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(1951). Psychiatry. Psychoanal. Rev., 38(4):374-394.
Psychoanalytic Electronic Publishing: Psychiatry

(1951). Psychoanalytic Review, 38(4):374-394

Abstracts

Psychiatry

(Vol. 11, No. 1)

1.   Sullivan, Harry Stack. The Meaning of Anxiety in Psychiatry and in Life.

2.   Sereno, Renzo. Obeah: Magic and Social Structure in the Lesser Antilles.

3.   Money, John. Delusion, Belief, and Fact.

4.   Myers, Henry J. and Yochelson, Leon. Color-Denial in the Negro.

5.   Carothers, J. C. A Study of Mental Derangement in Africans, and an Attempt to Explain Its Peculiarities, More Especially in Relation to the African Attitude to Life.

1.   Sullivan, Harry Stack. The Meaning of Anxiety in Psychiatry and in Life. A patient seen many years before is referred to who made a few starts at significant communication in the interviews held soon after an anxiety attack. The attacks themselves were of remarkable severity, approaching in content a terror of immediate death, with arrest of all gross motor activity including speech, and striking superficial resemblance to the appearance of a person in incipient schizophrenic panic. There came presently other patients who suffered relatively pure attacks of anxiety. In these early cases there was little useful contact. A theory is presented: In extreme abstract, the theory holds that one comes into being as a person as a consequence of unnumbered interpersonal fields of force, and that we manifest intelligible human processes only in such interpersonal fields. Like any mammalian creature, man is endowed with the potentialities for undergoing fear, but in almost complete contradistinction to infrahuman creatures, man in the process of becoming a person always develops a great variety of processes directly related to the under going of anxiety. The article is helped by numerous figures.

2.   Sereno, Renzo. Obeah: Magic and Social Structure in the Lesser Antilles. This paper is merely an attempt at defining the practices which occur in the Lesser Antilles and relating them to the existing social structure. The term Obeah is conceded to be a word of Gullah origin meaning witchcraft. But Obeah is not simply a superstition; it is a practice and profession. A summary observation of basic data of the Lesser Antilles reveals at once a world in recession. This process, which reaches its apex in Tortola, St. Croix, Montserrat, and Dominica, is the result of the decay of the sugar-cane industry of the West Indies and the consequent

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impoverishment of the islands. The most striking phenomenon in the social life of the islands is the precariousness of family ties in the nether strata of the population. The child learns the facts of vita sexualis by sharing the room and often the bed with his parents and witnessing their private affairs. The first sexual impulses find ready and wholesome gratification, not through devious channels implying a relationship with older people or with people of a different social group, or with strangers taking undue advantage of the lack of practical experience of the adolescent, but with friends and companions. No conflict is created by sexual drives or by sexual experience. The father usually fails to assume responsibility for the child and leaves it to the untrammeled love of the mother. The child grows up with an utter dependence on maternal love, yet does not develop any particular fixation. The male child of the lower classes grows up free, but also grows and ripens into a man as irresponsible, or as afraid of responsibility, as his father was. Social differentiation is based, as it is all over the West Indies, on race and color.

This slow process of social evolution causes powerful hostile drives. What a sensible, albeit at times careless, approach to sexual affairs avoids—is brought about by class distinction, and color and racial discrimination. West Indian culture is a former slave culture—that is, a culture where violence is monopolized by the elite and strictly forbidden to the others. Whatever hostile drives exist must either be sublimated or expressed through devious channels. They must be channelized along different, clandestine ways. The fear of direct violence and the imperious necessity for catharsis result in Obeah practices. The Obeah man is a practitioner who can bring about effects not rationally related to their causes. Since he bridges with non-rational formulae and manipulations this gap between cause and effect, and this gap cannot be bridged by rational means, he practices magic. The technique which one woman employed superbly, consisted of verbalization in a vocabulary which presented fantasies as concrete reality. The Obeah man is aware that he is the man to whom people bring their troubles. He knows that whoever approaches him needs help and is disposed to do anything to secure it; his skill is to assuage the anxieties of his client and make possible some form of immediate relief. The Obeah man needs one other definite trait; he needs to be less inhibited than his clients. He is not inhibited in stating a generality as a precise fact; he is not inhibited in creating in his client fears which he will be asked to dispel; he has no compunction in stating as positive reality what he knows only as rumor. The Obeah man is called on as a rule, only when the physician has done all he can. The task of the Obeah man is to channelize all the aggressive drives that do not come out in the open. The Lesser Antilles, limited and well-defined as they are by the sea, and by size and history, have offered the writer a chance to study the relationship between constant social pressure and variable phases of personal insecurity.

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Magic in this case is an answer to discrimination from those suffering under its impact. Even though born in Africa, even though practiced by non-Negroes, even though a local instance of a universal phenomenon, it derives its impetus and its strength from the very same forces that try to repress it. It disappears, at least in its extreme forms, where discrimination seems to abate; the growth of a competent group of physicians of local origin threatens it, but because it symbolized and epitomized the defeat of some of the assumptions that cause Obeah to exist. In the same way in which a patient is sick in more ways than one, a physician is a healer in more ways than one. In the same way in which increased educational facilities bring about an improvement in public health, the growth of public hygiene, symbolizing the acceptance of positive social values, affects the whole social context. Obeah is a very peculiar species of magic; it is the black man's answer to the white man's intolerance. It is a form of social control as illegal as discrimination, but while discrimination is neither punished nor punishable, Obeah is. It is a relic of the days of slavery which still finds strength in what is left of slave culture.

3.   Money, John. Delusion, Belief, and Fact. The end products of the psychological process of creative thought, whether they be private delusions, widely accepted beliefs, or scientifically validated facts, are not essentially different one from the other. Rather, they are due to differences in the degree of actual or possible validation of hypotheses. Some hypotheses about truth, good, and right, beauty and God have in the past shown themselves to facilitate continued psychosomatic existence, and have had the quality of absolutes attributed to them. These would be better called axioms, accepted on the basis of conventional agreement, and able to change by conventional agreement. Thus would be satisfied the human psychological need for some degree of stability as well as for change. Philosophical stagnation would be avoided, and philosophy would not be at cross purposes with science.

