Mental Healing and the Emmanuel Movement Religion and Medicine
REVIEWS AND CRITICISM. :Author: Elwood Worcester, D.D., Ph.D., Samuel McComb, M.A., D.D., and Isador H. Coriat, M.D. Moffatt, Yard & Co., New York, 1908.
Psychotherapy. A Course of Reading in Sound Psychology, Sound Medicine and Sound Religion. Vol. I, No. 1. Centre Publishing Company, New York, 1908. Letters to a Neurologist. By Joseph Collins, M.D. William Wood & Co., New York, 1908.
We shall discuss the system of mental healing or psychotherapy, represented in what has come to be called the “Emmanuel Movement,” under the following heads 1. As a social movement. 2. As a criticism of medicine and an appreciation of psychology. 3. As a curative system and propagandist movement for the Church. 4. As a system of psychology and philosophy. 1. As a Social Movement.
Any fair-minded man who hears for the first time of the practical work undertaken by Dr Richard C. Cabot, a physician, and Dr Elwood Worcester, an Episcopal clergyman, for alleviating the unhappy mental condition of a class of patients suffering from what are commonly called functional nervous diseases, must welcome it with cordiality and wish it godspeed.
Several very diverse streams of intellectiial and active endeavor are represented in the thought which underlies Dr Worcester’s work. These diverse streams of thought and action seem to agree in one particular, that they place increasing emphasis upon the importance of an applied or practical psychology.
This recognition of the value of an applied psychology is due in great measure to the development of psychology itself. Until the last quarter of the last century, psychology was not a separate science, but a department of philosophy. As a branch of speculative thinking its principles and conclusions had little or no reference to, and certainly no value for, ordinary life. Then came the laboratory, with its experimental investigations into problems of which we may take as an example the time it takes to respond to a stimulus of sight or sound, or to associate one idea with another,?in other words, the time of the thinking process.
These normal times once established, investigators led the way into the field of comparative psychology. The effects of alcohol, tobacco, and other drugs upon the character and time of the associations of ideas represented in thinking, and the differences between the sane and the insane mind with respect to these mental processes, were soon under investigation. So to-day we find in Germany, in France, and in this country a rapidly increasing series of investigations into the mental processes of various normal and degenerative types of mind, and different methods have been proposed to enable us to study the slightly disordered and insane mind as these have never been investigated before. Another field of applied psychology was opened,?and the credit belongs first of all to G. Stanley Hall,?by the persistent effort of investigators to obtain exact results as to the effect of the educative process upon the human mind during the developmental period. To these must be added a third line of inquiry, represented by the original work of Francis Galton in England, by the labors of Cattell and Thorndike in America, to determine the variability in mental processes dependent upon different levels of social and intellectual development. Thus, at the present time, certain pioneers in an applied psychology are developing new departments of knowledge in connection with medicine and education and social statistics. This stream of psychological investigation moving on toward fields of practical endeavor has been met by streams which had their origin each in its respective provinces of medicine, education and sociology. The study of nervous disease as a medical specialty has led physicians more and more to call attention to the psychological factors involved in the treatment of disease. Thus we find Dr S. Weir Mitchell among the first in this country to awake to a consciousness of the importance of the physician’s appeal to the mind of the patient,?a method which has never been absent from the repertoire of the genuine physician or healer, although until the time of Dubois no one had deemed it worth while to give expression and fixed form to these psychological methods. Within the field of education also, any number of men have shown that the educational problem was being studied from the psychological point of view, and that the educator was not only ready to accept the results of the laboratory investigator, so far as these might be helpful, but was even going abroad to search for psychological methods to solve the problems which confronted him.
