Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/123

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PSYCHO-ANALYSIS AND PSYCHIATRY 377

of morbid disturbance of mental activity excluding the free deter- mination of the will, so far as this state according to its nature is not temporary'. (Germany, B, G. B., par. 104.); 'The concept of mental disturbance has a special significance for every sphere of law. Here it concerns something so specific that the same individual can be a mental case in the meaning of one law and not one in the meaning of another law ' (E. Schultze in Aschaffenburg, Hand- buch der Psychiatrie).

The juridical definition of the concept of mental disease ('Failure of free determination of will', 'Failure of the necessary insight') has led a legal psychiatrist (O. Bumke in Aschaffenburg, Hand- buch der Psychiatrie) to allude expressly to the lack of scientific method underlying psychological concepts: 'Under circumstances the expert has to emphasise in opposition to this that this insight can exist, yet the capacity for employment — perhaps through dis- turbances of the mental qualities or qualities of the will — can have disappeared'.

While the absolute dependency of the concept of mental disease on the tolerance of society is wholly unconscious in the juridical definition of the concept, it begins to emerge in the psychiatric formulations.

Psycho-analysis can only continue this order of development. It has to accept the existence of the lay concept of mental disease and trace it back to its unconscious origin, which we found in the menace to cultural repression by the mentally affected person in consequence of his inadequate capacity for untruth and dis- simulation or repression and domestication. Psycho-analysis traces back these incapabilities to definite consequences of instinctive forces. It also shows that these consequences are found in numerous occurrences of normal hfe which are not looked upon as 'mental', because, as experience has shown, they only last a short time and admit of a definitely favourable prognosis (Hke the slips of everyday life), or — and tliis is valid for similar types of longer duration — because they occur in so many individuals that the average human being has been able to establish his repressions particularly firmly in this respect, and that he is always opposed to them and there- fore no longer shocked by them (idealism).

There is also a difference in the disposition. A regressive format- ion which affects simultaneously a number of individuals standing in social relationship to one another will easily find a social outlet