4.   Myers, Henry J. and Yochelson, Leon. Color Denial in the Negro. An attempt has been made in this paper to call attention to the frequency of concern with color in Negro psychotics and to understand it in light of the role of the Negro in the community at large and in light of the color notions prevalent both in the White and Negro community. The existence of a caste system and of stereotyped notions about the Negro have been indicated. These notions affect the Negro community and white standards; white ideals are often adopted as desirable goals. Whiteness represents full participation in American democratic society and “superior advantage, achievement, progress and power all of which have great significance for survival.” Within the Negro community, shades of color have considerable social significance, and greater opportunities for enhancement of status are offered to the light skinned individual. Because

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of the insecurity involved in being a Negro, the Negro becomes chronically anxious. Individual security operations become important. One expression of the need for increased self-esteem and security is the desire for whiteness. It finds expression in the social ordering of the Negro community, in the use of skin lighteners and hair straighteners, in the dreams and phantasies of the Negro, in the phenomenon of “passing,” and also in the psychotic reactions of the Negro patient. The psychosis often included elements which reflect a need to solve the problem of color and the difficulties in living associated with being Negro.

5.   Carothers, J. C. A Study of Mental Derangement in Africans, and an Attempt to Explain Its Pecularities, More Especially in Relation to the African Attitude to Life. Judging from the American Negro figures and from observations, one finds (rather surprisingly) that the African's inherited tendencies to mental disease are probably not very different from the European's. The African, in common with other primitive agricultural and pastoral peoples, has however evolved a social system that has probably remained substantially unaltered for many thousands of years. This system, though completely obstructive to any type of change or progress, must be well suited to man's mental needs, and rarely permits of situations that might cause mental breakdown (except of the transitory type that we have designated frenzied anxiety). The essential feature of this system is that the individual, in his social behavior patterns, is never introduced to abstract concepts, but obeys meticulous rules in a host of concrete situations. Internal consistency is not developed or required, and phantastic thinking prevails. Civilization of the modern European type, with its insistence on individual self sufficiency, derives from the ancient Hellenic culture. In its modern expression, however, it dates from the Protestant and the later Industrial Revolution, and is only a few hundred years old.

Its essential feature is the constant necessity for personal choice and personal decision—the constant application of general codes to particular situations. Its applications are manifold. It implies an attitude of responsibility for the past, and of concern for the future. It implies the emergence of a dominant “self-regarding sentiment,” to which the expression of conflicting urges must be reconciled. It implies the generalization of inhibition, for whereas the African attitude is “one may do anything not specifically prohibited by society,” the European attitude is “one may not do anything unless specifically permitted by oneself.” It implies the development of endogenously conditioned and sustained moods, as opposed to environmentally determined and transitory emotions. Finally directed thinking is required and a higher minimum level of intelligence. These developments, implicit in a change from social to personal control, must seriously disturb an equilibrium that had until recently been stabilized for so long. They appear to account for the occurrence of certain types of mental disturbance in particular, and its high incidence in general in

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Western Europe and America today. The habit of directed thinking and all that this implies in the way of intellectual self-confidence and fearlessness has doubtless come to stay. If evolutionary progress, as Huxley says, has always followed the lines of increased control over and independence of the environment, then directed thinking fulfils these requirements and is a valuable human asset. But this advance need not imply complete self-sufficiency, and a personal responsibility that embraces all aspects of life. The need for co-operation is not thereby diminished but, with the growth of recorded knowledge, is increased. Nor is such an attitude adequate to man's sense of values. Society is not absolved by this advance from its responsibilities to the individual, and we are led to surmise that the next steps in human progress must include a release of directed thinking into more totally satisfying and ultimately useful channels by a partial return to primitive ways in the shape of some form of social protection and control.

(Vol. 11, No. 2)

1.   Sullivan, Harry Stack. Towards a Psychiatry of Peoples.

2.   Powell, John Walker. The Dynamics of Group Formation.

3.   Levy, David M. Anti-Nazis: Criteria of Differentiation.

4.   Bruch, Hilde. The Role of the Parent in Psychotherapy with Children.

5.   Levin, A. H. Maine, McLennan, and Freud.

6.   Meadows, Paul. Toward a Socialized Population Policy.

1.   Sullivan, Harry Stack. Towards a Psychiatry of Peoples. This study is concerned with the limited objective of indicating the possibilities of general or social psychiatry, as a field in which method may be applied and from investigations in which information useful in promoting worldwide improvement of living may be expected to result. To come anywhere near reaching the objective, one has to deal with the implications of a good many terms which belong in a none too well-known system of thinking about people. As these terms are often also words of common speech, the possibilities of misunderstanding are great; so great, in fact, that the undertaking itself may be preposterous. Psychiatry has come to mean something to a great many people but, for these purposes it must be defined. Psychiatry, as here discussed, is a science and its related technology. The science that has grown from preoccupation with mentally disordered ways of living has naturally to become a science of living under the conditions which prevail in the given social order. It is believed that this statement is simply axiomatic, but it does not imply that a particular psychiatric scientist need concern himself with any and all aspects of man's life in society. The general science of psychiatry seems to cover much the same field as that which is studied by social psychology, because scientific psychiatry has to be defined as the study of interpersonal relations,

