the knowledge, and social condition, but has
to be chosen in such a way that it is full of associations and
ultimately of joyful emotions. Useless work can never confer the
greatest benefits; mere physical exercises are therefore
psychophysically not as valuable as real sport while physically, of
course, the regulated exercises may be far superior to the haphazard
work in sport. To solve picture puzzles, even if they absorb the
attention for a week, can never have the same effect as a real interest
in a human puzzle. There is a chance for social work for every woman and
every man, work which can well be chosen in full adjustment to the
personal preference and likings. Not everybody is fit for charity work,
and those who are may be entirely unfitted for work in the interest of
the beautification of the town. Only it has to be work; mere
automobiling to charity places or talking in meetings on problems which
have not been studied will, of course, be merely another form of the
disorganizing superficiality. The hysterical lady on Fifth Avenue and
the psychasthenic old maid in the New England country town both simply
have to learn to do useful work with a concentrated effort and a high
purpose. From a long experience I have to confess that I have seen that
this unsentimental remedy is the safest and most important prescription
in the prescription book of the psychotherapist.

There is one more feature of general treatment which seems almost a
matter of course, and yet which is perhaps the most difficult to apply
because it cannot simply be prescribed: the sympathy of the
psychotherapist. The feelings with which an operation is performed or
drugs given do not determine success, but when we build up a mental
life, the feelings are a decisive factor. To be sure, we must not forget
that we have to deal here with a causal and not with a purposive point
of view. Our sympathy is therefore not in question in its moral value
but only as a cause of a desired effect. It is therefore not really our
sympathy which counts but the appearance of sympathy, the impression
which secures the belief of the patient that sympathy for him exists.
The physician who, although full of real sympathy, does not understand
how to express it and make it felt will thus be less successful than his
colleague who may at heart remain entirely indifferent but has a
skillful routine of going through the symptoms of sympathy. The
sympathetic vibration of the voic