Another stream of modern thought and activity, which is to be found in combination with the currents of practical work proceeding from psychology, medicine and education, has its source in the study of social conditions. Statistical and economic investigations have tended to show that poverty is not so much a cause as an effect of economic and social conditions, and this discovery has led to a more exact investigation, to which such organizations as the United Charities in New York under Dr Devine are committed, in order to ascertain the extent to which social inefficiency is due to economic conditions or to the defective character of the individual. The sociologist, therefore, who on the practical side is the social worker, has been ready to extend the hand of co-operation to the psychologist and the physician. The physician, for his part, has begun to cry out for help to the social worker. Already in waging his combat against the plague of smallpox the physician found it necessary to seek for social and political assistance in order to place effective vaccination laws upon the statute books for the prevention of this dread disease, and to-day smallpox is reduced to a minimum in most civilized communities through the enforcement of compulsory vaccination in combination with compulsory education. In the same class with smallpox in this respect we find one after another diphtheria, malaria, typhoid fever, yellow fever, but at the present time most of all tuberculosis, the centre of a rallying cry for the co-operation of the social and medical influences of the country to carry out such precautions as the medical profession has demonstrated to be necessary. This co-operation has taken concrete form in the organization of many medical and non-medical societies to combat tuberculosis, the most conspicuous example of which was the International Congress, carried on with such distinguished success last October in the city of Washington. Of less general importance but perhaps even greater significance, because it is a definite and concrete realization of the association of social worker and physician, is the social service department, organized and guided originally by Dr Richard C. Cabot and Dr James H. Putnam, which was first undertaken at the Massachusetts General Hospital, and since has spread to other hospitals. The physician, so they contend, wastes his time if he endeavors to cure tuberculosis at the dispensary without sending some one into the home to instruct the patient’s family and to see that the medical advice given is actually carried out. From tuberculosis Dr Cabot applies the same principles to nervous and mental diseases. The medical profession recognizes that in the treatment of functional and even organic nervous disease the only efficient cure or ameliorating agency is what may be comprised under a regimen of life. Dr Cabot in a remarkable article invites attention to a consideration of the value of the social worker, whom he considers at the present day the only expert in the field of human character. There can be little doubt that the social worker and the grade teacher will become in time the most important repository of information concerning the development of mental, moral, and physical traits.
Another significant feature in modern medicine is the breaking down of the spirit of secrecy which surrounded the methods and prescriptions of the old-time physician. To-day many physicians even go to the extent of instructing the apothecary to copy the prescription upon the label, and there is a growing consensus of opinion that one important function of the medical profession is to instruct the public in the hygienic measures which are necessary to prevent and cure disease. These various streams of intellectual progress we see united through the agency of Dr Cabot and Dr Worcester, with quite a different stream of activity. To this union we owe the organization of what has come to be called the Emmanuel movement. It produced the church clinic, and has given rise to the interesting contention that the clergyman has a service partly social in character and partly medical, which he can and ought to perform. As Dr Cabot puts it, “What we need is team play, and there are at least three on the team, the medical man, the social worker, and the minister.” Let us examine a little more narrowly the stream which at this point combines with that which took its origin in medicine on the one hand and in social and philanthropic work on the other.
The church has always been a social and political force. Through its social service to humanity in connection with education, in fostering the arts and sciences through several centuries, in the establishment of hospitals and other philanthropic institutions, the church for many years kept a firm hold upon its people. When there was no expert physician, no psychologist, 110 sociologist, 110 real educator, the church was able to offer to mankind in the person of its representative one who combined the functions of priest, physician, educator, psychologist and sociologist. But with the development of modern science one branch of learning after another was swept away from its ancient moorings in the church. The first to go were medicine and the physical sciences. Then the moral sciences split off, in the first instance through the development of social science, economics, and politics, each branch developing institutions of its own quite apart from its ancient foster mother. Last of all psychology as the newest of all the sciences to take its place as a separate branch of investigation and instruction in our universities, achieved its independence of philosophy and theology. The first laboratory of psychology was established by Wundt in the University of Leipzig in 1879, and the first chair restrictedly designated as a .professorship of psychology was established at the University of Pennsylvania in the year 1888. The recency of this development of psychology as a separate science gives rise to such a phenomenon as that observed in Dr Worcester’s teaching philosophy and psychology while exercising the functions of chaplain at Lehigh University. In many other universities outside of the Roman Catholic communion, there is still this combination of theological and psychological activity, and even in some of our leading institutions one and the same man will presume to cover the fields of both philosophy and psychology, a combination which has no more warrant, except in tradition, than a similar combination of philosophy with one of the exact sciences, say physics, chemistry, or mathematics. But the theologian no longer spreads his surplice over sociology, economics and history, and it has almost escaped the memory of man that there was a day when he even ventured to cover the physical sciences.