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and this in the end calls for the use of the kind of conceptual framework that is now called field theory. The master tactics for a psychiatrist's work with a handicapped person consist in (1) elucidating the actual situations in which unfortunate action is currently shown repeatedly, so that the disorder-pattern may become clear; (2) discovering the less obvious ramifications of this inadequate and inappropriate way of life throughout other phases of the present and the near future, including the doctor-patient relationship and the patient's expectations about it; and (3) with this now clearly formulated problem of inadequate development before us, utilizing his human abilities to explore its origins in his experience with significant people of the past. For a psychiatry of peoples, these tactical requirements of good therapy—which is also good research—have to be expanded into (1) a preliminary discovery of the actual major patterns of tensions and energy transformations which characterize more adequate and appropriate living in that group, as a background for noticing exceptions—the incidents of mental disorder among these folk uninformed study of which would be misleading; (2) a parallel development of skill at rectifying the effects of limitations in our own developmental background; in order (3) that it may become possible to observe better the factors that actually resist any tendency to extend the integrations of our subject-persons so that they would include representatives of other groups relatively alien to them—a pilot test of which is the integration with oneself—and (4) thus to find real problems in the foresight of intergroup living which can be tracked down to their origins in the subject-peoples' education for life. Progress towards a psychiatry of peoples is to be expected from efforts expended along two lines of investigation: (1) improving grasp on the significant patterns—and pattern of patterns—of living around the world; and (2) the uncovering of significant details in the sundry courses of personality development by which the people of each different social organization come to manifest more or less adequate and appropriate behavior in their given social setting.

2.   Powell, John Walker. The Dynamics of Group Formation. The most significant recent advance in adult education is the recognition that education is an inter-, and not exclusively an intra-, personal process. In practice, this is resulting in a shift of emphasis from the individual to the group as the unit of educational experience, and from informational content, to the integrative interpretation of data and of meanings already available within the experience of the group. The author discusses the subject under these headings: Composition and purpose of group, Characteristics of a True Group, Stages in Group Development, Transference to Action and Carry-Overs from Group Activity.

3.   Levy, David M. Anti-Nazis. When the criteria of differentiation are studied for the purpose of determining what they all add up to, it

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appears clear that as a group the anti-Nazis, in comparison with typical Germans, have escaped the conventional and rigid family structure. They have been brought up with more affection and less restraint. Their world is a broader one, less limited in terms of religious, social, and intellectual boundaries. They have attained a more critical attitude. Theoretically, the strongly disciplinary father should produce a son very much in his own image. He uses various forms of persuasion, prohibition, and coercion to adapt his son to his traditional set of ideas. In the typical family this is strongly aided by a wife who, in the German traditional sense, is the Hausfrau, subservient and cooperative. In a father-centered family, when the son makes the usual submissive adjustment to the family pattern he lives in full accordance with the values he has imbibed. In those cases in which the father died in the infancy of the subject and no substitute father appeared on the scene, the maternal influence was naturally increased. In most of the case studies where this occurred, the individual was more independent in his viewpoint, more demanding of his “rights.” “Demonstrative maternal affection” is evidently concrete evidence of warm maternal response. Typically, when an individual stated that his mother did not show her love in kisses and embraces, he would add that she showed it, however, in other ways. Then followed the usual proof in the form of self-sacrifice, nursing care during illnesses, sympathy and the like. The Germans studied, strongly insisted that both parents were loving, also that they never felt any hostility toward either parent. As compared with American case studies, which in this respect resembled the anti-Nazis, maternal love was present, though diminished, either in feeling or in outward manifestation of feeling. The main psychological significance of the deviation factors is that they appear to be selective of certain types resistant to “Nazi-mindedness.” The deviation is in the form of liberation from traditional thinking, more critical judgment, a broader point of view, wider sympathies, and greater independence.

4.   Bruch, Hilde. The Role of the Parent in Psychotherapy with Children. One of the outstanding differences of psychotherapy with children as distinguished from the treatment of adults is the fact that one's activity is not restricted to just one patient, the sick child, but that one has to deal with the parents and other significant people of the child's environment as well. Without undue exaggeration one might say that in many cases it is the parents who constitute the real problem in child psychiatry. They often seek help for their own difficulties in rearing their children, for their anxiety and guilt, and for their own annoyance and disappointment about the child's symptoms and shortcomings. This paper discusses some problems in the handling of parents which have been encountered in the private practice of child psychiatry. Focus also is on those aspects which personally have been found difficult and many of which have remained unsolved problems in daily work. Apology is made

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for presenting a paper which raises new questions instead of answering them. But it is hoped to stimulate further thought by raising these questions and to clarify at least some of the issues involved.

5.   Levin, A. J. Maine, McLennan, and Freud. Startling though it may seem, it is a thesis that Maine and Freud proceeded in substantially identical directions by similar processes of thought. The one sought explanations of the origin of legal institutions and the development of the social product called “law,” while the other explored the motivations and impulses which underlie all activity, be it legal or otherwise. How the painstaking researches of another student of the law, John Ferguson McLennan, contributed to the ultimate results will appear subsequently. The reader may have already anticipated the comparison of the Father armed with his Paternal Power and Freud's Father Imago. Darwin furnished to Maine the historical basis of the Patriarchal Theory which attributed the origin of society to “separate families, held together by the authority and protection of the eldest valid male ascendant.” He went on to say that “the advance in intelligence of which Darwin speaks would lead men to establish institutions in conformity with this proportion between the sexes, if only for the purpose of keeping within bounds that sexual jealousy which could not fail under such circumstances to produce, if unrestrained, a perpetuity of violence and bloodshed.” But he insists that there can be no question that monogamy or polygamy during the period necessary to raise the young is the result arrived at whenever the higher animals are strong enough to give reign to sexual jealousy. But sexual jealousy, indulged in through Power, might serve as a definition of the Patriarchal Family.” There are some additional links between Maine, McLennan, and Freud. In his criticism of McLennan, Maine refers to Professor Robertson Smith's work, Kinship and Marriage in Early Arabia. This is the same eminent scholar who wrote Religion of the Semites and to whom Freud made acknowledgment as the discoverer of the Totem Feast. Another correspondence between the psychodynamic methods of Maine and Freud only touched upon because it is in itself so large a subject as to warrant separate treatment. Maine saw that “it was a step forward when men learned to pause before attacking instead of attacking at once.” This is an early form of Notice and one of “the most valuable of institutions.” This is a form of postponement of instinctual satisfaction which Freud found as one of the key problems of childhood adjustment to reality and, therefore, at the root of neuroses. Maine observed the fact. Freud went further and explained it. It would be a mistake to reach any final conclusion about social origins from a discussion of the thinking of the eminent men whose names appear in this paper. But it would be entirely in order to draw significant inferences from the convergence of these efforts into some synthesis as a result of the advances in the science of psychodynamics. The story of jurisprudence

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as a psychodynamic study offers large possibilities for the one who is able to see the individual as a constant source of beliefs, motivations and avoidances—all of which appear in the ultimate product we label law.

