A Psychiatric Milestone | Page 8

and effective data. Many of the factors mentioned as causes do not have the claimed effects with sufficient regularity. It is quite true that not everybody is liable to any serious upset by several of the handicaps sometimes found to be disastrous during the years of development; but we have learned to see more clearly why the one person does and the other does not suffer. Evidently, not everybody who is reserved and retiring need be in danger of mental disorder, yet there are persons of just this type of make-up that are less able than others to stand the strains of isolation, of inferiority feeling, of exalted ambitions and one-sided longings, intolerable desires, etc. The same individual difference of susceptibility holds even for alcohol. With this recognition we came to lay stress again on the specific factors which make for the deterioration of habits, for tantrums with imaginations, and for drifting into abnormal behavior, and conditions incompatible with health.
It was at this point that our great indebtedness to the Bloomingdale Hospital began. Dr. August Hoch, then First Assistant of the Bloomingdale Hospital, began to swing more and more toward the psychobiological trend of views, and with his devoted and very able friend Amsden he compiled that remarkable outline,[2] which was the first attempt to reduce the new ideals of psychobiology to a practical scheme of personality study--that clear and plain questionnaire going directly at human traits and reactions such as we all know and can see at work without any special theories or instruments.
After studying in each patient all the non-mental disorders such as infections, intoxications, and the like, we can now also attack the problems of life which can be understood only in terms of plain and intelligible human relations and activities, and thus we have learned to meet on concrete ground the real essence of mind and soul--the plain and intelligible human activities and relations to self and others. There are in the life records of our patients certain ever-returning tendencies and situations which a psychiatry of exclusive brain speculation, auto-intoxications, focal infections, and internal secretions could never have discovered.
Much is gained by the frank recognition that man is fundamentally a social being. There are reactions in us which only contacts and relations with other human beings can bring out. We must study men as mutual reagents in personal affections and aversions and their conflicts; in the desires and satisfactions of the simpler appetites for food and personal necessities; in the natural interplay of anticipation and fulfilment of desires and their occasional frustration; in the selection of companionship which works helpfully or otherwise--for the moment or more lastingly throughout the many vicissitudes of life. All through we find situations which create a more or less personal bias and chances for success or failure, such as simpler types of existence do not produce. They create new problems, and produce some individuals of great sensitiveness and others with immunity--and in this great field nothing will replace a simple study of the life factors and the social and personal life problems and their working--the study of the real mind and the real soul--_i.e._, human life itself. Looking back then this practical turn has changed greatly the general view as to what should be the chief concern of psychology. One only need take up a book on psychology to see what a strong desire there always was to contrast a pure psychology and an applied psychology, and to base a new science directly on the new acquisitions of the primary sciences such as anatomy and histology of the nervous system. There was a quest for the elements of mind and their immediate correlation with the latest discoveries in the structure of the brain. The centre theory and the cell and neurone theory seemed obligatory starting-points. To-day we have become shy of such postulates of one-sided not sufficiently functional materialism. We now call for an interest in psychobiological facts in terms of critical common sense and in their own right--largely a product of psychiatry. There always is a place for elements, but there certainly is also a place for the large momentous facts of human life just as we find and live it.
Thus psychiatry has opened to us new conceptions and understandings of the relation of child and mother, child and father, the child as a reagent to the relations between mother and father, brothers and sisters, companions and community--in the competitions of real concrete life. It has furnished a concrete setting for the interplay of emotions and their effects.
It has led us from a cold dogma of blind heredity and a wholesale fatalistic asylum scheme, to an understanding of individual, familiar, and social adjustments, and a grasp on the factors which we can consider individually and socially modifiable. We have passed