Destiny and Disease in Mental Disorders
With special reference to the schizophrenic psychoses. :Author: C. Macfie Campbell, M.D., Professor of Psychiatry, Harvard University. London: Chapman & Hall. 1935. pp. 207. 10/6 net.
This is the first volume of publications on Psychiatric subjects which will be issued as * nomas W. Salmon Memorial Lectures in tribute 0, that mental physician who was a distinguished pioneer in modern American psychiatry and whose professional life coincided with the Sreat advance made in this sphere during the first decades of this century. Later contributions under ,. e same aegis will be forthcoming from Dr WilA. White and Dr Adolf Meyer, the value of vhose work in this field is universally acknowledged. Dr Macfie Campbell’s writings are ‘Ways lucid, suggestive, and stimulating. Our atural anticipation of an intellectual treat from study of these pages was eminently fulfilled.
eyond a brief introductory foreword, the conents are divided into three parts. The first eals with the various ” trends of psychiatry,” second with ‘’ the stuff of life and the schizophrenic reaction,” while the third discusses ? .?.Ur kinship with the schizophrenic.” In his ^tial survey of modern work the author points ^t how research in many spheres has brought , ?ut the accumulation of data bearing on ,Ulfian behaviour, the failure to arrive at satisconclusions through the methods of eniistry and physiology, and the great need of Udying the mosaic of mental symptoms in the mg of the adaptation of the individual to the ?’^ands of his environment. Stress is laid on e necessity for dealing with the individual as ^ Vvhole. The physical health, metabolism, or ^cal infection, may be important factors for ^atment, but as well the internal equilibrium the patient, environmental strains, and supah fr”om the social group, must receive due , ention. The trend of psychiatric thought is emphasize the integration of all the comfient forces which may be at work. Afterards, Dr Campbell discusses the contributions (]e by the study of the personality in the evel?pment of the schizophrenic type of rew lQn and how far such a study and of the situation render any case intelligible and ?^,er a guide to treatment and prevention. ?ugh it is fully realised that any attempt at t(JSlficati?n is apt to be artificial, as a first step ^ards a dynamic analysis, a grouping of the ny illustrative clinical cases is made. In a general way this tends to correspond to Kraepelin’s divisions of dementia praecox into hebephrenic, catatonic, and paranoid forms. The discussion of each case material is mainly from the point of view of personality reactions to internal and external stresses.
The first group comprises patients presenting a picture of non-adaptive turmoil or disturbance of function; in the second group are those who show lack of interest in or response to the external world, those who present an anergic, indifferent or parasitic condition, those with a stuporous syndrome, and those demonstrating a reduction of interest with distortion of the outside world; in the third group there are those with a distorted world picture, patients with wish-fulfilling phantasies, cases with a world picture which is a receptacle for discordant components of the personality, and patients with an accusatory world picture. In nearly a hundred pages of varied life histories, the drama of each individual life is portrayed. In that material it is indicated that, no matter whether an underlying impersonal process be present or not, the behaviour and outlook of the patient seem in part to be the expression of underlying needs of the personality and of an attempt at adaptation to the demands and deficiences of the life situation.
Finally, there is a discussion on how the general trends of psychiatry, which were expounded at the beginning, converge upon the special problems of the cited and grouped cases. ” One again reviews the fullness of human nature, the underlying atavistic beliefs, the persistent childhood formulations, repressed memories associated with guilt and fear, repressed tendencies of the appetites and affection. One does justice to the role of repression, projection, and symbolism. With the human personality understood in terms of the above component forces, the development of even a phantastic picture of the outside world may become in large part intelligible, may perhaps not require the introduction of any extraneous factor of disease.”
One can hardly speak too highly of this book. The author’s human insight, breadth of outlook, and convincing approach to one of the most difficult problems in psychiatry, should appeal to that ever widening circle of readers who wish for an enlightened attitude to all that pertains to healthy human adaptation. C. Stanford Read.
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