6.   Meadows, Paul. Toward a Socialized Population Policy. The study of population is, as a sociological discipline, only about a half century old. The temporary eclipse of Malthus during the nineteenth century tended to obscure relevant sociological aspects of population study. Population was usually considered a branch of economics or of actuarial science. The political and economic questions arising from the volume of immigration during the period before the first World War opened the way to a rather careful study of the vital rates of Western peoples. The facts about the birth and death rates gave rise to much speculation about future population growth. These calculations began to have a practical bearing on social and economic problems and programs. In the last two decades the field of population study has for social scientists become a very extensive one. In concluding this discussion of population policy, it may be said that the desiderata brought out in this paper have been aimed at a socialized conception of population and at the destruction of the high value generally placed on the perpetuation of traditional population purposes and methods. The requirements of a sound population policy will vary from country to country, and for the American people, from time to time and from region to region. In general, a “numbers” policy which places emphasis on the increasing rate of births regardless of the circumstances has been rejected in favor of a “family-centered” policy which respects personality and the conditions under which children are born and reared. Again and again it has been stressed here that population policy cannot be separated from social policy in general.

(Vol. 11, No. 3)

1.   Sullivan, Harry Stack. Two International Conferences.

2.   An International Multidisciplined Group. UNESCO Conference on World Tensions.

3.   Statement by International Preparatory Commission. International Congress On Mental Health: London, August, 1948.

4.   Fromm-Reichmann, Frieda. Notes on the Development of Treatment of Schizophrenics by Psychoanalytic Psychotherapy.

5.   Spindler, G. Dearborn. American Character as Revealed by the Military.

6.   Levin, A. J. The Oedipus Myth in History and Psychiatry.

7.   Harris, Irving. Observations Concerning Typical Anxiety Dreams.

1.   Sullivan, Harry Stack. Two International Conferences. There has come to be a distinctly pessimistic view about the usefulness of international conferences at this particular juncture. One hears quite generally

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that they always wind up in disagreement. It seems desirable, therefore, to report two recent exceptions to this unfortunate course; namely, (1) a conference in Paris under the auspices of the United Nations Educational, Scientific and Cultural Organization to inquire into the influences throughout life which predispose towards international understanding on the one hand and aggressive nationalism on the other; and (2) the meeting in England of the International Preparatory Commission for the London Congress on Mental Health as also to refer, in passing, to (3) the First World Health Organization, after its prolonged Interim Commission status; to (4) the International Conference on Mental Hygiene in the course of the London Congress on Mental Health; and to (5) a UNESCO Seminar on Childhood Education towards worldmindedness including some 40 participants of 15 different nationalities who worked for five weeks at Podebrady, Czechoslovakia, this summer. All five of these conferences accomplished a good deal that promises to be useful. None failed to promote something of international understanding and to provide improved basis for transnational collaboration. The writer participated through their course in the first two, and had some contact with the other three.

2.   An International Multidisciplined Group. UNESCO Conference on World Tensions. At the end of June, UNESCO brought to Paris eight eminent social scientists to consider the causes of nationalistic aggression and the conditions necessary for international understanding. The following statement, signed by each of them, presents the opinions on which all could agree. Its significance lies in the fact that a series of important propositions on the causes of international tensions have been formulated and agreed to by social scientists widely differing in their ideological allegiances. Man has now reached a stage in his history where he can study scientifically the causes of tensions that make for war. We agree to the following twelve paragraphs: (A) To the best of our knowledge, there is no evidence to indicate that wars are necessary and inevitable consequences of human nature as such. (B) The problem of peace is the problem of keeping group and national tensions and aggressions within manageable proportions and of directing them to ends that are at the same time personally and socially constructive, so that man will no longer seek to exploit man. (C) If we are to avoid the kind of aggression that leads to armed conflict, we must among other things, so plan and arrange the use of modern productive power and resources that there will be maximum social justice. Economic inequalities, insecurities and frustrations create group and national conflicts. (D) Modern wars between nations and groups of nations are fostered by many of the myths, traditions and symbols of national pride handed down from one generation to another. (E) Parents and teachers find it difficult to recognize the extent to which their own attitudes and loyalties—often acquired when they were young and when conditions were different—are no longer adequate to serve as

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effective guides to action in a changing world. (F) The development of modern means of swift and wide-range communication is potentially a great aid to world solidarity. (G) The prospect of a continuing inferior status is essentially unacceptable to any group of people. (H) Many social scientists are studying these problems. But social scientists are still separated by national, ideological and class differences. (I) Objectivity in the social sciences is impossible to achieve whenever economic or political forces induce the investigator to accept narrow, partisan views. (J) We recommend, for example, the co-operation of social scientists on broad regional and international levels, the creation of an international university and a series of world institutes of the social sciences under international auspices. (K) While other factors are concerned, we hold that the chances for a constructive use of the potentialities of scientific and technological developments will improve if and when man takes the responsibility for understanding the forces which work upon him and society both from within and from without. (L) In this task of acquiring self-knowledge and social insight, the social sciences—the sciences of Man-have a vital part to play. Effort in behalf of one's own group can become compatible with effort in behalf of humanity.

