Psycho-Analysis
MENTAL HEALTH 21 Reviews
A Handbook for Medical Practitioners and Students of Comparative Psychology.
2nd Edition. :Author: Edward Glover, M.D. Staples Press. 15s.
Psycho-Analysis To-day. Edited by Sandor Lorand, M.D. George Allen & Unwin. 25s.
All who desire to acquire a basic knowledge of the fundamental theories and tenets of psycho-analysis will welcome the appearance of these two books, each completing the other. Dr Glover sought in re-writing his handbook for its second edition, to re-state the basic theories of psycho-analysis which the student can then see in their applied form in the volume of essays edited by Dr Lorand, where issues wider than the purely clinical ones are more fully discussed. Through these two books a full appreciation of the extent of the contribution of psychoanalysis to human knowledge, both in depth and range, can be easily obtained.
Of the two, Dr Glover’s book is the most difficult and is even, at times, very difficult. The difficulty lies in the dryness of his style, the concentrated and often metaphysical nature of his thought, so that the reader can never afford to relax his attention. Or. Glover is not helped by the type in which the book is set which is too close, dazzles and fatigues the eye. But the mastery of Dr Glover’s exposition a rewarding experience and enables the reader to acquire a very thorough and sound grounding in Psycho-analysis not only in its theoretical aspects put also in its clinical applications. One of the “Tiportant attractions of this book is that after the theoreticai exposition, Dr Glover relates theory to clinical material and gives a clear account of the Psycho-analytic interpretation of psychiatric disorders. A psycho-analytic textbook of psychiatry (as Muncie attempted for the Meyerian point of yiew) is long overdue, and Dr Glover in this section ?f the book has most usefully shown the way. Dr Glover’s book has three sections, the first dealing with theory, the second with clinical psychlatry, and the third with problems relating to treatment. On the theoretical side the basic three-fold approach of psycho-analysis to any niental event is stressed and is then discussed in subsequent chapters in relation to the various phases ?f ego and mental development. Thus, in the first Place every mental event has a ” topographical ” basis involving the various component parts of the ^ind; this approach is based on the concept of the ?und as an apparatus with a definite structure. Then ” mental activity is a response to disturbances ?f equilibrium ” and this is the second or dynamic Approach which is further discussed in terms of Instinct-tension. Thirdly, there is the economic aPproach which is ” governed by a general tendency ?f the psychic apparatus to master such instinctual e*citation as cannot be immediately discharged and in consequence threatens a variety of discomforts, one of the most compelling of which is described as anxiety An important point is then made that unconscious mental mechanisms are means whereby the mind achieves it’s aim of reducing instinctual stimulation to an optimum level. Dr Glover, therefore, is able to stress that normality ” is essentially a pragmatic standard indicating that the individual has achieved a working balance between the claims of his own instincts and the standards of behaviour laid down by himself and by the community in which he lives The point is that these standards not only vary from community to community and from culture to culture, but more important still, vary in the particular aspects of behaviour emphasized by them.
In the clinical section, these three approaches, the topographical, the dynamic and the economic become basic conceptual instruments for the analysis of symptom formation and mental ill-health. This section has many excellent chapters, particularly the one dealing with psychosomatic disorders, the discussion of which is very important in view of the increased interest taken by physicians in these conditions. Dr Glover establishes a two-fold distinction between the psycho-neuroses and the psychosomatic illnesses. The psycho-neuroses have in the first place ” psychic content and meaning and secondly follow a standardized pattern in the process of symptom formation “. On the other hand, the psychosomatic disorders ” although influenced by psychic reaction at some point or other in their progress, have in themselves no psychic content and consequently do not present stereotyped patterns of conflict. Should they develop psychic meaning, it may be assumed that a psycho-neurotic process has been superimposed on a psychosomatic foundation.” In the other clinical chapters there are many valuable points. Thus the drug addictions are linked to the manic depressive disorders, and Dr. Glover argues that the drug addict is not a true psychopath since he seeks to solve his conflicts by the alteration of the forces within himself and not through the alteration of his environment to suit his unconscious drives. Although the chapter on the psycho-analysis of children is all too short (the omission of any reference to Mrs. Klein’s work is most noticeable and reveals the author’s personal bias), it contains the important point that ” owing partly to the immaturity of mental organization and partly to the rapid vicissitudes of early mental development, the clinical manifestations of mental disorders during the first five years are extremely ‘ fluid ‘. Symptom formations begin to manifest a classic outline only during the latency period.” There is also a chapter on ” social difficulties a descriptive term used to embrace conditions where ” the effect on social relations is a primary criterion and the disorder of the ego is relegated to second place This concept is an important one and raises a vital question which the clinician in reaching his diagnosis must seek to answer.
The final section of the book contains practical notes on the nature of psycho-analytic treatment, its duration and cost, the choice of analyst and the results of treatment. At various times throughout the book, Dr Glover allows his personal prejudices to distort his thinking, a point well illustrated by the following remarks on group therapy. ” Group therapy in general has acquired considerable popularity recently, partly because of a passing craze for group methods, partly because of the need for a rapid turnover of cases, but mostly because it offers an escape for the arduous and conflict inducing labours of psycho-analysis proper ” !
Psycho-Analysis To-day consists of 31 articles by 29 psychiatrists and psycho-analysts, all of whom have made important contributions to present-day psycho-analytic knowledge. The quality of these articles varies greatly. The main value of the book lies in the variety of the problems it raises, and shows how psycho-analysis can effectively contribute to their solution. These articles cover theoretical problems, as in Mrs. Klein’s outline of her views on the early developments of the conscience of the child, clinical conditions with chapters on the psycho-neuroses and the psychoses, as well as articles on broader subjects such as the psychology of religion, and the contribution that psycho-analysis can make to sociology, anthropology, literature and art. The book as a whole successfully shows the extent to which psycho-analysis continues to uncover new aspects of mental life, and how the psychoanalytic method is successful not only in giving a deeper understanding of the clinical problems discussed by Dr Glover, but also of the wide range of human endeavours, religious, artistic and cultural. P.N.T.
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