Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/120

 374 AUGUST STARCKE

the neurotic only seeks advice on his own initiative in exceptional cases. The concept of psychosis is only conceivable in a society ; an isolated individual, Robinson Crusoe for instance, could have a neurosis, but not a psychosis, because a psychosis can only exist in relation to a society regarded as normal. Its criteria are:

1. Social troublesomeness, harmfulness, or failure of co-operation, in as far as their motives are unintelligible to society. When they are intelligible then the deviating individual is regarded as an offender or criminal if he is defeated. If he knows how to carry himself through, then he is regarded as a hero or great man.

2. Inability to appreciate the feelings of others. The relativity of this criterion is evident ; so we have the constantly repeated conflicts as to whether this or that symptom stamps a person as a mental case.

3. B'ailure of relation to reality. I need only allude to the per- secutions which science has suffered at the hands of religion in order to demonstrate the subjective character of this criterion. Whoever does not feel convinced of tliis might consider how psycho-analysts are reproached by their opponents with failure of relation to reality, and that it finally depends solely on the numerical superiority of the one or other party whether society considers the opponents as unfortunately left behind, or Freud's pupils as a paranoiac sect. r.fs-.icu.

4. Lack of insight into the illness, or defence of his position

on the part of the patient by means of projection. As concerns ,.

logical response the mental patient is inaccessible. We trace this peculiarity to reinforced narcissism. The number of 'normal' people 1

who lack any insight into the morbid nature of their peculiarities, for example, alcoholics, is very great, yet they are not considered mental cases; not to speak of religious and philosophical convic- j'

tions, the adherents of which mutually reproach one another with '^

the same charges. ^ ^i^ufo ^rprt rti :nm^']"

Failure of co-operation is also found in neurotics arid many normal parasitic natures, and so our first mentioned criterion is incomplete. Obviously a certain degree of capacity for positive transference and intellectual performances can cause society to

' See also Dresslar's questionnaire referred to by Ernest Jones in the Zmtralbl. f. Psa., Bd. II. Dresslar found 7176 descriptions of different super- stitions in 875 American students; in 3225 cases there was belief in the truth of the superstition.

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