3.   Statement by International Preparatory Commission. International Congress on Mental Health: London, August, 1948. The purpose of this Statement is to outline the tasks immediately ahead, and indicate where there is scope for the application of the principles and practice of mental health in the broadest sense. Countries represented at this Congress differ in cultural traditions, economic resources, provision of health and social services, size and density of population, and facilities for the development of the social sciences and psychiatry. These differences make it extraordinarily difficult to adapt to local needs the knowledge gained from these sciences. This statement is addressed to administrators, workers in the social sciences, in psychiatry, medicine and allied professions, and to thinking people everywhere. Their attention is drawn to the urgency of considering the problems of to-day and to-morrow, not only in the field of health and social relations, but also in the wider issues of great moment. The pursuit of mental health cannot but be a part of a system of values. Here it is possible only to indicate the promise which the social sciences and psychiatry hold out of reducing the toll of human waste and suffering and of promoting social well-being. Fulfillment of this promise rests largely on the hope of full cooperation between the social scientists and the administrator, who should be fully aware of the new vistas of human achievement opened up by the social sciences. While far more has to be learnt than is now known, it is evident that we stand on the threshold of a new epoch of the science of man, and in the accomplishment of this aim, public opinion, enlightened by a broad system of adult education, has an important part to play. The authors discuss the subject under the following

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headings: Problems of Mental Health in Relation to Human Development, Problems of Mental Health in the Life of Society, Mental Health and World Citizenship, Recommendations. The mental health services of a given community can only develop and justify major expenditure after elementary human needs, such as those for minimum food, shelter and clothing, and reasonable freedom from epidemics have been secured. Other subjects under discussion are: Principles Underlying the Practice of Mental Health, Planning and Organization of National Mental Health Services, General Education, The Education of Specialists, Education of the General Public, Research, United Nations, World Health Organization, United Nations Educational, Scientific and Cultural Organization, and World Federation for Mental Health.

4.   Fromm-Reichmann, Frieda. Notes on the Development of Treatment of Schizophrenics by Psychoanalytic Psychotherapy. In the pre-analytic phases of psychiatric development, psychotherapists considered schizophrenic states nontreatable. There seemed to be no medium in which the schizophrenic and the psychiatrist could communicate with one another. The thought processes, feelings, communications, and other manifestations of the disturbed schizophrenic seemed nonsensical and without meaning as to origin, dynamics, and actual contents. It is now generally recognized that the communications of the schizophrenic are practically always meaningful to him, and potentially intelligible and not infrequently actually understandable to the trained psychoanalyst. It was not the nature of the schizophrenic communication therefore that constituted an obstacle to psychoanalytic psychotherapy with schizophrenics. The reluctance to apply psychoanalytic knowledge and technique to the psychoses stems from Freud's paper on narcissism. Subsequent revisions have led to changes in Freud's concept. It appeared then that it was possible to deal with schizophrenic communication as meaningful and potentially understandable and to establish workable relationships between the psychoanalyst and the schizophrenic. The author sums up briefly those basic schizophrenic dynamics which have guided the psychoanalysts in developing and changing the psychotherapeutic approach to schizophrenia. The schizophrenic is painfully distrustful and resentful of other people, due to the severe early warp and rejection he encountered in important people of his infancy and childhood, as a rule, mainly in a schizophrenogenic mother. During his early fight for emotional survival, he begins to develop the great interpersonal sensitivity which remains his for the rest of his life. His initial pathogenic experiences are actually, or by virtue of his interpretation, the pattern for a never-ending succession of subsequent similar ones. Finally he transgresses the threshold of endurance. Because of his sensitivity and his never satisfied need for benevolent contacts, this threshold is all too easily reached. The schizophrenic's partial emotional regression and his withdrawal from the outside

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world into an autistic private world with its specific thought processes and modes of feeling and expression is motivated by his fear of repetitional rejection, his distrust of others, and equally so by his own retaliative hostility, which he abhors, as well as the deep anxiety promoted by this hatred. I am convinced that many schizophrenics who remain ill could recover if the goal of treatment were seen in the light of the needs of a schizoid personality, not according to the needs of the non-schizophrenic, conforming, good-citizen-psychiatrist. In conclusion, I wish to recommend that the therapist be trained in recognizing and controlling his own dissociated feelings and motivations and in overcoming his own insecurity, previous to working with schizophrenic patients. Many failures in the treatment of schizophrenics, due to the therapist's failure in handling his and the patient's mutual interpersonal problems adequately, could then be avoided.

5.   Spindler, G. Dearborn. American Character as Revealed by the Military. Though much has been written about American “character,” relatively little has been accomplished in a systematic way because of the complexity of the source of personality—American culture. Social stratification and regional differences blur the picture. Middle-class Americans seem more like their European counterparts than they do their fellow countrymen above and below them in the class structure, and the western rancher and the eastern farmer seem to have little in common other than fresh air. If any broad but valid generalizations are going to be made about a national character structure, a control situation must be utilized. Lacking a neat laboratory abstraction, the social scientist must use what already exists in social and psychological reality, applying objective methods in systematic analyses. Compared to a primitive, non-Western culture like that of the Alorese the culturally patterned behavior towards the child in the family situation shows some general similarity throughout the entire West. It consists of three main processes: good maternal care; discipline demanding obedience to parental directions; and restriction of the biologically determined drives broadly related to sex. This milieu furnishes Western man, in the broadest sense, with the potentialities for strong superego formation, based on willing introjection of parental demands; an attitudinal idealization of parents which tends to exaggerate their capacity for good and harm; and encouragement of the curiosity and executive capacities. The repressive features of taboo and restriction on pleasure-seeking impulses, particularly those related to genital sexuality, interfere with the difficult integrative tasks of childhood, creating anxieties that may be relieved by strict obedience or object-channelized hostilities. On the other hand, there is some evidence that the contemporary American family emphasizes relatively less the disciplinary aspects, with the mother the center of both discipline and love, in a female dominated society. The egocentric tendencies of the American type are so marked that it is

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safe to assume that they were formed in a process which involved reinforcement. The two fields are congruent in American culture. No American grows up without being imbued with the ideals of self-initiative, independence, individual freedom in religious, economic, and political affairs, and success—to be gained through personal endeavor. These egocentric values are fundamentally related to the frontier way of life that only recently passed from the American scene.