And so the church has been stripped one by on<. of the ornaments of civilization which it had helped originally to design. This circumscrip216 THE PSYCHOLOGICAL CLINIC tion of its influence is observable, according to Dr Worcester, not merely in its general relations to society, but also in its personal contact with the individual. It is the object of Dr Worcester to give to the church some measure of its original significance for society and for the individual. Of all the arts at one time practiced by the church, the art of healing was by far the most important. Since mankind has learned to go to the doctor and not to the saint for the treatment of his physical ills, the church’s function in this field has been to offer solace and such assistance as may come through prayer. It is not Dr Worcester’s intention to claim that the church clinic, in resorting to prayer, will rely upon a divine interruption of the orderly course of nature,?a miracle, in the ordinary meaning of that word. In his opinion the healing power of prayer lies in the suggestive influence that the surroundings of a church and the personality of a righteous and godly man may exert upon the mental processes of the sick. In Chapter XIX of “Religion and Medicine,” written jointly by Dr Worcester and Dr McComb, the attempt is made to prove that certain of the healing wonders of Christ may be explained by psychotherapy. They group the miracles of Jesus under four heads, (1) ordinary acts of healing, (2) the expulsion of demons, (3) the raising of the dead, and (4) the so-called nature miracles. An explanation of these miracles is offered which covers only the first two of these groups. The authors do not wish to be understood as throwing doubt upon groups three and four; they merely set them aside “to be reserved to the day of fuller light.” In order to make good their contention with regard to the first two groups, that these cures are the result of suggestion, they are obliged to distinguish between curable and incurable leprosy, between genuine epilepsy and hystero-epilepsy, and the well known phrase “cast out demons” is modernized into hysteria and double or multiple personality. We are told that if the evidence warrants us in holding that Jesus shared the contemporary belief in demonology, this fact does not invalidate his spiritual authority as the founder of the kingdom of God.
Hence Dr Worcester’s idea is that the church should follow literally the example of Christ in healing the sick and entering more deeply into the personal lives of the people. “Beneath the vulgar exterior of Christian Science,” Dr Worcester finds a truth, “a spiritual power answering to men’s needs, which the churches at present do not possess.” He therefore sees in this new movement her opportunity to regain some of the power and prestige which she has lost, in consequence of having been relegated through the progress of science to a small and secondary role in human affairs.
The practice of psychotherapy through religious organizations was first brought to popular attention through the Society of Emmanuel, founded in London in October, 1895.* It was taken up nearly three years ago by the Emmanuel Church of Boston, when, as stated in the introduction to “Religion and Medicine,” that church began its first work for the relief of the sick through an organization of tuberculosis classes under the medical direction of Dr Joseph H. Pratt. “The treatment consisted of the approved modern method of combating consumption, plus discipline, encouragement and hope, in short a combination of physical and moral elements.” The success of the tuberculosis class led to the formation of many similar classes, and readily convinced Dr. Worcester that the church had an important mission to discharge to the sick, and that the physician and the clergyman could work together to the benefit of the community. Accordingly, similar work was undertaken in 1906 among the nervously and morally diseased. The work opened in November of that year with an address by Dr James J. Putnam, who presided at the preliminary meeting, and brought with him the cooperation of approved neurological science with the work of the church. Health conferences for both tuberculosis and nervous cases, employing religious exercises and including prayer as a psychotherapeutic measure, were held weekly. This work was later supplemented with what would be described as a free clinic, a church clinic, at which the patient was treated by hypnotic and non-hypnotic suggestion in the study of Dr. Worcester and his assistant, Dr McComb. It is reported that the work has been taken up along similar lines by other churches, representing not only the Episcopal denomination, but including Baptist, Congregational, Universalist, Unitarian and Presbyterian congregations, in Chicago, New York, Brooklyn, Jersey City, Buffalo, Detroit, and Northampton, Mass.* This work is therefore an attempt to help the sick by mental, moral and spiritual methods. “To be successful,” Dr Cabot says, “we must appeal to the whole personality.” In addition, the patient is encouraged to work. “We have also realized that the mental, moral and spiritual health of the individual, through which we hope to influence his bodily condition, depends upon his work, upon the way he does his work, upon the spirit he puts into his work, and upon the satisfaction he gets out of it. We have realized, furthermore, that the health of the mind is largely influenced by home conditions, by personal friendships, by family affections, by all that goes on between man and man, as well as by work, and by more distinctively intellectual or religious influence. Hence, the American type of psychotherapy busies itself not only with the ideas that are floating through the patient’s head, not only with his thoughts, his worries, his griefs, but also with his personal relations, with his friendships, his love affairs, his domestic and family affections.”
It is made quite plain that the methods to be employed are not based upon an appeal to any supernatural agency, nor do Dr Cabot and Dr. Worcester require, as one would at first sight imagine, that the priest shall have a knowledge of medicine. A physician is to diagnose the cases before the clergyman undertakes their treatment. If the physician has ascertained that tlie patient is suffering from any functional nervous disease, he is invited to turn the patient over to the clergyman for treatment.
