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Page 8
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 from giving mere
wholesale advice to a conscientious study of the problems of each unit,
and at the same time we have developed a new and sensible approach to
mental hygiene and prevention, as expressed in the comprehensive surveys
of State and community work and even more clearly in the development of
helps to individuals in finding themselves, and in the work in schools
to reach those who need a special adaptation of aims and means. To the
terrible emergency of the war it was possible to bring experienced men
and women as physicians and nurses, and how much was done, only those
can appreciate who have seen the liberality with which all the
hospitals, and Bloomingdale among the first, contributed more than their
quota of help, and all the assistance that could possibly be offered to
returning victims for their readjustment.
It is natural enough that psychiatry should have erred in some respects.
We had forced upon us the herding together of larger numbers of patients
than can possibly be handled by one human working unit or working group.
The consequence was that there arose a narrowing routine and wholesale
classifications and a loss of contact with the concrete needs of the
individual case; that very often progress had to come from one-sided
enthusiasts or even outsiders, who lost the sense of proportion and
magnified points of relative importance until they were supposed to
explain everything and to be cure-alls. We are all inclined to sacrifice
at the altar of excessive simplicity, especially when it suits us; we
become "single-taxers" and favor wholesale legislation and exclusive
State care when our sense for democratic methods has gone astray. Human
society has dealt with the great needs of psychiatry about as it has
dealt with the objects of charity, only in some ways more stingily, with
a shrewd system and unfortunately often with a certain dread of the
workers themselves and of their enthusiasm and demands. Law and
prejudice surrounded a great share of the work with notions of stigma
and hopelessness and weirdness--while to those who see the facts in
terms of life problems there can be but few more inspiring tasks than
watching the unfolding of the problematic personality, seeking and
finding its proper settings, and preventing the clashes and gropings in
maladjustments and flounderings of fancy and the faulty use and
nutrition of the brain and of the entire organism.
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