6.   Levin, A. J. The Oedipus Myth in History and Psychiatry. The Oedipus complex was considered by Freud to be the “nuclear complex of the neuroses … the essential part in the content of the neuroses” presenting “the task before each new human being … to master the Oedipus complex; one who cannot do this falls into a neurosis. Progress in psychoanalytic work has resulted in an ever clearer picture of the significance of the Oedipus complex; its recognition has become the shibboleth which distinguishes the followers of psychoanalysis from its opponents.” To repeat, it is the “actual nucleus of neuroses.” Culturally its function is also nuclear—it is the “beginnings of religion, ethics, society, and art (which) meet in the Oedipus complex.” Criminal intent and a sense of guilt are, of course, derivatives. The orthodox followers of Freud have extended rather than constricted the universal compass of the Oedipus complex which is considered as something that has always existed. The author quotes Freud and Sophocles at some length. Thus, Aristophanes jokes about incest. The discussion of the birth of Moses appears in the early pages of Moses and Monotheism. Rank found amazing similarity in the history of the birth of national heroes and of their early years and some literal sameness even though the stories referred to different peoples who were geographically removed from one another. When Freud came to apply his Oedipus theory to the genesis of Christianity, his earlier fantasy had again the upper hand. Freud directed the attention of man to the unconscious processes of the mind which reach back into childhood. It would seem now that this is not far enough back. The new interpretation of the Oedipus myth should help to dispel Freud's gloomy forebodings. For it points to deeper—and possibly simpler—sources of the effects he noticed when it is understood that the father is hated as a depriver and the mother is wanted because she is the nearest female; when it is possible to notice in the very mandatory family restrictions and cultural taboos the deceptive substitutes offered as palatable disciplines by parents who were themselves deceived when they were “fed” with the need to conform as a substitute for oral and love requirements. It is granted that life in a group requires some organizational awareness for the essential needs of the infant and child which converts cultural conditioning into a rejection-dynamism.

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7.   Harris, Irving. Observations Concerning Typical Anxiety Dreams. The first section of this paper dealt with the widespread occurrence of the falling and attacked dream, with the finding that one or the other of these dreams was judged to be the most unpleasant anxiety dream by an overwhelming majority of large groups of people, and with the finding that individual differences existed as to the occurrence and unpleasantness of these dreams, certain clinical and theoretical concepts pertaining to the early development of the child were recalled. It was suggested that the manifest content of the falling and attacked dream probably was derived from early threatening factors emanating from the parents. A preliminary hypothesis was proposed which involved two psychic threats described by Freud. This hypothesis in effect is: The falling and attacked dreams may signify respectively fear over loss of love or support, and the fear of castration in its most general sense. The corollary would be: the predominant experiencing or unpleasantness of one or the other of these dreams may reflect respectively the predominance of one or the other of these psychic threats. Several clinical observations dealing with selective direction of overt hostility toward a particular parent were presented which seemed to give some degree of support to the validity of this hypothesis. The suggestion was made that the systematic and routine elicitation of the occurrence and comparative unpleasantness of the falling and attacked dreams may be of value in the diagnostic interview.

(Vol. 11, No. 4)

1.   Arieti, Silvano. Special Logic of Schizophrenic and Other Types of Autistic Thought.

2.   Immediate Retrospects on the I.P.C.

3.   “Official” Retrospects on the I.P.C.

4.   Querido, A. Notes on An Experiment in International Multiprofessional Cooperation.

5.   O'doherty, F. Eamonn. Multidisciplinary Methods in Retrospect.

6.   Baker, Sidney J. Speech Disturbances: A Case for a Wider View of Paraphasias.

7.   Line, William. Mental Hygiene in Industry.

8.   Sullivan, Harry Stack. Psychiatry, Education, and the UNESCO “Tensions Project.”

9.   Arsenian, John and Arsenian, Jean M. Tough and Easy Cultures: A Conceptual Analysis.

10.  Gillin, John. Magical Fright.

1.   Arieti, Silvano. Special Logic of Schizophrenic and Other Types of Autistic Thought. In 1925 William Alanson White complained that there was almost nothing in the literature on the mechanisms of thought processes in schizophrenia—a subject which he considered of paramount importance. With due regard to a few exceptions outstanding among

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which are the contributions of Vigotsky and those published in the monograph edited by Kasanin, with Sullivan, Goldstein, Von Domarus and other authors collaborating—the same complaint could be repeated today. The same complaint would be even more justified in regard to researches concerning a particular aspect of thought processes in schizophrenia and other psychopathological states—namely, the study of logic. Paleologic is to a great extent based on a principle enunciated by Von Domarus. This author, as a result of his studies on schizophrenia, formulated a principle which, in slightly modified form, is as follows: Whereas the normal person accepts identity only upon the basis of identical subjects, the paleologician accepts identity based upon identical predicates. A step forward toward the interpretation of this way of thinking has been made by Max Levin who compares Schizophrenic thought to that of young children. From the foregoing it appears that paleologic thinking is much less exact than Aristotelian. In the latter, only identical subjects may be identified. The subjects are immutable; therefore, only a few and the same deductions are possible. In paleologic thinking, on the other hand, the predicates lead to the identification. Since the predicates may be extremely numerous and one does not know which one may be chosen by the patient, this type of thought becomes unpredictable, individualistic, and often incomprehensible. The unconscious choice of the predicate which is used as the identifying link, out of numerous possible ones, is often determined by emotional factors. Now it is possible to formulate a second important principle of paleologic. Whereas the healthy person in a wakened state is mainly concerned with the connotation and the denotation of a symbol but is capable of shifting his attention from one to another of the three aspects of a symbol, the autistic person is mainly concerned with the denotation and the verbalization, and experiences a total or partial impairment of his ability to connote. In view of this principle, two phenomena have to be studied in schizophrenia and other types of autistic thinking: first, the reduction of the connotation power; second, the emphasis on the verbalization. It has already been stated by Benjamin that the schizophrenic is unable to interpret proverbs correctly. The emphasis on the verbalization together with the application of Von Domarus' principle may also be found in normal adults in the technique of jokes and witticisms. I mentioned before that the first three laws of thought of traditional logic were eliminated by Von Domarus' principle. On the other hand, there is retained in paleologic thinking the fourth law, the law of sufficient reason: “We must assume a reason for every event.” The methods, however, by which a reason for, or a cause of, an event is searched are different from those used by the normal mind. To use Sullivan terminology, the schizophrenic, in a desperate attempt to regain security, uses more and more autistic mechanisms. From the foregoing the reader has certainly inferred that the autistic person has the tendency to live in a world of perception rather than in a world of conception. The