Why are we to believe that these cases will be better treated by a clergyman, unlearned in medicine, than by a neurologist or the general practitioner of medicine?
2. 4s a Criticism of Medicine and an Appreciation of Psychology. “So long,” says Dr Worcester,* “as the training of our physicians is strictly material, such patients will continue to be their despair.” In this statement, manifestly unfair, an appeal to prejudice strikes the first note which puts the Emmanuel movement out of harmony with a sound and conservative development. What does Dr Worcester consider a spiritual training which should supplement that which our physicians at present receive? Do not our physicians and our clergymen partake of much the same training? Physicians, let us hope, have been subjected to the moral and spiritual influences of a good home. Most of them have gone to Sunday-school and church; they have attended the elementary and secondary schools, many of them a college where they have enjoyed with other young men bound for the ministry the same opportunity to profit by instruction in philosophy, psychology and ethics. It is only when the one enters the medical school and the other the divinity school that we find a separation in professional interests. And yet we cannot call the one strictly material and the other strictly spiritual. The theological student spends a great deal of his time in textual criticism, and this is quite as definitely a training in material things as is the examination of dry bones by the student of anatomy. If Dr Worcester means the training which develops character, we doubt very much the justice of the contention that a course in a divinity school is more likely to develop an exalted moral character than a course in a medical school. If it be devotion to social service which Dr Worcester desires to see cultivated, we find the medical profession presenting the most conspicuous examples of an unselfish service for mankind in their writings, in their attendance on free dispensaries and hospitals, in public addresses, in work on sanitary and hygienic commissions, and in the active support of important public measures before our legislative bodies. It would be a difficult undertaking to prove that the church within the last ten or twenty years has performed a more important social service to American society than the medical profession. If it be the force of personality which Dr Worcester has in mind, that rare combination of keen insight into human nature, of enthusiasm and sympathy, which makes a man mentally and morally the helper, teacher *”Religion and Medicine,” p. 5. Consider also in this connection the following passage: “One reason why American physicians are so slow to avail themselves of psychical influence in combating disease is that they have been educated in a too narrowly materialistic school of science, which assumes that only material objects possess reality and which thinks that the mind can safely be ignored.” /&., p. 52. and hope of lais fellow-men, and which Dr Worcester himself calls, “A factor of the highest importance, the individuality of the physician,” then we inquire,?does Dr Worcester believe that any kind of training, either theological or medical, can develop this trait in a man? Such a combination of qualities can scarcely be cultivated. If a physician happens to have this rare personality he will do great things; if a clergyman, he also will move mountains as, for example, Father de Nisco at Roseto, Pa., but it is doubtful whether he can train a school to follow in his footsteps.
To ask that the clergyman shall perform a useful social service as an assistant to the physician in the treatment of certain mental and nervous diseases, is one thing, but to claim that the necessity for the assumption of this service on the part of the clergyman is due to the lamentable failure of the neurologist and practising physician, is quite another thing, and when this fact is explained as due to the physician’s neglect and ignorance of psychology, it becomes necessary to inquire whether there is any justification in fact for this statement, and whether Dr. Worcester offers a form of psychological treatment which is any better than that which the medical profession has been employing. Dr Cabot, in an address delivered in New York City on December 3d, whether intentionally or otherwise, even went to the extent of limiting the function of the neurologist in connection with functional nervous disease to its mere diagnosis. When such diagnosis has been made, his recommendation is to turn the case over to a clergyman for treatment. A man desiring to purchase something often gets into the wrong shop, so he contended, and for these nervous cases the wrong shop is the neurologist’s office, and the right shop is the church and the clergyman’s study. Dr Cabot, a physician himself, appears to forget that the physician is not a diagnostician primarily but a healer, when he invites his professional colleague to admit himself a failure and turn over a part of his practice to his clerical brother.
