A Psychiatric Milestone | Page 8

the
influences of the mental factors, and in 1908 a paper on "What Do
Histories of Cases of Insanity Teach Us Concerning Preventive Mental
Hygiene During the Years of School Life?" All this was using for
psychiatry the growing appreciation of a broad biological view-point in
its concrete application. It was a reaction against the peculiar fear of
studying the facts of life simply and directly as we find and experience
them--scoffed at because it looked as if one was not dealing with
dependable 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