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author goes on to discuss Further Application and Limitation of Paleologic Rules—Reference to more Primitive Mechanisms and Paleologic and Psychopathological States. These ten examples disclose that one has the tendency to resort to paleologic thinking when one's wishes cannot be sustained by normal logic. If reality cannot grant gratification of wishes, a new system of logic, which will transform reality into a more complacent form may be adopted. This tendency, which each person has to think paleologically, is of course, usually corrected by Aristotelian thought. In Schizophrenia, instead, the paleologic way of thinking has the upper hand and seems to the patient a sound interpreter of reality.

2.   Immediate Retrospects on the I.P.C. Elsewhere in this issue are published three more of the considered statements by participants in the International Preparatory Commission for the recent Congress on Mental Health, the first of which series appeared in the August issue, pages 223-229. The following “‘Official’ Retrospect on the I.P.C.” is the new, anonymous Foreword to a reprinting of the Statement by the World Federation for Mental Health. Like the papers by Drs. Querido and O'Doherty, it has some reference to the thirteen statements in immediate retrospect which were submitted anonymously in the week following adjournment of the Roffey Park meeting. It is believed that the data of these statements should now be made available to those interested in this instance of the multidisciplined, international conference, and they are printed below.

3.   “Official” Retrospect on the I.P.C. With one or two minor verbal alterations and proof corrections, this pamphlet is an exact reprinting of the statement produced by the International Preparatory Commission for the International Congress on Mental Health which was held in London in August, 1948. It will appear in the proceedings of the Congress, but many people who are concerned with the issues dealt with in this statement have expressed a wish for a wider distribution of the original document.

4.   Querido, A. Notes on an Experiment in International Multiprofessional Cooperation. Since this will not be the first article to appear on the experiences gained this summer in the International Preparatory Commission of the Third International Congress on Mental Health, it is not necessary to explain the way the IPC came into being and of how it was constituted. The experiment and its implications are undoubtedly of the utmost importance; and in attempting to put down as honestly as possible how this experiment is reflected in the mind of one participant, perhaps some insight into the problem of group activity under very special conditions may be obtained; it seems that no justification is needed for the fact that the account will be purely subjective; it will only try to reproduce the reactions evoked by the fortnight's contact in the IPC. And so this is the

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lesson of the IPC: you can call men and women together from all countries and all professions; and you will find them very willing to give time and energy, ingenuity and intelligence, and all the best things they have; and you may find yourself not hampered by boundaries of the mind arising from national or professional training; but self knowledge and self-discipline has not so far advanced that self-direction and all it implies may be expected to emerge spontaneously.

5.   O'doherty, F. Eamonn. Multidisciplinary Methods in Retrospect. It is believed that “the work of the Inter-Professional Committee advisory to the World Federation for Mental Health—into which … the IPC has now been converted-will not be at all reduced in utility by the most searching scrutiny of its experiences at Roffey Park.” Because of this, it is intended to state as accurately as possible what has been concluded as a result of mature reflection-what Dr. Sullivan has called “a carefully studied retrospect of the conference at a distance of some weeks.” It seems to be an elementary principle that those whose chief interest is the mind should also have a keen interest in the workings of their own minds, especially as this is revealed in their intra-group behavior. The ideas which follow, therefore, must be regarded as a personally disinterested attempt to assess our effort in the interests of multidisciplined methods generally. The author discusses the following subjects: What Multidisciplined Thinking Means, Hierarchy, and Tensions. For the Future the following suggestions are made: 1. A multidisciplined group needs a clearly defined task before coming together. 2. It needs a designated chairman, also prearranged. 3. It demands that its members recognize the dynamics of group-functioning, one of which is certainly the generation from within of subgroups. 4. As most of the work will be done by one or two members anyway, others should be prepared to yield a certain leadership to these members. This is especially the case at two of the most important stages of multidisciplined work-the determination of precise material for discussion, and the actual drafting of documents. The final verdict is that the multidisciplined conference is one of the most valuable tools in our possession for the scientific study of man. But it must be looked on not as something analogous to the generation of a mythical group-mind, but rather as the grooming of each person's mind for a specific purpose-the thinking of his thoughts in the context of his confreres.

