W.H.R.Rivers

“ The influence of the war upon psychiatry in Great Britain has been profound and shows itself in many different directions. A most important effect has been to draw psychiatry into closer relations with neurology. As an indirect result of the stringency of the lunacy laws there had come into existence in Great Britain a state unknown in other countries, in which a deep gulf existed between those who deal with the insane and those who treat the neuroses, the latter affections usually coming under the care of physicians otherwise occupied with the treatment of organic nervous disease. ”

“ The partisans of Freud have been led by experience of the war-neurosis to see that sex is not the sole factor in the production of psycho-neuroses, but that conflict arising out of the activity of other instincts, and especially that of self-preservation, takes an active if not the leading role. ”

“ Those in the medical profession who are moving towards reform will gain a large body of support from many members of the laity who have come through the war to recognise the gravity of the problem. A large body of exact knowledge will be available to assist those whose business it will be to set the care and treatment of mental disorder on a new footing. Psychiatry will emerge from the war in a state very different from that it occupied in 1914. ”

“ The results of warfare have now compelled psychiatrists to consider from the medical point of view the conflicts between the instinctive tendencies of the individual and the forces of social tradition which workers in other fields have come to recognise as so potent for good and evil in the lives of mankind. ”

“ Closely related to this movement is another which has left those dealing with psycho-neurosis to recognise far more widely than hitherto the importance of mental experience which is not directly accessible to consciousness. Warfare has provided us with numberless examples of the process of dissociation and suppression by means of which certain bodies of experience become shut off from the general mass making up the normal personality, but yet continue to exist in an active state, producing effects of the most striking kind, both mental and physical. ”

“ On the other hand, independent students who, partly though lack of opportunity, had not previously committed themselves to either side, have been forced by the facts to see how great an extent the nature of psycho-neuroses of warfare support the views of Freud have made it their business to soft the grain from the chaff and distinguish between the essential and the accidental in his scheme. ”

“ This science has hitherto mainly dealt with the intellectual side of mental life and has paid far too little attention to the emotions. Students of certain aspects of mind, and especially those engaged in the study of social psychology, were coming to see how greatly psychologists had over-estimated the intellectual factor. ”

“ As a result of the war psycho-therapy has taken its place among the resources of the physician. There is still far from general agreement concerning the value of different forms of psycho-therapeutic treatment, but work is steadily going on in testing the value of different methods. ”

“ The general trend of opinion, however, has been against its employment as tending to undermine the strength of character which is needed to enable the victim of neurosis to combat the forces which have temporarily overcome him. ”