Active Psychotherapy
- Author:
Alexander Herzberg, M.D.,
Ph.D. Heinemann. Pp. 152. 12s. 6d.
Dr Herzberg has had a wide experience of Psychotherapy, both in Berlin and in London and in this book describes a method of treatment devised by him to shorten the psychoanalytic technique, especially in the treatment of the psychoneuroses and the sexual perversions. How necessary and desirable this is, must be obvious to everyone who is in any way concerned with these all too common disabilities. If even the fringe of the problem of readjustment to life of the very large numbers of persons who require treatment now and who will require it as the result of the difficult transitions from war to peace, is to be touched, it is imperative that some short method of analytical treatment should be discovered.
The author discusses the classification of psychogenic disorders, the originating causes and the importance of repression in determining the neuroses and maintaining them. He briefly discusses the psychoanalytic methods necessary to disclose the structure of the patient’s illness, but is not content to leave the cure to the gradual freeing of his inhibitions by allowing him to discover their geneses and to work off his emotional entanglements through the negative and positive transference on the psychotherapist and the subsequent difficult resolution of this transference. He believes that much more direct methods are needed, and seeks to persuade his patient to exert his will on the fulfilment of tasks which are directed actively to break through these inhibitions and to overcome the phobic and compulsive situations which are responsible both for the geneses and maintenance of the conflicts.
He further discusses the causes of relapse and suggests special methods to prevent these relapses. He points out that where constitutional predispositions are relatively important in the genesis of neuroses compared to environmental influences, the prognosis is less favourable, but even here he believes it is possible to devise tasks to counteract these predispositions and enable the patient to make a sufficiently satisfactory adjustment to life.
He deals in a similar way with the sexual perversions and holds that homosexuality is far the most difficult problem to deal with in this field though other authors do not share his view.
In the last three chapters he gives a general description of his special technique and compares it with other methods, and finally discusses the difficult question of the moral responsibility of the physician in relation to the advice he gives to his patients, especially in respect of extra-marital relationships.
The general impression of this valuable contribution to psychotherapeutic literature is that if Dr Herzberg’s methods can be carried out they are of the greatest value, but since the tasks involve supreme efforts of will on the part of patients notoriously incapable of such efforts, the teaching will not be of universal application.
This will be appreciated when it is realized that the tasks imposed on the patient involve not only his forcing himself to face phobic situations and to inhibit compulsive actions, but even to forego affections involving conflict even though the patient may be unwilling to abandon the love affair. Some psychotherapists may have sufficient influence over their patients and enough persuasive power to impose such tasks on them, and and some patients will have sufficient strength of character to carry out the tasks to a successful conclusion, but certainly universal success cannot be expected. Nevertheless this book merits careful reading by all doctors interested in abnormal psychological reactions and their cure, and it is to be highly commended to everyone engaged in the study of mental health and disease. R.G.G.
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