d
self-consciousness, of emotions and volitions, of intellectual
capacities and organized actions. But we do not have to enter here into
a discussion of such diagnostic means; our chief interest belongs to the
therapy.
The variety of the psychotherapeutic methods is great and only some
types are to be characterized here. But one rule is common to all of
them: never use psychotherapeutic methods in a schematic way like a
rigid pattern. Schematic treatment is a poor treatment in every
department of medicine, but in psychotherapeutics it is disastrous.
There are no two cases alike and not only the easily recognizable
differences of sex and age, and occupation and education, and financial
means, and temperament and capacity are decisive, but all the subtle
variations of prejudices and beliefs, preferences and dislikes, family
life and social surroundings, ambitions and prospects, memories and
fancies, diet and habits must carefully be considered. Every element of
a man's life history, impressions of early childhood, his love and his
successes, his diseases and his distresses, his acquaintances and his
reading, his talent, his character, his sincerity, his energy, his
intelligence--everything--ought to determine the choice of the
psychotherapeutic steps. As it is entirely impossible to determine all
those factors by any sufficient inquiry, most of the adjustment of
method must be left to the instinct of the physician, in which wide
experience, solid knowledge, tact, and sympathy ought to be blended.
Even the way in which the patient reacts on the method will often guide
the instinct of the well-trained psychotherapist.
It is therefore certainly not enough that the knowledge of the physician
simply decide beforehand on a definite course of psychical treatment and
leave the carrying out to a well-meaning minister or any other medical
amateur who schematically follows the indicated path. The finest
adjustment has to come in during the treatment itself and the response
of the patient often has to suggest entirely new lines of procedure.
More than in any other field of medicine, the physician himself has to
extend his influence far beyond the office hours and the strictly
medical relations. And yet, on the other hand, there is no department of
medicine in which the treatment might not profit by the
psychotherapeutic influence. With a few vague words of encouragement
mechanically uttered, or with a routine of tricks of suggest
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