The vital question is not whether the physician fails to treat successfully a large number of cases. Human beings will always die, some will always suffer from incurable diseases, and others will get along as best they can with diseases more or less curable. The profession therefore will always be subjected to outside and ignorant criticism. It is also subjected to the keenest criticism from inside the profession itself. In the most whole hearted and disinterested way, every method known to man is being employed within the medical profession, though not necessarily by its every member, to improve therapeutic practice. Has the physician overlooked the importance of psychology in the practice of his profession? It is significant, indeed almost humorous, to find in “Religion and Medicine” as well as in the serial called “Psychotherapy,” not one single authority quoted as having contributed to the development of psychotherapy who is not a physician. It is true, opinions are cited of such psychologists as William James and Joseph Jastrow, and such pseudo-psychologists as Myers and Hudson, but these are known for their contributions to the theory of psychology and not at all for any practical applications of psychological principles in the treatment of disease. It is a very common mistake to imagine,* because psychology is defined as the science of mind, that the psychologist as a psychologist must have something to offer in the mental treatment of disease. You might just as well imagine that a professor of pedagogy will necessarily be a good teacher, or a psychologist a good judge of character. Something more than general principles is needed. If the psychologist will address himself to the solution of practical problems and develop an applied psychology, there can be 110 doubt that in time the profession of psychology will develop methods of psychological treatment which will be far and away better than those which are at our disposal at the present time. Just as within the medical profession itself, the subject of pathology is developing as a separate line of inquiry, and a group of pathologists are arising who do not practise medicine, but who contribute results which are reconstructing the basis of practice, so we shall expect to find psychological experts connected with institutions for the insane and with the public school systems, whose work will doubtless contribute results of great value, and on whose work mental and educational treatment will be based in the future. But to-day, while it calls attention to the science, it invites criticism to play up the psychologist at the expense of the practicing physician and neurologist. The reason why Dr Worcester, and probably Dr Cabot also, fail to take cognizance of the work that is really establishing psychotherapy on a sound basis, is because they are not familiar either with “sound medicine” or “sound psychology.” In “Religion and Medicine” we find authorities on hypnotism and suggestion quoted ad libitum and ad nauseam, but you will find no mention of the psychotherapeutic work of Kraepelin, the most conspicuous example of an investigator who combines in one person a sound training in psychological method with a similar training and experience in medicine. Kraepelin, a product of the psychological laboratory at Leipzig, is the leader in psychiatry today. To hypnotism, suggestion, and double personality he has paid no more attention than the importance of these subjects warrants, and hence he is unknown to the leaders of the Emmanuel Movement, except as an investigator of the psychical effects of alcohol. It would lead us too far afield to attempt to collate the evidence which might be brought to show the existence of a practical psychological experience within the medical profession. Take for an example such a judicial paper as that of Dr Charles K. Mills on “Psychotherapy, Its Scope and Limitations,” read before the Philadelphia County Medical Society, March 25, 1908, from which I quote the following conservative opinion of Dubois’s *For example:?”To-day, if he so willed, Professor James might easily rank with the greatest neurologists in the treatment of a large group of diseases, and this solely by virtue of his consummate ability as a physiological psychologist.” Worcester, “Religion and Medicine,” p. 15. work, called “epoch-making” by Dr Cabot: “I would not for a moment question the verity of his reports, but it has seemed to me with regard to some of them that, like reports of cures from operations or from new medicinal remedies, sufficient time has not been allowed before recording, to decide on the real merits of the treatment. It is true that he tells us of the relapses of his patients, and of his occasional failures, but discounting these, his results still remain apparently so brilliant that it is hard to reconcile them with our experience, even making all allowances for the superior powers of the recorder.”
“The American type of psychotherapy,” says Dr Cabot, meaning thereby the type of psychotherapy practised in the church clinic, “busies itself not only with the ideas that are floating through the patient’s head, not only with his thoughts, his worries, his griefs, but also with his personal relations, with his friendships, his love affairs, his domestic and family affections.” That the American neurologist did not need to receive illumination from the Emmanuel Movement in order to treat the entire personality of his patient is shown in a conspicuous manner in a timely work entitled “Letters to a Neurologist,” which may helpfully be employed to offset the criticisms of Dr Cabot and Dr Worcester. Through the medium of this correspondence Dr Collins presents types of mental and nervous disease which will be familiar to every neurologist. They would be reported ordinarily in the medical literature in such a manner that they would not interest the general reader or make a permanent impression upon his mind, despite the fact that persons suffering from such diseases often present interesting personalities, clearcut and aggressive. This is because the neurologist draws his clinical pictures primarily in order to furnish a description, analysis and classification of symptoms. These letters to a neurologist present to the reader the neurasthenic, the psychasthenic, the manic-depressive, the mentally defective child, and other types of mental and nervous disorder in such a way that they will live henceforth in the reader’s mind not as gradually fading groups of symptoms but as concrete individuals introduced to him through the medium of a personal letter.
