is to be
feared, excited a certain amount of antipathy among the uninitiated.

(6) The fears of insanity prevalent among the laity and the repugnance
of patients to any idea that they may be "psychotic" or "psychoneurotic"
(words that, in their opinion, refer to "imaginary symptoms," or to
symptoms that they could abolish if they would but "buck up" and exert
their "wills") undoubtedly exert a reflex influence upon practitioners
who put the "soft pedal" on the psychobiological reactions and "pull out
the stop" that amplifies the significance of any abnormal physical
findings.

(7) Psychotherapy, to the mind of the average medical practitioner, is
(or has been) something mysterious or occult. He uses much psychotherapy
himself but it is nearly always applied unconsciously and indirectly
through some form of physical or chemical therapy that he believes will
cure. He is usually quite devoid of insight into the effect of his own
expressed beliefs and bodily attitudes upon the adjusting mechanisms of
his patients. Conscious and direct psychotherapy is left by the average
practitioner to New Thoughters, Christian Scientists, quacks, and
charlatans. If he were to use psychotherapy consciously and were to
receive a professional fee for it he would feel that he was being paid
for a value that the patient had not received. A highly respected
colleague once privately criticised a paper of mine (read before the
Association of American Physicians) on the importance of psychotherapy.
"What you said is true," he remarked; "we all use psychotherapy but we
are a little ashamed of it; and it is better not to talk about it." Even
he did not realize that every psychotherapy is also a physical therapy.

(8) The rise of specialism, through division of labor and
intensification of interests restricted to limited fields, in practical
medicine, t