In psychiatry, the patient often hides its history

The years in Burgholzli, a psychiatric hospital in Zurich
University, were the years of apprenticeship, when the main issue for me was
one: what happens to mentally ill? I don't
could to answer it, and none of my colleagues, it seems that this problem does not
occupied. The work of the psychiatrist was the following: abstracted in
perhaps largely from what the patient says, the doctor was
to make a diagnosis, describe symptoms and to compile statistics. With the so-called
clinical point of view, which then  dominated, the doctor did
patients not as an individual, possessing personality, and how
patient X with an appropriate clinical picture. The patient received the label,
he attributed the diagnosis than usual and all was over. Psychology
mentally ill no one cared.
 In this respect, the role of Freud, and especially its fundamental
research on the psychology of hysteria and of dreams. His concept pointed out to me
the way and helped me in my subsequent studies, and in understanding
in each particular case. Freud came up to psychiatry, it is as a psychologist,
although he was not a psychologist, and a neurologist.

 I still remember a case which then made me
strong impression. The clinic had brought in a young woman suffering
melancholy, she entered my office. The survey was conducted with
usual care: anamnesis, examination, analysis of physical condition and
T. D. Diagnosis: schizophrenia (or, as they said, dementia praecox).
Prognosis: negative.
 At first I did not dare to question the diagnosis, the young man, and
especially the newbie, ought not to Express their point of view. But the case
seemed strange to me. I have a suspicion that this is not schizophrenia, but
ordinary depression, and I decided to use his own method. At the time
my hobby was the associative method in the diagnosis and I tried
to conduct the Association experiment with the patient. We talked a lot about and
her dreams that allowed me to learn something significant about her past, something
what history could not clarify. So I got the information
directly from the unconscious, I opened the story grim and
tragic.
 To marriage this woman had a friend, the son of a wealthy industrialist.
He was in love with all the girls around here, but my patient was very
attractive and thought that she has a chance. He also seemed to not
was interested, and she married another.
 Five years later she was gone an old friend. They remembered the past,
when suddenly he said, "When you get married, someone was in shock - this is your
NN". From this moment began her depression, and after a few weeks it
led to the misfortune.
 She bathed her children, four daughter and two year old son. Family
lived in the village, where the water did not meet hygienic standards: clean
drinking spring water, river used for bathing and washing. Noticing that
daughter suck the sponge, she did not attach any importance to this, the son was allowed to drink
a glass of river water. Naturally, she was quite aware that
what to do, her mind was already clouded by the shadow of impending depression.
 When the incubation period has passed, the girl fell ill with typhoid fever and
died. She was the darling of the mother. The boy was not injured. In a state of acute
the stage of depression, a woman came to the clinic.
 After  Association test, I found out that the patient considered himself
killer. Thus, her depression was a serious reason. In fact it is
was psychogenic disorder.
 The question arose, how to treat it. Before she was given sleeping pills and drugs
to prevent suicide attempts. Nothing else was done.
Her physical condition was quite satisfactory.
 I thought long and hard on the problem, is it possible and should I take
with her openly? Do I have to intervene, do the right? It was
question my conscience, and to decide it could only I. I turned to colleagues,
they probably would have warned me: "for God's Sake, don't tell the woman anything
like. She finally loses her mind". But in my opinion, the effect could be
and the opposite. In psychology, there is no unequivocal truths - the answers to
any question can be very different. It all depends on whether we accept
we into account the factor of the unconscious. Of course, I knew the risk and that
if the patient goes wrong, then I will follow her.
 Nevertheless, I decided, although confidence in the successful outcome I
was not. I told her what I found out through associative
experiment. You can imagine how hard it was. This is not a trifle -
to take on human murder. And what was patient to listen and to take all
this. But the effect was striking: in two weeks she was discharged from the hospital
and never came back.
 Colleagues I didn't say anything, and there were reasons. I feared that,
after discussing this case, they will make it available to the public that may
to lead to complications. Of course, to prove anything is hardly possible, but for
patient all of these proceedings could have been fatal. Much more important
had to have it  back to normal life. Fate enough as it is
punished her! Released from the hospital, she went home with a heavy heart. Her
had to go through all this. Her punishment has already begun her illness, and loss
child caused her deep suffering.
 In psychiatry, the patient often hides its history. For me
proper therapy begins with the study of this very personal story. For
it comprehends the mystery that caused the disease and destroyed
psyche. If I open it, I get the key to treatment. In other words, the task
the doctor is in learn the history of the patient, and it can
ask questions concerning the identity of the patient as a whole and not only
the symptoms of this illness. Often what lies on the surface of consciousness,
it turns a little. And Association test can open some running.
Sometimes it helps the interpretation of dreams, or long and patient
human contact with the patient.