Nor is there any evidence in the neurologist’s replies to these letters which would indicate that Dr Collins overlooks the importance of psychotherapy in the treatment of his cases. The presentation of his methods of psychotherapy, which include practically every method in Dr. Worcester’s repertoire, excepting hypnotism, prayer and the appeal to religious emotion through the setting of a church edifice or a clergyman’s study, comes just at the critical moment when its real position is endangered by a crude and exaggerated popularization. The presence among these twelve letters of one dealing with the education of mentally defective children invites attention to a field which would seem to be peculiarly the province of the clerical therapeutist. The case presented by Dr Collins is one of mental retardation. In the moral sphere an analogous retardation is attracting the attention of the modern psychologist, social worker and physician. How to avoid moral de222 THE PSYCHOLOGICAL CLINIC linquency in young adolescents and how best to treat it are questions on which we naturally look to the clergyman to throw much light. But in our search for those who are doing the most active work in this field we come upon a member of an entirely different profession, Judge Lindsey of Denver, for the first inspiring exhibition of what may be accomplished through intelligent psychological insight. It seems almost trivial to talk of the wonders of hypnotism and suggestion when Judge Lindsey, relying only upon his powers of logic and moral suasion, can induce a juvenile offender to take a railroad journey, without a guard or attendant, for the purpose of committing himself to the Reform School. Dr Collins does not discuss the case of the morally retarded child, but of the trainers who are necessary to carry out the treatment of the mentally defective children, he says, “The successful trainer of mentally defective children should have unusual force of character, intelligence, insight, originality, knowledge of articulation work such as is given to deaf mutes, and a familiarity with the modes of application of massage, baths and calisthenics.” Many a case of psychasthenia, neurasthenia, melancholia, and perhaps even dementia prascox, would stand a better chance of recovery could the neurologist call upon a thoroughly competent psychological assistant to carry out such mental and moral educational programs as the one outlined by Dr Collins.
The value of work as a therapeutic measure is also emphasized by Dr Collins, as it has been by Dr Cabot and Dr Worcester. It has already been recognized as an important element in the training of the insane. Adequately trained attendants or nurses require a thorough knowledge of the crafts and arts in order to keep their patients constantly occupied and interested. To this end there must be a variety of occupations at the instant command of the person in charge of the patient. No amount of special instruction from outside teachers will avail. Such a disciplinary regime can be carried out by no one but the single trainer who is constantly with the patient. The Friends’ Asylum for the Insane at Frankford, Phila., where the services of a resident psychologist are beginning to make themselves felt, has found this form of treatment so essential that a course in handiwork has this year been added to the regular training course for nurses, and it is reported that the results obtained are already most encouraging.
This little book of Dr Collins’s also exemplifies what has already been referred to as the tendency of the medical profession to tear down the veil of mystery and to instruct both the public and in some cases the patient as to the exact nature of the disease. Thus, in a letter to a patient suffering from migraine, who reports her experience in going about from one physician to another, from osteopathy to Christian Science, Dr Collins frankly admits that she is suffering from an incurable disease of which the chief manifestation is headache, from which no drug or remedy known to medicine can permanently relieve her. “When your headaches are very severe, send for any commonsense doctor and ask him to give you one or two doses of some simple pain reliever. Tell him you don’t want to be cured, you want only to be relieved. Smile blandly at the doctor who says he can cure you.” Which shall it be,? the apparently pessimistic truth or the false optimism which we are advised operates so powerfully through suggestion? It is certainly a mistake to imagine that every pessimistic opinion is objectionable. What the patient usually desires in these cases is to lead an unhygienic but pleasant life and be freed from the consequences. For such a patient the only remedy is a full and complete knowledge of the situation, and the resolution to carry out a stoical regime of life.
There would thus appear to be little warrant for the opinion that the neurologist or even the general practitioner has failed to pay about as much heed to psychology as is warranted in view of the present undeveloped state of that science.. In fact, when we consider the history of the development of psychotherapy within the medical profession and in connection with social work, we must admit in all fairness that the physician and the social worker exhibit a greater readiness of mind to accept the co-operation of the professional psychologist than do those whose training and experience lie within the profession of the ministry. The Emmanuel Movement gives promise of performing an important and necessary social work. Dr Worcester is a man of action as well as of words. He has done something worth while, and we must recognize in his work much that is good. Unfortunately he has addled a very good egg through a premature exploitation of his work, which has brought him into an attitude of criticism toward the medical profession, and through the foundation of his psychotherapy upon a type of psychology which, as it will appear, is not representative of the best which that science affords. (To be continued.)
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