Page:The Modern Treatment of Mental and Nervous Disorders.djvu/22

— 20 — "nervousness," so that he starts and trembles at the slightest sound.

From causes of this kind, acting no doubt upon a constitution favourable to their action, and complicated by the bodily effects to which these causes give rise, there result a large number of the symptoms of nervous disorder. The complications and repercussions produced by the bodily factors are unquestionably of importance, a fact which we have endeavoured to portray in the diagram given above, but the primary and essential causes would seem to be of the mental order described.

If this is so, treatment here must logically be treatment by psychological methods, and the goal which it must strive to achieve is evident. It must discover the jarring elements and warring forces, then proceed to rearrange them, and thus help the patient to recover the internal harmony he has lost. The advice so often given to these unfortunate people, "Pull yourself together," expresses literally and exactly what is required. It is, however, absolutely useless unless the patient knows what he has to pull together, and unless he is shown how to do it, and helped to do it. And these are just the points where all the practical difficulties are encountered.

To begin with, we have to find out what is wrong, and this is often by no means easy. It might be thought that, as the things that are wrong are in the patient's mind, the patient has only to be asked to describe them. But in these cases this is precisely what he cannot do; often he does not know the causes of his troubles, and even if he is aware of them