Page:The International Journal of Psycho-Analysis III 1922 1.djvu/71

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BOOK REVIEWS 63

might have been expected, with actual neuroses and psychoneuroses, for 'psychoneuroses' are listed in both groups and the 'suppression neuroses' even contain the war neuroses and mild types of manic- depressive insanity as well. The essential cause of war neurosis is a maladaptation to the causes of fear, which are (i) potential death or injury, and (2) an uncontrollable subconscious craving to commit sub- missive homosexual perversions (p. 287), a guess which is an approxim- ation to the truth. Morbid fear in general is not always a reaction to repressed impulses, as Freud holds; it is sometimes this and sometimes the direct effect of the memory of past danger (as used to be believed in pre-analytical days and as is still believed by Morton Prince and others). On the basis of this distinction Dr. Kempf divides phobias into two classes (p. 730).

The pernicious neuroses are divided into three groups: (l) 'Com- pensation neuroses', which seem to represent an accentuation of the j mechanism present in the ' repression neuroses ', (2) ' Regression neur- ' OSes', where the compensation has failed, so that the patient regresses to an earlier, irresponsible level, and (3) 'Dissociation neuroses', in which the uncontrollable cravings dominate the personality. Manic cases come under the first of these captions, depressive cases under the second. 'The depressives are either types who renounce all competitive interests in the world, give up hope of winning the love-object through the striving methods of maturity and regress to an infantile, or intra- uterine mother dependence ; or, autoerotic, they struggle anxiously,

desperately to escape the obsessing cravings of the pelvic segment' i

(p. 712); there is here no hint of the central part played by hate in ;

the genesis of depression. On the other hand the) importance of repressed homosexuality in paranoia is recognised, though only fitfully. Dr. Kempf makes the interesting statement that 'the most important determinant of the malignancy and incurability of the psychopath's methods of thinking is hatred ' (p. S5o), one which contains a great deal of truth.

More than half of the book is taken up with descriptions of cases, and Dr. Kempf deserves great praise for the labour and skill with which he has recorded this valuable material. It is most interesting in itself and is interestingly presented. It is accompanied by a series of beautiful and well-reproduced illustrations, from classic art, from anti- quarian finds, photographs of characteristic expressions and postures, of apparatus invented by insane patients, and so on. One of his main objects here, successfully achieved, is to demonstrate the wide occur- rence of unconscious symbolism quite apart from psychopathology : 'When one recalls the ridiculous tirades some inspired psychiatrists levelled at the psychoanalysts' recognition that the appearance of a knife, wand or beast in a dream or hallucination probably had