6.   Baker, Sidney J. Speech Disturbances. The aim of the present paper is to suggest that current concepts of paraphasia—as a term for speech blunders in general-should be widened to include a number of speech acts which are not commonly classed as lapsus linguae. To illustrate this enquiry evidence will be offered from a verbatim record of a psychoanalytical case. This leads to the radical deduction that the unconscious

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aim behind all speech is silence. The silence which one tries to achieve is one of complete psychic equilibrium, of agreement, content, and tranquility. Endlessly in daily speech one renews efforts to arrive at this silence. The reason is because speech serves to discharge psychic energy and one's whole life is oriented toward achieving intrapersonal psychic equilibrium. In the course of these efforts, which one is under continual compulsion to renew, one encounters many obstacles. Among them are questions one is obliged to answer and requests to tell the whole truth and nothing but the truth. In this way conflict arises. In the first place there is the unconscious intrapersonal drive to arrive at positive silence, and in the second place there is the imposed demand from without that this silence—and its reward of psychic equilibrium—can be achieved only by obeying certain rules or orders. In this contest between the id and reality, the ego is called into service. But the external world may demand more than the id wishes to give and the ego may be too weak to reconcile those often-opposing influences. The resulting struggle will certainly be revealed in the speech. If the external world inflicts serious traumas, one will find those traumas revealed in fixed non-organic speech disorders. Where the traumas are less serious, they will be exposed in paraphasias.

7.   Line, William. Mental Hygiene in Industry. As a background for the discussion which follows, two obvious facts are cited: First, industrialism has had a trial run in many countries and is spreading to others. Present-day world shrinkage is not visibly due to religion, philosophy, art, or to a deeper conception of the brotherhood of man, or even to threat of war; rather it is due to the forward march of industrialism. Second, it is high time that this trial run were examined, and examined thoroughly, to see what influences it is having on human living, what influences it may or could have on people in countries not yet industrialized. Being clear on postulates, the professional base of operations, and on conditions of labor, what does one do? The postulates demand that any person entering an industrial enterprise has the right to an opportunity to learn how to live more effectively with others in a socially valuable undertaking; that work must become an experience in continuous growth, not a monotonous routine. The professional base demands that all mental health work in industry be sponsored by industrial health. Lay groups, however willing and helpful, must be professionally directed and sanctioned. And ultimately the coordination and sponsorship of our professional sanctions belong to world health. There should be immediate recognition of this fact by all the medical societies of the world.

8.   Sullivan, Harry Stack. Psychiatry, Education, and the UNESCO “Tensions Project”. While psychiatry may be defined variously, it is here to be understood to be the science of interpersonal relations:

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“The science of psychiatry has been nurtured by work with the mentally ailing, has grown in the milieu of hospital and clinic, but is no more a science of mental illness than geography is a science of Western Europe.” Research into the so-called mental disorder, schizophrenia, compelled an inquiry into the whole course of development of people's abilities for dealing with others. The more extraordinary performances of a person suffering this disturbance in living were only to be understood when the “mental life” of the very earliest years of life had been scrutinized. Over the years since 1925, the accumulating data had gradually formulated itself into a theory of personality development, and the theory has now been tested for some seven years in the collaboration of the senior faculty and others in the Washington School of Psychiatry. It is believed that the scheme of developmental stages which is given is a good theory for the next few years. It has some very important bearing on formal education as practiced from nursery school entrance, onwards.

9.   Arsenian, John and Arsenian, Jean M. Tough and Easy Cultures. Attempts at systematic analyses of single cultures have proceeded apace since the early classic monographs of Malinowski, Radcliffe-Brown, Fortune, and others. Studies have long since become more preoccupied with people, less with artifacts, more concerned with the meaning of rituals than their bare recital. Recently exciting attempts have been made to further the understanding of cultures by studies of personality development. Culturally characteristic personalities are viewed as determined derivatives of different cultural practices and patterns. The terms “basic personality structure” and “character structure” have become common conceptual coinage for cultural anthropologists and social psychologists alike. Curiously enough these comparative analyses of people as end-and-sustaining products of a culture have advanced more rapidly than the comparative analyses of cultures as such. The analyses of cultures has suffered for want of specification of dimensions in which cultures may be meaningfully compared. Whatever the causes, somehow students have kept away from the following integration of ideas which will show how cultures can be compared and evaluated regardless of their vastly varying contents. It is hoped to show that and wherein some cultures are tough on their members while others are easy—an observation long since made by widely assorted groups: novelists, philosophers, cultural anthropologists, sociologists, psychiatrists, psychologists, and socialists. Under the heading Properties of Paths, effectiveness, efficiency, number accessibility clarity, approval, substitutivity, congruence and cognizance are discussed. The essential argument is double-edged: Psychological tension depends upon and varies with the properties of paths as means of reducing tension; and where a culture's paths make for easy tension-reduction in its members the culture is easy. Conversely, where a culture's paths make

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for difficult tension reduction the culture is tough. The following are tentatively cited as behavioral indices of toughness: “nervousness,” suicide, neurosis and psychosis, crime, general malaise. Pragmatically the procedure then seems to be systematic inquiry asking: (1) what do people want (specification of goals)? (2) how do they go about getting what they want (paths), with what success? and finally, (3) what tensions result from discrepancies between desire and gratification?

10.  Gillin, John. Magical Fright. A seemingly widespread syndrome or group of ailments current among folk peoples in various parts of the Latin American area is the condition which one might call “magical fright.” In Spanish it is known as espanto or susto. Both of these words mean “fright,” but they are used in two different types of context. On the one hand, they are used to describe “ordinary” incidents which involve fear but which do not affect the “soul”—that is, they are not believed to have serious psychological consequences. For example, one may be “frightened” by the prospect of rain before the harvest is completed, by the power of one's opponent in a quarrel, by the announcement of an epidemic, and so on. In the second type of context, however, espanto and susto always refer to an illness or abnormal condition of body and personality. For this reason, it seems best to render the latter concept in English by the qualifying expression “magical fright.” Shaman cures have been seen. A case is reported in some detail, with the cure. The patient was a dull person on the intellectual side and a person whose life story had been full of frustrations and repressions. The curer would be labeled as a schizophrenic in North American Society. Some 60-70 million people follow mixed folk cultures in modern Latin America. The Magic, etc., do not merely exist in the thinking of the people, but are quite real. A man's anxiety does not have to be based on the germ theory of disease to make him ill.

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Article Citation

(1951). Psychiatry. Psychoanal. Rev., 38(4):374-394

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