Note 61 — Chapter III · THE HYMN OF CREATION

This mental disturbance had until recently the very unfortunate designation, Dementia Praecox, given by Kraepelin. It is extremely unfortunate that this malady should have been discovered by the psychiatrists, for its apparently bad prognosis is due to this circumstance. Dementia praecox is synonymous with therapeutic hopelessness. How would hysteria appear if judged from the standpoint of psychiatry! The psychiatrist naturally sees in the institutions only the worst cases of dementia praecox, and as a consequence of his therapeutic helplessness he must be a pessimist. How deplorable would tuberculosis appear if the physician of an asylum for the incurable described the nosology of this disease! Just as little as the chronic cases of hysteria, which gradually degenerate in insane asylums, are characteristic of real hysteria, just so little are the cases of dementia praecox in asylums characteristic of those early forms so frequent in general practice, and which Janet has described under the name of Psychasthenia. These cases fall under Bleuler’s description of Schizophrenia, a name which connotes a psychological fact, and might easily be compared with similar facts in hysteria. The term which I use in my private work for these conditions is Introversion Neurosis, by which, in my opinion, the most important characteristic of the condition is given, namely, the predominance of introversion over transference, which latter is the characteristic feature of hysteria.

In my “Psychology of Dementia Praecox” I have not made any study of the relationship of the Psychasthenia of Janet. Subsequent experience with Dementia Praecox, and particularly the study of Psychasthenia in Paris, have demonstrated to me the essential relationship of Janet’s group with the Introversion Neuroses (the Schizophrenia of Bleuler).